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[Elle66]

I have been following this forum for some time and have found it so useful that I thought I would share my story in the hope that it may also be of benefit to others.  Sorry it is rather long!

My journey began start of 2011 (age 45) still having regular periods but began waking during the night for no apparent reason.  More symptoms appeared over next 18 months and periods dropped down to 4 in the year.  By the end of 2013 I was sleeping a maximum of 90 minutes at a time.  No periods for 1 year.  Having put up with the symptoms for almost 3 years was exhausted due to sleep disruption so I went to my GP who prescribed a non-HRT treatment which unfortunately for me had no effect.

In January 2014 I was prescribed HRT:

Evorel Conti (due to the fact I had gone for a year with no period)
The good … within 7/10 days sleep was much improved, around 3 to 4 hours at a time……bliss! 
The bad … within weeks started bleeding, experienced intermittent headaches/fuzzy head/difficulty concentrating and intermittent periods of very low mood.  Stuck it out for 6 months with a lot of bleeding and lower abdominal pain/feeling of pressure on bladder which only started after going on HRT.  Urine tests/pelvic ultrasound were all clear.  After 8 months GP agreed it was time to try a different progesterone. 

Changed to Femseven Conti 
The good … bleeding stopped, within 2 weeks lower abdominal pain/pressure on bladder had gone …. Result!  Still sleeping around 3 to 4 hours at a time and fuzzy head/difficulty concentrating was less frequent. 
The bad …… seemed to be fine for a good few months then started to have really bad anxiety - especially bad first thing in the morning, wake up and immediately felt anxious before the day had even started.   Seemed to gradually decrease and by evening would feel a bit better.  Anxiety levels seemed totally out of proportion with reality.
Depression - mood very low, swinging between high levels of anxiety to very low mood (tearful, lack of energy/enthusiasm, wanting to stay in bed etc)
Heart Palpitations: aware of palpitations especially at night when trying to sleep.
Strange muscle pain in upper abdomen for no apparent reason.
Stuck with it for over a year in the hope that things would settle down before eventually going back to the GP ……. maybe third time lucky. 

Changed to Femseven Sequi
Within a couple of months mood was so low and anxiety so high I decided to stop the HRT and see which of the symptoms seemed to be purely menopause related and which seemed to be due to HRT patches.

I have now been off the patches for about 4 weeks.  My hot flushes have returned during the night and sleep is back to around 2 hours at a time but my mood is so much better and my anxiety levels are back to what I would class as “normal” anxiety for anyone with a busy life and dealing with menopause.  Palpitations and strange muscle pains are also much reduced.
I am pretty much back to where I was when it all started but I am going to give it another month or so and see how things go but it would seem that unfortunately for me the HRT was giving me more issues than it was resolving.

[Hurdity]

Hi Elle66

 

So sorry to hear you had problems with HRT that initially helped your symptoms and then made them worse.

Unfortunately this is often the case with the synthetic progestogens used in most HRT types and the fact that you were given them on a continuous basis meant that you were experiencing continuous low grade progestogenic side effects like you mention.

First you probably would benefit from a higher dose of oestrogen - you are still young and many women have not yet reached menopause at your age.  This is much easier to change if you use separate oestrogen and progestogen rather than the combi patches you have tried ( including the sequi one).

Second if you are intolerant of synthetic progestogens then you could switch to Utrogestan - micronised progesterone - which is biologically identical to the one in our own bodies. You would then take oestrogen in the form of separate patch (which go up to 100 mcg in dose rather than the 50 mcg of the combi patches), or gel - which is easy to change the dose of.

Third - until you know what you can tolerate - then far better to remain on a cycle because at least that gives you some of the month on oestrogen only. The problem with the combi patches like Femseven sequi - you take the progestogen for two weeks, and then there is the withdrawal phase when the progestogen is still in your system - say the next 3 days - so you only have about 10 days to feel anywhere near normal! If you take oestrogen and separate progesterone - the starting dose is 200 mg for 12 days per 28 and you could try this and see how you got on. You could use it vaginally too if you were sensitive to it orally, and also maybe slightly lengthen your cycle ( depending on your oestrogen dose).

I really think you should persevere - because you would still benefit from extra oestrogen at your age and once you get sorted out you should feel so much better - and as your own hormones are stable you should be able to find a dose and regime to suit you.

If this appeals to you - have a look at the oestrogen HRT types and the section of progestogen and if you want to go back to the doc and have any more questions please do ask!
http://www.menopausematters.co.uk/treatafter.php
http://www.menopausematters.co.uk/to_progestogens.php

Hope this helps

Hurdity x

[Elle66]

Thanks Hurdity 

I did mention to my GP on my last visit that I thought I was progestogen intolerant and asked about Utrogestan but she appeared to have very little knowledge on the subject which is unfortunate.

I will definitely look into the separate regimes you have mentioned.

 

[Catspelle]

Hi so sorry to hear you are having a tough time. I am struggling too but nowhere near as long as you! There are SO many different forms of HRT but no HRT experts to help us all. I ended up doing my own research and asking for a specific brand of HRt. There are so many others you can try. You might want to try a different doctor. In all seriousness none of them are experts and if yours is anything like mine it was pot luck for his little black medicine book. Good luck x

[Mary G]

Elle66 welcome to MM!

Sorry you have had a difficult time finding the right type of HRT, it took me years.  Unfortunately most GPs are not very clued up on HRT and don't know what to prescribe.

I agree wtih Hurdity and also think you need to change to a different regime.  I am also intolerant to synthetic progesterone but my current regime is the best I have been on so far.  I use 2 pumps of Oestrogel every day, 100mg of Utrogestan (used vaginally) for 7 days each month and 1 tiny bead of testosterone.  I take the minimum amount of progesterone because I am so intolerant and cannot take any more.  I prefer the gel to patches because you can easily adjust the dose to suit your needs.

You are far too young to be oestrogen deficient and your oestrogen dose is far too low which is why you have not felt any of the benefits.  I think you would really notice the difference with a regime similar to mine.

Why not go to your doctor and ask to change?

[Hurdity]

Yes re the doctor.

The most important thing is to do your own research - as has been said they are GPs after all and not gynaecologists. Print out any info you need from this site eg the info about utrogestan on the link I gave you. get clued up as to the reasons you want to choose what you want to choose, and then hopefully you will be able to get what you ask for - you should not be fobbed up because they have not heard of it. The dosage is given on this site - what more do they want? The SPC (product info) is readily available on the web: http://www.medicines.org.uk/emc/medicine/19895/SPC

Good luck and keep us posted

Hurdity  x

[Elle66]

Thanks everyone for your thoughts and suggestions.

I am definitely going to do some more research and pay another visit to the GP.