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[Lanzalover]

I did write a full review of all my health problems earlier but seem to have lost it before I could post it probably just as well as it was epic and I haven't got either the time or energy to type it all again as I'm not very good at anything IT related.

I am 58 and was given a 3 month trail of hrt by my GP. Oestrogel and Utrogestan on a conti basis.
After doing some research on this site GP just went along with what I requested.
For the main I have got on well with this hrt my quality of life has improved,but still nothing like it was before this meno madness started.

My 3 month review is due on Monday and would just like a little help with a couple of issues I have had.

1) I did try the utrogestan vaginally but couldn't get on with using it that way for the 25 days so now take it orally.

2) Since starting hrt my breasts feel very heavy but tender if that makes sense.

3) There have been times during these 3 months I have felt like I was going to have a period. I haven't had one nor have I had any spotting which was a problem when I previously tried HRT tablets approx 6 years ago and the reason I gave up until recently when I jus couldn't cope anymore.

I use 2 pumps of gel a day plus 1 utrogestan tablet for 25 days I have also recently been given Vagifem which helps matters down there!!!

Does anyone know what would cause the above issues ?

Would changing to a seqi basis get rid of the problems I know it means having a period but until peri kicked in I never had a problem with periods.I also think I could maybe use the utrogestan vaginally if it's for a shorter period of time  but I am unsure of the amount to use and for how many days. I await any advice you lovely ladies may have.

I have had problems with my thyroid for the last 8 years hyper and hypo but at the moment it seems to be properly medicated so if I can just sort out the HRt bit I will be a happy bunny and finally able to move on from what I can only say have been the worst 8 years of my life.!!!

Many thanks
Lanzalover

[CLKD]

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[Hurdity]

Hi Lanzalover

Sounds like you know what you want to do - and as I was reading your post I would have advised the same!  I use utrogestan vaginally and on a long cycle - for the same reason that I wouldn't want to use it continuously vaginally and also I don't like the side effects and how it makes me feel.

Your symptoms may just be due to the settling down period - my breasts have changed semi-permanently on HRT (slightly larger and more dense - they were floppy shrunken things before I started HRT and when I stopped for 3 months) but they never ache any more.

Some women seem to be able to feel the effect that HRT is having on the endometrium - and maybe this is more apparent as you get older - I certainly feel a certain heaviness at the end of my long cycle, and also get some minor cramping when I start the progesterone phase - well before the withdrawal bleed.

The licensed dose is 12 days x 200 mg per 28 days used orally - which is also what the French instructions say to use vaginally or orally. However limited research has shown that more is absorbed when used vaginally so theoretically you could use a lower dose (depending on how well you tolerate the progesterone) although this is not advisable except under the supervision of your doctor so that you can check on the endometrium regularly.

Personally I would not want to use progesterone for fewer than 11 days (especially as you get older) because although it is dose-dependent, I am sure it takes time as well as a sufficient dose to change all the lining from proliferative (as with oestrogen) to secretory - which can then be shed when you stop the progesterone.

You might also be able to try a slightly longer cycle eg monthly rather than 28 days?

Hope this helps?

Hurdity x

[Lanzalover]

Hi Hurdity

Many thanks for the reply.

Sorry to bother you again I was going to hopefully get the repeat script and then do my own thing and change to seqi see how I got on and I would then have the fall back position of going back to conti if it didn't work.She really was quite insistent on conti when I got the org script as it was so long since my last period.She did say I needed to take the utro every day but I have only used it for 25 days of the 28 days.( info leaflet said this was ok)
Anyway cann't see her agreeing to anything which would mean continuos monitoring of the endometrium.

I had planned to use the utro vaginally at 100mg for the 12 days but on reading your reply I think this
needs to be 200mg no matter what the route of delivery and I could possibly do this on a 31 day cycle without causing any real problems to myself and I wouldn't need to let my GP know.

If I went for the 31 day cycle would I add the utro for the last 12 days of the cycle or do you add it in a some other time during the month and if so which days ?

Also I intend to continue with the 25 days of Utro for this month so as to not upset anything and then have the three oestrogen only days to day 28 would this then mean that the next day would be day 1 of the new 31 day cycle or should this be counted as day 4.

Do hope you can understand what I am asking as I seem to have got myself in a complete muddle.

Lanzalover

[Hurdity]

If you are post-meno then it doesn't matter when you start the cycle - yes just do the utrogestan the last 12 days of the month. Do the 200 mg to start with and see what sort of bleed you get - and maybe see the GP to ask if you can reduce to 100 mg for 12 days. If so I would defo recommend an annual scan initially to check how you respond to this dose.

The easiest way is just to take the utrogestan on the first of the month or any specific date and keep it the same - easy to remember then! Yes you could count the old Day 26 (oestrogen only) as the new Day 1 and then count back 12 days from the same date the next month and start then (if you see what I mean!).

Basically just take the utro the last 12 days of the monthly cycle whenever you start Day 1 and make sure you remember the date you start and keep it the same each month!!

Good luck and hope I haven't confused you!

Hurdity x

[Lanzalover]

Hi Huridty

Yes I am post meno (8 years).
I will take the Utro for the last 12 days of the cycle and see how things go.

Many thanks for your help you are a star.

Lanzalover x