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[linz57]

As my current hrt, Femseven Conti, isn't keeping my endo lining thin enough ( measuring 6.5mm) I am going to visit my doctor on Monday to discuss a new regime. I say discuss but to be honest it will have to be me saying what I would like to try next as she isn't knowledgable on hrt.
If I switch to a patch for estrogen and Utrogestan for the progesterone but still keep to a Conti regime will it realistically thin my lining more than my current product? If not, I may be better opting for the Mirena but I don't really fancy that .

[flutterby]

Hi linz57 I was on Evorel Sequi after starting to bleed erratically I had an ultrasound my lining was also 6.5 started on Evorel 25 with daily Utrogestan 100mg on Dr Curries advice, next measurement was down to 2mm. The following ultrasound ( I am having them 4 monthly) showed thickening in one area which was a polyp but the lining was only thin. As soon as the polyp was removed the bleeding stopped. What I am trying to say is that I believe in my case the Utrogestan is keeping the lining thin. Dr Currie explained to me that oral progesterone was better absorbed than that from the patch. I hope this might be helpful.
Flutterby
 

[Hurdity]

linx57 - you can't say how well you will absorb the different products as there is such variation amongst women and between different methods - eg patches, oral methods, tablets, gel etc.

Over-thickening usually means there is insufficient progesterone compared to oestrogen. You can only try and see. Utrogestan is better absorbed vaginally but not many women would want to do this on a continuous basis. Most of us who use utrogestan vaginally are on a cycle.

Hurdity x

[Michelle46]

Hi ladies
I'm not really clued up on HRT. I am using 2 pumps of the estrogen gel and 100mg of utrogestan for 14 days of the month . Would you say this is a good combination? My doctor is not at all helpful. She just said she would check things in 12 months. I have a withdrawal bleed when I finish the utrogestan tablets.  How do I know if things are ok? Sorry if I sound vague.

[linz57]

Helpful posts, thanks ladies. I suppose the only way is to try it and see, I'm just a little reluctant to changing my regime as I've tolerated the Levenorgestrel in the patch well.
When you changed flutterby, did you have a lot of bleeding initially and is that how it thins the lining?
Michelle46, I suppose the best thing would be to have a scan after say 12 months to check your lining thickness. I would have thought you would have to take 200mg Utrogestan with 2 pumps of Oestrogel but I may be wrong. Someone more knowledgable will be able to help you better.

[Dancinggirl]

Linz57 - If you current HRT isn't keeping your womb lining thin then I have to say I am not hopeful that Utrogestan will be any better.  In my experience, Utrogestan wasn't strong enough to stop me getting erratic bleeding and spotting, however, we are al different and you may be more lucky - as others have said, the sequi version could be better. Being on any conti HRT can bring these problems with womb thickening and problematic bleeding and I think if one is prone to this then your only options would be to either have a sequi HRT and put up with monthly bleeds or you could have a Mirena fitted which is far more effective at keeping the lining thin.
The Mirena has the same progesterone as the patch you are using(so it is likely to suit you) but delivers progesterone directly to where it is needed and this is why it is so good. I had a Mirena for 4 years in post meno and it was the best option for me at that time - when I then tried Utrogestan, after having the Mirena removed, this is when I got all the problems with bleeding and also horrible cramps as well.  Do discuss this with your GP - I think the Mirena might be your best option.  DG x

[linz57]

Thanks Dancinggirl, the gynae I saw before my hysteroscopy said the Mirena could be my best option then I could alter my estrogen strengths to suit.
I guess its just the thought of it maybe becoming embedded or causing infections that's putting me off. The Utrogestan taken orally sounds a simpler option but it's no good if it doesn't help thin my lining. Hmmm, food for thought here.
I haven't had a period in over six years and am wondering if  I did change to a sequi regime, would I likely have bad cramps and heavy flow initially? Or, is it likely to be like  most things and it would vary person to person ?

[Dancinggirl]

linz57 - don't listen to all the scary stuff about the Mirena - there are very good reasons why it is such a favourite with gynaes.  It is very rare to get problems and it will usually sorts out problematic bleeds with less side effects. After the first few weeks after fitting, when one gets a bit of bleeding and spotting, you can simply forget about it and enjoy the benefits of the oestrogen.  It could be a good idea to ask for a referral to have a womb scan to check if there are fibroids or polyps and to also get some more specialist advice. DG x

[linz57]

Thats my problem Dancing girl, I tend to focus on the horror stories rather than the success stories. I suppose it didn't help me recently when I had my hysteroscopy and the woman in the bed opposite was in for removal of her Mirena under a general anaesthetic!
I like the effect of Levenorgestrel so would hate to think after a settling in period I wouldn't get the calming feeling anymore but I won't know until I try it I guess. Thanks for your comments and mentioning positive side☺

[flutterby]

Hi Linz57 when I changed I had nearly a month without bleeding. In the past when I tried continuous I always had spotting so I went back to sequential. I do think if I hadn't had the polyps the bleeding would have settled down sooner. Looking at my ultrasounds after starting on Utrogestan it does seem to be keeping the lining thin. Why don't you have an email consultation with Dr Currie. Both my GP and gynaecologist were very happy for me to follow her advice now and in the future. By the way my friend is very happy with her Mirena coil as well. Flutterby x

[linz57]

Glad to hear it's keeping your lining thin flutterby, that's one less worry for you. I have emailed Dr Currie, but today my doctor wouldn't prescribe what was suggested.
I am so annoyed right now  as I've waited over two weeks for my doctors appointment today and I've come out  no better off.
I said I had decided to opt for the Mirena coil and estrogen patch. I got told the surgery will not supply me with the coil as it is not licenced to be used for hrt, particularly in  Post menopausal women.
Next, I said OK then, p!ease let me try the regime Dr Currie has suggested. The doc said she had never heard of Utrogestan and even when I mentioned it is known as micronised progesterone she just shrugged and said she knew nothing about it so wouldn't prescribe it. I even showed her the email print out I had from Dr Currie but to no avail.

So, all she can suggest is I go see a gynae at my local hospital.....waiting time well over two months ......to say I am fuming is an understatement

The last time she sent me up there regarding hrt was a disaster. The gynae greeted me with " why are you here when this could be dealt with by your doctor?" I saw her point as she must be extremely busy with women who are ill but I still felt mortified.

What an almighty c*ck up !!😡
I've already changed surgeries a couple of years back  as no one in my old surgery understood hrt once the clued up doctor retired so hey ho, looks like I'm stuck now until mid October 😧

[CLKD]

Send Dr Currie an e-mail and explain that her suggestion has been refused?  GPs are GPs because 

[linz57]

Will that mean paying again as it's some time since I last was in contact?
It's so frustrating when you are given good advice by a knowledgeable gynae like Dr Currie yet local, clueless 12 year old gp's won't listen

[CLKD]

I saw a 12 year old taxi driver yesterday  and one aged about 14 teaching someone to drive ……. 

Would it be worth the fee to let Dr Currie know that her advice hasn't been listened to, maybe ask Emma if there is another charge?

[linz57]

Will do!