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[Belladonna]

Which of these would you choose and why?

I need to call my gyn before noon and say which I want to try, please help!

1 mg norethindrone acetate with 2 mg estradiol

2 mg drospirenone with 1 mg estradiol

I feel so miserable on my current hormones I can't take it anymore! 

[vintagefiend]

Poor you- I'm afraid I don't know about the medications you mention, but just wanted to say that you're not alone. I'm peri and trying qlaira- hanging in there on month two- really hoping that this is the one!
I googled drosperinone and it seems to be the prog in the bc yaz which is given to those who find the prog stage of menstrual cycle unbearable (eg pmdd). But i dont have experience of it.
on the other hand i get terribly depressed when oestrogen low (ie during period) and i notice the other preparation you mention has double the oestradiol of the other.
How old are you, Bella?
Sorry not much help but wishing you well x

[Belladonna]

Thanks for your reply, I am only 34...

Yes if the drospirenone one had 2 mg estrogen I would definitely choose that. But like you I am worried about it being too low.

On the other hand, a lot of people seem to think that norethiserone/norethindrone is the worst progestogen of all in terms of side effects. So I really don't know what to do.

If I want bio identical estrogen then these two plus medroxyprogesterone are the only available formulations in my country.

[Dancinggirl]

What about trying Femoston 2/10 - this has a kinder progesterone that suits many women very well.  DG x

[Belladonna]

Unfortunately that's not available where I live.

Right now I am thinking of just going back on my patch tomorrow because I can't take all the side effects anymore.

I wonder if it could be topped up with more estrogen? Or does that cause build up of the endometrium?

[Dancinggirl]

Where are you exactly?

Taking any progesterone continuously can be the issue - many of us prefer to stick with a sequential HRT regime and put up with a monthly bleed to try to achieve fewer side effects overall.
If you can get Provera (medroxyprogesterone) - this is also one of the kinder types of progesterone and could be better???  You could use an oestrogen patch or Oestrogel daily and take the Provera separately for 10-12 days each month to reduce any side effects - you can take Provera daily but this could also give some problems.  It is about finding the progesterone that gives the fewest side effects - most progesterones will give many of us problems.
Have you ruled out having a Mirena fitted?
Also, another thought, don't be put off by trying the drospirenone as, though it seems to be in a higher dose, that may just be the dose needed in that particular type of progesterone. With most HRT regimes it's about getting the right balance of hormones, to control meno symptoms and also protect the womb lining from building up.  DG x

[Belladonna]

I didn't know medroxyprogesterone was one of the kinder types, I read somewhere that it was really high risk?

I can get it in a pill with estradiol, 2/5, 1/5 or 1/2.5

I am very reluctant to have a bleed. I hate it, have terrible pain and struggle with very low iron. So that's an absolute last resort.

[Dancinggirl]

I'm afraid any progesterone will give side effects if taken continuously. If you don't want bleeds then the Mirena is a good option??? Often giving the fewest side effects.  DG x

[vintagefiend]

Dancing Girl- do you know if femoston can be prescribed to peri women as well as post menopausal? I notice only half the tablets contain a progestin which is interesting! Would that dose prevent ovulation?
Thank you and hope you don't mind me hijacking your thread, Bella but sounds like we have similar needs anyway so hopefully useful to you, too!

[Dancinggirl]

vintagefriend - I am certainly no expert but I believe to suppress ovulation the dosage has to be much higher than is in Femoston but you would need to see a specialist gynae for advice on this??!!
Femoston certainly does come in a form that is suitable for the peri meno phase - this would be a sequential HRT (which you may have been given) and progesterone is added to oestrogen in the pills for the second half of each month - then when you finish the pills with oestrogen plus progesterone and go back to the oestrogen only pills, this will trigger a withdrawal bleed that ensures there is no unnecessary build up of the womb lining.
Taking HRT in the peri stage doesn't necessarily stop ovulation but will regulate your hormones to alleviate the fluctuations that happen through the peri meno years.
Here is the link on this site that shows all the HRTs available for the peri meno phase.
http://www.menopausematters.co.uk/perimeno.php
DG x

[vintagefiend]

Thank you very much Dancinggirl- that's all very helpful and a great link! Feeling so depressed today- I can't imagine that that the qlaira will suddenly be ok- looks like it's not for me.
Hope you're ok, Belladonna- think I saw that you were considering patches with enough oestradiol to suppress- I'm thinking along those lines, too- def with separate progestogen so if something makes me feel crap, I'll know whether it's the oestrogen (which I do think is unlikely) or the prog (more likely!) good luck!

[Belladonna]

My ovaries don't work so I don't have to suppress ovulation, but because I am young I need more estrogen. 

I've been thinking more and more about adding estrogen to the combi patch. If the doctor okays it, it might be worth trying.

I think that the symptoms I got on the patch was due to estrogen deficiency, not a reaction to the norethiserone. And of course norethiserone has the advantages of being the only transdermal progestogen that will prevent endometrial thickening.

[Dancinggirl]

Belladonna - Norethisterone is not the only progesterone that can be used transdermally to prevent endometrial thickening. Femseven combined patches have levonorgestrel in it which is a different synthetic progesterone which may suit you better - however most progeserones will give side effects particularly if used continuously.  The Mirena can and does reduce the side effects of progesterone and gives a non bleed HRT regime but not everyone wants to give this a try.
Is there a particular reason why you want to use progesterone transdermally? If Oestrogel and Medroxyprogesterone (this would be transdermal oestrogen and progesterone in pill form) is an available option, then I would give this a go. It is also a good idea to use any HRT in a sequential regime first to see if it's the progesterone that is giving the problems.
Adding in extra oestrogen is not always the answer and too high a dose can bring other problems - it is trial and error and finding the progesterone that gives the fewest side effects. DG x