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[GypsyRoseLee]

Hell Everyone

I haven't been around much recently (though I have been reading).

I have felt I was slowly improving after increasing to 4 pumps of oestrogel back in June. Then I definitely started to improve when my GP also started me on Sertraline 50mg in July. There have been a few rocky parts, but on the whole I have felt so much better. I was still having my own (very light and short) periods. A month ago, because I was still having some bad days of anxiety my GP injcreased me to 75mg of Sertraline. Everything was fine, and I felt better apart from a couple of days when I think I ovulated, and I got anxiety again.

This month I have tried to sync taking the Utro so that it would cause a withdrawl bleed at the same time as my own period. Prof Studd had advised me to take 100mg Utro for 7 days on the 1st of the month, but then advised I try and sync it with my own bleed. I got my dates a bit mixed up, so started taking the Utro a bit too late, as my period was due last Friday or Saturday. But I started taking the Utro last Tuesday anyway. Within 12 hours of starting it I was feeling very 'off' and on edge. I continued feeling really 'off' with waves of anxiety. And my period didn't start last Friday/Saturday. My sleep was disrupted too, and I kept waking really early feeling anxious again (which hadn't happened for quite a while). I took the last Utro on Sunday night (couldn't stand anymore). On Wednesday I started with a bleed and I felt much worse, really bad, so jittery and tearful. Didn't feel depressed at all, just awful anxiety. Yesterday was even worse. And today I just feel absolutely dreadful. Don't see how I can stand it much longer? My bleed seems to be finishing (I only ever bleed for 2-3 days now, and it's always very light).

Last month I didn't react like this to taking Utro, but I had just increased to 75mg of sertraline, and increases always make me feel very chillaxed, so this might have helped. So, don't know if the Utro can be causing this reaction? But the timing is incredibly coincidental otherwise. Not sure if it's due to starting to take Utro for several days before my natural period was due and this actually stopped my period starting on time? And this has somehow caused chaos? I do remember having a nasty mood 'dip' a few days after finishing the Utro, but it was no where near as bad as this.

Feel at the end of my tether. Any advice/opinions very welcome.

[puddlesmum]

Hey honey.  I'm feeling similar at the moment.  I'm at the tail end of my "skanty" bleed but it's about 2 weeks away from when I normally get my bleed anyway so I know my hormones are all over the damn place still. I was super jittery yesterday but today I'm about 80% and afraid to stand up as I get dizzy.

I think they might just be trying to still get themselves sorted. Professor Studd said that it could take me nearly 6 months to straighten out as I'm expecting too much too soon and went up to 4 pumps on my own (back down to 3 now).

I know Utrogestan was fine for me for 5 days as it sent me to blissful sleep then the last 2 days gave me horrendous nightmares and started off the anxiety again.

I had a fabulous month in July when he let me just have estrogel all the way through until I had my own bleed through which started anxiety again.

Massive, massive hugs to you honey, I know exactly how you're feeling.

xxxx

[GypsyRoseLee]

Thank you for replying Puddle.

It is so, so horrible isn't it? If I knew, for certain, that I was just reaching to the progesterone dip, and that it would right itself in a day or two, then I'd be stoic about it.

But, this feels worse than anything I've suffered with before and I'm starting to panic.

I have been.on 4 pumps since June, and Prof Stuff said that women who suffer hormonal depression/anxiety need 3-4 pumps.

But, I definitely felt a real improvement after starting Sertraline too. I think.I need both.

But now I'm panicking and thinking that all this oestrogen + increasing to 75mg of Sertraline a month ago is perhaps giving me too much serotonin now?

But, then it could also be just a very severe reaction to the Utro dip, and the bleed starting? I just wish I knew for sure, and I feel so hopeless because I know no one can really tell me.

[GypsyRoseLee]

Also wanted to ask Puddle, as you still have your own periods didn't Prof Stuff tell you to try and sync taking Utro so the 'scanty' bleed coincided with your own period?

Ate you taking 100mg Utro for 7 days from the 1st of every month?

[puddlesmum]

Nope he just told me to take it for the first 7 days of each month which I thought was a bit strange as I still have my own periods, but I just took him at his word and hanging on to the hope that it will straighten itself out.  Yep 100mg.

I know the hot sweats stopped but the anxiety is still just hanging around. I was apprehensive about taking the Utro anyway as it's the mini pill in the 90s that started the whole mess with my periods in the first place so wasn't keen on taking it. 

I'm on Seroxat but I think that's not working so I'm asking if I can up it to 50mg instead of 40mg. 

But I'm like you. I'm happy on the routine, but not knowing when it's going to calm down freaks me out so much.  I don't know what my levels are doing from day to day and although I've emailed the Prof, I've not had a reply at all about it.

I definitely don't have depression now (thanks to BHRT and therapy I think) but just the damn anxiety which stops me in my tracks yet I don't know what's doing it.  Is it a dip in Estrogen or what? You're right, no one can really tell you anything either.

xxx

[GypsyRoseLee]

It's such a hideous rollercoaster isn't it?

I have just come back from an astounding appointment with a locum GP. As luck would have it, she has a special interest in Menopause and has seen Prof Studd speak many times.

I thought she'd increase my Sertraline, but no. She thinks this severe reaction is due to the double whammy of taking Utro during the 5 days before my own period was due, coupled with the rise in my own progesterone. So a double hit.

So (and this is the astounding bit) she has told me to only take 7 days of 100mg Utro once every three months! She has several progesterone intolerant patients on this regime and it works well. When I asked about the risk of endometrial cancer she said I'd be fine because I'm still producing enough of my own progesterone to give me a light period every month.

She knew I used 4 pumps of oestrogel and she agreed that a high dose was best for low mood or anxiety.

She also said blood tests were a total waste of time to diagnose hormone levels in peri women because the levels can change, literally minute to minute. And this is why our mood can change within a few minutes, too.

So, I am more than willing to give it a go. She agreed it wasn't a coincidence that all my problems started as soon as I started Utro this month.

I'm sorry you haven't had a reply from Prof Studd. I also emailed him, and he never replied.

I do believe anxiety is caused by a drop in oestrogen or a rise in progesterone. Do you keep a mood diary to keep track of your anxiety?

[puddlesmum]

That sounds promising!

I imagine that's what's happening to me too.  I might drop him another email and if he doesn't reply, get the OH to give his secretary a call as it might be what I'm going through.  Felt fabulous until I started taking the Utro and had this damn period.  I think I could cope if it was once every 3 months.

Yep, I've started keeping a diary (well since June) but I'm all over the shop and can't see a pattern apart from it happens just before my period and normally buggers off a few days into it.  Damn hormones.

[GypsyRoseLee]

It's worth even talking to his secretary as she is very knowledgeable, too.

I think the fact your problems start just before your period and disappear a few days into your period is a classic pattern on progesterone intolerance.

What happened when you started the mini pill years ago? It's progesterone only I think, isn't it?

[puddlesmum]

Yeah I was actually fine on it originally (they put me on it because I was becoming quite violent and would kick doors in and stuff through puberty) and then I came off it.  It was when I came off it that I had massive problems and got diagnosed with PCOS. Went back on it and it didn't stop anything, periods were still erratic and I started getting all sorts of issues like a year long bleed whilst on it.  Nightmare.  I imagine that it messed up my system as from then on my periods just went totally haywire. 

It's been on and off now for about 10 years and always seemed to get horrendous depression, anxiety and fatigue just before my period which once I came on, would disappear as quickly as it arrived. 

Now I get horrible thoughts and obsessive thoughts about a week before I have a period (but it started day 5 of taking Utro this month) and today is the first time I've felt it lift a tad (period is petering off).  Still got banging headache though.

[puddlesmum]

Just asked the Professor what he thought and he's told me not to take the Utro for the next 2 months and contact him again after that.  I suspect I too may be progesterone intolerant. 

[GypsyRoseLee]

So glad he got back to you. I really think you probably are progesterone intolerant, given everything you have told me.

You sound like a classic case.

Can I ask did you use to suffer with PMS or post natal depression? Both are strong markers for severe progesterone intolerance (I really suffered with both).

Did Prof Studd say how long before the Utro should be out of your system? My bleed is finishing now, so hoping my mood should start lifting by the end of the weekend.

[puddlesmum]

I can't have kids so don't know about the PND, but I often had horrendous PMS growing up until I went on the mini pill, then everything disappeared until I came off it, then I ended up having these similar episodes to what I'm having now but without the hot sweats.

I did originally say to him that anxiety was kicking in around ovulation mildly then it would just build up and build up until my period started then a few days in it would go away.  He gave me the Estrogel for a full 8 weeks and I experienced none of the anxiety at all. Had a fabulous June as I sailed through, until I had a breakthrough period at the end of July which threw me straight back to square one again.

No he didn't say, just replied, stop progesterone for 2 months then contact me again.  A man of many words lol but I gather from that he's thinking the same as us...  But I am right at the end of my Utrogestan induced bleed at the moment (got horrible cramp in my left ovary) and so I'm hoping it too will be gone in a few days.

[GypsyRoseLee]

If you suffered with bad PMS that just proves you're progesterone intolerant. If you can't even tolerate your own progesterone you're never going to handle a synthetic. Even one as good as Utro.

Yes, he is very, very gruff and abrupt isn't he! But, I do think he genuinely cares. All his staff seem to love him.

I'm not going to take Utro until at least December, and then just take it vaginally.

[puddlesmum]

Me too now.

Oh yeah he's abrupt but I don't mind that tbh.  Especially when he called me "my dear" which I think is quite endearing lol.

Let's hope the next few months for us are peachy

[GypsyRoseLee]

Yes, he is very old school but rather sweet. Let's hope this works for us both!