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[Peacegirl]

Thanks all! I had sleep last night- 6 lovely hours. Peegeetip, Thank you for the support and all the info. I'm realising now that I misunderstood the term 'bio identical' and didn't know that most hrt uses bio identical estrogen . Even after much googling and reading on here, I've been struggling to understand what doses of estrogen v progesterone I've been taking and this has now become quite become important to me. I have been taking the prescribed femoston conti the past few days but am concerned that it's only 1mg estrogen to 5 mg progesterone as low estrogen has caused bone ache and horrific mouth ulcers in the past. I'm not sure that ive taken this much progesterone before. Hope that will be ok but I guess I can ask about this this at the clinic on Tuesday. If I tell them I felt great on the evorel conti/sequi patches but can i ditch the hair loss factor, will that be a sensible question? 

I totally relate to the mum stuff, wish mine was here too 😭 so I could be more supportive and learn.
Kathleen, your comments about your neighbour made me laugh a lot!
While we're on this too, I've made huge lifestyle changes to accommodate menopause. I went from being superwoman, doing a full time manager job and managing a home too to working part-time and having to rest a lot and consider what invitations I accept. My partner of 6 years is younger than me so this is tricky. I've taken a big hit in the appearance department too as my skin literally hangs and my muscle-tone is poor too. But actually I've grown into my new life. I guess what I'm saying is that some gps dont recognise how hard we've worked to cope and adjust. We accept aging but I sometimes feel like I was 97 and I'm 57.

[Mary G]

Peacegirl, that sounds like a lot of progesterone!  I imagine Femoston was prescribed for you because it is one of the better tolerated forms of progesterone so you might find it's OK but if you find the oestrogen dose is too low and you don't feel as good as you either could or should, then you might need to change to something stronger. 

You obviously had problems with the evorel conti/sequi so have you thought about going for something with more inbuilt flexibility like Oestrogel and Utrogestan?  The beauty of the oestrogen gel is you can very quickly and easily adjust the dose to suit your needs and I have found it to be the best form of oestrogen I have used by a very long way.  The Utrogestan (micronised and NOT synthetic progesterone) can be used vaginally too which means fewer side effects and if necessary, you can get away with using a bit less because it is localised and hits the spot as opposed to getting lost in your digestive system. 

It might be an option worth looking at.

[Peacegirl]

Peacegirl, that sounds like a lot of progesterone!  I imagine Femoston was prescribed for you because it is one of the better tolerated forms of progesterone so you might find it's OK but if you find the oestrogen dose is too low and you don't feel as good as you either could or should, then you might need to change to something stronger. 

You obviously had problems with the evorel conti/sequi so have you thought about going for something with more inbuilt flexibility like Oestrogel and Utrogestan?  The beauty of the oestrogen gel is you can very quickly and easily adjust the dose to suit your needs and I have found it to be the best form of oestrogen I have used by a very long way.  The Utrogestan (micronised and NOT synthetic progesterone) can be used vaginally too which means fewer side effects and if necessary, you can get away with using a bit less because it is localised and hits the spot as opposed to getting lost in your digestive system. 

It might be an option worth looking at.

Thanks, will give this some thought. The patches were OK except for the hair loss. Can i get utrogestan and oestrogen prescribed easily? I really do like the idea of more localised and faster adjustment particularly as my body normally responds quite quickly. I can feel the progesterone from the femoston already I think as feel a bit dopey and slept a fair bit last night. My breasts are pretty sore but different from the oestrogen sore, though that's a symptom I can handle ok.

[Mary G]

Peacegirl, yes, I believe you can get Oestrogel/Utrogestan easily on the NHS but if I were you, I would tell them that this is what you want and don't give them a choice!

The great thing about this regime is the flexibility of both products which, in my opinion, is the key to success. 

This is Professor John Studd's preferred regime so it might be worth having a look at his website.  He prescribes 7 days of 100mg Utrogestan each month which a lot less than the NHS recommend but this dose is bearable for most women and has fewer side effects when used vaginally.  He doesn't make it a condition of using this regime but it is worth having a scan from time to time to make sure everything is OK and you are getting proper clearance/thinning.

Definitely worth a go!

[peegeetip]

Hi

just bare in mind the following:

1 mg estradiol & 5mg dydrogesterone daily

Yes thats a low dose - but so is the 5mg of prog in real terms.

For those who used to be prescribed dydrogesterone as a separate tablet - it used to come in 10mg tablets.

So if your finding 1 in 24hrs is not enough - then trying two in 24hrs (giving you a medium dose) might help show if thats the way to go.

Unfortunately  dydrogesterone is only available in the UK as part of the Femoston products.
The 10mg option was discontinued a few years ago.
This was only for commercial reasons (ie no doctors were prescribing here) unlike other countries where its still available.

Its up to you if you want to try this or goto a medium strength HRT like Elleste Conti (2mg estrogen instead of 1mg in the femoston).

Hope that helps you see what works.

 

[Hurdity]

Hi peacegirl

That is not a lot of progesterone in Femoston 1/5! You cannot compare the amount of oestrogen to progesterone by looking at the doses because they are metabolised differently and work in different ways. if you were taking oral oestrogen at the same dose and micronised progesterone (Utrogestan) you would be taking 1 mg of oestrogen and 100 mg progesterone daily for the same purpose!!!!! The reason the progestogen dose in Femoston is so low is because it is dydrogesterone and more stable than progesterone itself so can be taken in tiny doses by comparison. You need to take even less of the other synthetics.

I am puzzled though as to why you are on a continuous combined HRT when you were on a cyclical one. Have I missed somewhere that you are post-menopausal and your age?  It would be far better to be on a cyclical one to give a withdrawal bleed and then you wouldn't have to take continuous progestogen and maybe would feel less dopey? However for many women the initial side effects like you are experiencing tend to settle with time ( but for others they continue hence the advice to go on a cyclical HRT). That particular HRT type - Femoston - seems to be the best tolerated of all the tablet HRT types. The cyclical one ( Femoston sequi) comes as a 2 mg tablet as well so available in higher doses.

If you do decide to go down the oestrogel/utrogestan route - you do not need to seek the expensive services of a private gynae - Prof Studd does not have a monopoly on this treatment - these are simply products that are available on NHS so you should be able to get them from your own doc if you do your homework first and go to a GP in your practice whom you know is understanding about menopause and sympathetic towards prescribing HRT. All the product are listed under treatments/HRT preparations ( top tabs light green banner).

Hope this helps

Hurdity x

[Dana]

Doses of progestins are very individualised. I use provera and there are no clear cut guidelines on what amount you should use. It varies from 5mg to 10mg if on a cycle.

When I first started using it my doctor prescribed 5mg for about 12 days and that worked fine, but then I started scaring myself by reading things about it being 10mg, so I asked both my doctor and pharmacist and both said it was variable and basically "if it ain't broke don't fix it".

My doctor also said if I wanted to try it continuously I could see how well 2.5mg worked, but I haven't done that experiment yet.

[Peacegirl]

Hi peacegirl

That is not a lot of progesterone in Femoston 1/5! You cannot compare the amount of oestrogen to progesterone by looking at the doses because they are metabolised differently and work in different ways. if you were taking oral oestrogen at the same dose and micronised progesterone (Utrogestan) you would be taking 1 mg of oestrogen and 100 mg progesterone daily for the same purpose!!!!! The reason the progestogen dose in Femoston is so low is because it is dydrogesterone and more stable than progesterone itself so can be taken in tiny doses by comparison. You need to take even less of the other synthetics.

I am puzzled though as to why you are on a continuous combined HRT when you were on a cyclical one. Have I missed somewhere that you are post-menopausal and your age?  It would be far better to be on a cyclical one to give a withdrawal bleed and then you wouldn't have to take continuous progestogen and maybe would feel less dopey? However for many women the initial side effects like you are experiencing tend to settle with time ( but for others they continue hence the advice to go on a cyclical HRT). That particular HRT type - Femoston - seems to be the best tolerated of all the tablet HRT types. The cyclical one ( Femoston sequi) comes as a 2 mg tablet as well so available in higher doses.

If you do decide to go down the oestrogel/utrogestan route - you do not need to seek the expensive services of a private gynae - Prof Studd does not have a monopoly on this treatment - these are simply products that are available on NHS so you should be able to get them from your own doc if you do your homework first and go to a GP in your practice whom you know is understanding about menopause and sympathetic towards prescribing HRT. All the product are listed under treatments/HRT preparations ( top tabs light green banner).

Hope this helps

Hurdity x

Hi, thanks for the info, l'm realising that the doses can't be taken at face value. Believe it or not, I google my hrt every time but find the dosing very confusing. I'm also confused as to why I'm on a continuous combined femoston, but this was prescribed in my absence when what was originally prescribed (by a grumpy locum who had to ask my own GP what to prescribe and then couldn't explain it to me) wasn't available at the chemist. I did question this by phone and the gp said it can also be given to women over 50. I will discuss this and a zillion other things at the clinic! Is it better to go the cyclical route then? I'm not sure if I'm post-meno or not tbh and I haven't been on the ball the past few weeks. Having now had a bit of sleep and feeling less awful, I'm coming to and trying to learn a bit more. Tbh I've learned more on here the past few days than in the last year! Thanks again.

[Peacegirl]

Doses of progestins are very individualised. I use provera and there are no clear cut guidelines on what amount you should use. It varies from 5mg to 10mg if on a cycle.

When I first started using it my doctor prescribed 5mg for about 12 days and that worked fine, but then I started scaring myself by reading things about it being 10mg, so I asked both my doctor and pharmacist and both said it was variable and basically "if it ain't broke don't fix it".

My doctor also said if I wanted to try it continuously I could see how well 2.5mg worked, but I haven't done that experiment yet.

That's really useful info Dana, thanks for taking the time to post!