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[jasper]

Hi Everyone,

Not been on here a while as I was waiting to see how things settled after giving up on my Zoely trial.

I am back on Evorel 50 and have just had my 2nd period since stopping the pill.  My main issue and reason for all this is severe homonal migraine which I've posted at length about previously.

2 questions if anyone can help?
1) does the fact that I have a regular and proper period on Evorel without any addition of progesterone mean that my progesterone levels are not low despite blood tests sometimes indicating that they are? Having Evorel only was initially only a temp measure to see how migraines responded and I don't think consultant expected my cycle to override it.
2) I am getting a severe and predictable migraine from day 5 which doesn't subside until I get close to ovulation. I realise that my own estrogen levels are fluctuating and the only thing I can think of is that I have too much at this point? This time is far worse for me now than before or during period. Any thoughts?

Thanks as ever

[Hurdity]

Hi jasper

Sorry to hear about your ongoing migraines. I would be surprised if 50 mcg patch would override your cycle - doses usually need to be higher than this to achieve suppression of ovulation.

Re blood levels of progesterone - when in your cycle were the blood tests taken? Progesterone is usually measured to determine whether ovulation is occurring and if so whether progesterone levels are sufficient to maintain a pregnancy. In this scenario they are taken sometime during the second half of the cycle - can't remember exactly - but probably around Day 17-22 when they should be at their highest. If they are taken during the first part of your cycle they would be expected to be low - this is normal.

I can't comment on your Day 5 migraine apart from to sympathise because they are so wretched.  At this point progesterone levels should be at their lowest, and oestrogen levels should begin to rise. These levels are at their highest about a day or two before ovulation. So if it subsides before ovulation - then surely it cannot be due to high levels per se - since levels only fall following ovulation    . It sounds like it is due to changing hormone levels in some way - but as you say if you are peri-menopausal they are likely to be variable anyway.

My cyclical migraines always occurred in the week leading up to my period - usually a couple of days before so were either due to the oestrogen dip or progesterone withdrawal symptoms.

Sorry I can't help further and hopefully someone else might be able to suggest what to do?

Hurdity x

[jasper]

Thank you Hurdity,

It is so confusing! I cannot work out what it is about day 5-10!! Interestingly I remember when I was given testosterone gel a couple of yrs ago (negligible levels but gel no help) it did the same thing - hideous headaches after period before ovulation🤔.
My progesterone was tested on the right days - under or low in range.

Thanks again

[Tinkerbellj]

Hi jasper just back from meno clinic and she has suggested two 100mg patches to replace my four pumps of oestrogel as this will hopefully shut down my own hormones. I  also having a regular period on oestrogen without using the progesterone. the consultant today basically said im sorry dont know what else to do with u try playing about with the doses yourself unless u can suggest something. Two and a half years to be then told this! not happy. And  she wrote down what i needed on the back of an envelope not the usual.script pad so of course gp wont accept this so had to ring the clinic and now it will be a week until they get a letter to gp. all.after saying I think u should just stop everything I think your dose of oesteogen is too high.  fed up. As I left I apologised for not being straight forward. she didnt bat an eyelid. NOt going back. waste of time.

[jasper]

I feel your frustration Tinkerbellj :-( it's so hard when you just can't get it sorted.  I've been trying this since last easter and am getting nowhere. 2 x 100 seems like a massive dose? But I guess that would stop your own hormones. I need to speak to my consultant again but just can't afford it at the moment unless I have a clear plan as to where I want to go with it - I know she will be annoyed I stopped the Zoely as she said to give it 3 months but 2 months of constant pain on it was just too much.  I seem to be better in the 2nd half of my cycle while on the Evorel 50 so trying to work out what that means???! Maybe I need some progesterone?

[Tinkerbellj]

Jasper I gave up the zoely after 10 days. ..when u know u know! I think I actually feel better on progesterone. I asked if I could take a small dose every day  she said no not until your post meno...but thats what happens on the pill? oh I dont know she made me feel so stupid.  SHe kept talking about pmt but my mood isnt up and down its permanently down. something is causing that!!

[jasper]

Yes surely that makes no sense Tinkerbellj😔. I had a feeling that some element of being on proj helps me too - esp as I'm now better 2nd half off cycle.

[Hurdity]

If you are having Evorel 50 all through your cycle then this means you won't be experiencing the mood dips from the oestrogen crashes to the same extent, so this can account for your feeling better now during this phase maybe . Do you feel normal pms just before your bleed and in the first few days - or perhaps you have never suffered from this?

Hurdity x

[jasper]

Hi Hurdity,
I feel relatively ok pre period now, and first few days despite heavier bleed. As period is ending I then get days of migraine and don't pick up til around ovulation🤔