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[merryperi?!]

Hi all,
I'd really appreciate some help please as from what I've read online, I'm worried my doctor has made a mistake.
I'm 52, going through the perimenopause and just recently had to start taking contraception and because of my age, it had to be the mini pill (Cerazette).
The main symptoms of my perimenopause that are affecting me badly are the tiredness and anxiety.  I already take anti-depressants but would like to eventually come off them (have had episodes of depression since my thirties) but anxiety just appeared with the peri.
I did lots of research online and found a recommendation by Prof John Studd to try bioidentical hormones as follows: Oestrogel daily along with Utrogestan for the first 7 days each month (to protect the womb I believe).
I took the article in to my doctor and she has prescribed oestroegel for 7 days each month and says the progesterin of the mini pill will provide the progesterone.  Has she got it wrong?  I've read elsewhere that the mini pill does NOT provide enough progesterone to protect the womb while take oestrogen. 
Another alarm bell went off when I went to collect the prescription (Oestrodose) and the pharmacist said that one is hardly ever prescribed!  Or should I just trust that the doc knows what she's talking about?!
Any help would be much appreciated, thanks.

[Hurdity]

Hi merryperi

 

I think your doctor has misunderstood the prescription or something? Oestrogel as part of HRT should be taken every day - and the gel is fine and a properly licensed oestrogen to take for HRT (see list here: https://www.menopausematters.co.uk/treatafter.php - scroll down for gel). Ignore the pharmacist!  That comment is irrelevant to your prescription! Re the progestogen - yes you are right that Cerazette is not licensed to be used as the progestogen part of HRT because it may well not contain enough progestogen. In actuality it may do with low doses of oestrogen but there is no dose that allows for this. It may be that a low dose of progesterone for 7 days along with the pill will do the trick (I haven't come across anyone who has been prescribed this though) - but I would hope in these circumstances your doc would eg agree to scan your uterus after a year or so to check all was OK - if for example you experience bleeding. Women who are sensitive to progestogens would find this too much but others may well be fine.

In the absence of the mini pill you don't know what your periods would be doing naturally and 7 days progesterone alone is far lower than the licensed dose  so may not be sufficient. If you stopped the Cerazette then ideally it would be best to take a licensed dose of progesterone and take it from there for a few months.

If you need to use contraception and prefer something like the mini pill and Cerazette agrees with you then the Mirena coil is another option as this provides both contraception and uterus protection when using HRT.

Hurdity x