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[ouchouch]

Advice please. Am now 56,  Always been on birth control pill and noticed in summer 2012 no periods in between  then hot flushes started.
tried HRT 2013 to 2016 but no amazing feel great results.
So after everyone saying go natural took myself off everything.
Tried homepathy, magnet in pants etc. Went to doctors about VA and he said about pessaries but was welcome to try natural stuff,
After our much anticipated xmas holiday of a liftime and hot flushes worse in sunny climate, days out made the VA worse husband says you have tried everything think you should see a specialist.
Asked GP to refer and they said we can try you on other type of HRT.
I am always rushing so the thought of months waiting to see if it works then trying something else toooo slow.
So paid up my £250 to specialist they normally recommend when they have tried everything themselves.
She put me on Evorel 25 and Progynova and said must cut out carbs/sugar as insulin blocking any oestrogen.
VA so bad Vagifem two pessaries per night for month then 3 x a week.
after a week increase to evorel 50 still nothing and poxy patches fall off after 2 days!! so have upped Progynova to 1 am and 1 pm so 2mg per day and asked my GP to prescribed Kliofem to replace as that is 2mg and will include progesterone and vaigem on nhs prescription.
Awaiting the paid presc annual cert so not started yet, still not much change on 2mg progynova and have follow up with specialist on 23rd....
I am wondering if I should ask for blood tests to see exactly what levels I have, surprised she didnt do originally but think as I was self funding trying to save me money.


Any advice.... thanks x

[Dotty]

Blood tests are unreliable and most specialists go on symptoms.

You need to stick with the same dose for 3 months as hrt does not work instantly.

The best hrt is estradiol through patches or gels and utrogestan.

[Dancinggirl]

Hi and welcome

Vagifem is great - keep with this for the rest of your life. Do you use vaginal moisturisers as well?  Most of us use SYLK or the YES products which can be very helpful alongside (though not at the same time as) Vagifem.

Very surprised at the HRT suggestions by the meno specialist - no progesterone in the mix until then Kliofem?!!
Most specialists now recommend Oestrogel or Estrodot patches ( very small and stick better) - with separate progesterone which would be either Utrogestan or Provera. Oestrogel usually absorbs really efficiently and allows you to use as little or much as you need. Pills tend not to be as effective as so much can be lost in the liver - much higher doses are needed as a result.  If you use progesterone continuously, then this can sometimes counter the oestrogen and give flushes, low mood etc.  Many women choose to stick with a sequential HRT regime(even in post meno) and put up with monthly periods to reduce the side effects of continuous progesterone.  A good non bleed HRT alternative is to have a Mirena fitted and use Oestrogel alongside.

Whilst I understand the suggestion of cutting out sugar and carbs, this can also lead to low blood sugar and low energy levels and this can increase flushes - bread and potatoes are good in moderation.   So I'd eat small meals often, with some carbs, but highly nutritious.

It will take some months to really feel the benefits of any HRT as you are starting from a very low base line hormonally.

I would ask to try Oestrogel with Utrogestan on a sequential regime to see if that works better. Look under TREATMENTS at the top of this page and you will find the various options but the regime I'm suggesting is under the Oestrogen and the progesterone sections. The Mirena will Oestrogel was my best option in post meno. DG x

[Taz2]

Hi ouchouch - it is very frustrating when you know you have to wait at least three months for things to take effect but, unfortunately, that's the way with HRT. Chopping and changing wont give you a clear picture of what will work for you.

Which HRT were you on to start with? Patch or gel HRT are a better option for you at 56 I think. Pill HRT is not recommended as you get closer to 60 due to the increased stroke risk.

Patches can be tricky although Evorel usually sticks really well. Which part of the body were you putting them on as this can make a difference. Also, follow the application directions to the letter to get a firmer "stick". It's not much good sticking them on with tape either as the hormone is contained in the adhesive.

Which progesterone have you been given by the way as I thought Progynova was oestrogen only?

So many questions - sorry!

Taz x

[Taz2]

Good advice from Dancinggirl - we posted at the same time I think 

Taz x

[ouchouch]

Tried a coil for birth control and husband hated it as could feel it. Doctor once said I had a short vagina!!  tried the premique in 2013 then femosten but put on weight with that.   yes progynova oestrogen only think that was to start and now why she suggested my GP give the Kliofem which is combined.  originaly she said definately not syntehtic progresterone when I do have it and on reading Kliofem that is synthetic.... dont like to query what the specialists say... but want it right.
its all those lucky people that say I started on HRT and felt fantastic it changed my life in days, that makes me want I guess unrealistic time scale results

[ouchouch]

reading now .. thanks dancing girl

[Mary G]

Ouchouch, I would say that Oestrogel is a better choice than patches because it absorbs well and it's more dose flexible.   I didn't get enough oestrogen out of patches and I didn't like wearing them either.

Blood tests are definitely useful if you want to find out how well you are absorbing your HRT and know what you oestrogen levels are.

[CLKD]

Welcome!  Good advice given.  If you are like me you want instant results, but the body doesn't get where it is suddenly so takes a while to absorb changes.  Let the medication do the work ;-)

As for vaginal atrophy: do read our threads here.  [My Bladder etc.. and others].  If my bladder feels irritated with is my warning sign that I am dry down there, I use more of the appropriate atrophy reliever for a few nights. 

Browse round.  make notes.