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[patti]

Hi everyone, I started 2xpumps of oestrogel daily and utrogestan days 1 x25, 2 Jan 2018 .My last period was July 2015 so definitely post meno,and after a horrendous 2017 ,with lack of sleep due to night sweats,hot flushes,joint pain,dry eyes (that run continuously!) and just generally knackered with no lust for life - I could not go on anymore.  Went to my GP who ,after I suggested what about HRT ? Looked at my family history -my grandmother had breast cancer aged 82 (died age 85) my mother had breast cancer aged 49 ( spread to lungs and died)and her niece ( my cousin) had breast cancer aged 46 (spread to liver and died) I have had regular mammograms since age 40 and suffered with tender/ lumpy breasts with a couple of cysts that have been drained- I was referred to a genetic councillor- and they made the conclusion that as my grandmother would have been classed - age related cancer  - my mother and cousin - just unlucky to have developed at a young age ( I have no idea if these were oestrogen receptive as it was 1981/1986 respectively) my GP said it was my decision - so I was given  Elleste Duet Conti 5/12/17 I didn't take them ! Made another appt with different GP who was more understanding - told me about this website and other options i.e Antidepressants ? I'm so glad I found this website ..... I went back to my GP told her I wanted to try oestrogel topically and utrogestan -(vaginally)as I have coeliac disease I did not want  to take anything orally ,she was ok with this . I have been on this regime now since 2/1/2018 the night sweats / hot flushes had all but gone in 2 weeks but had some slight spotting around  day 12 for 7 days then day 26 bleeding for 6 days this happened again in February- now in March I'm on day 13 and for the last 2 days I have lost a lot of blood/tissue/clots and terrible stomach cramps- I'm still taking oestrogel/utro as before I haven't missed any doses and always take them at night before bed  - is this normal ?? I know it takes a while for the body to adjust - but this seems like a lot of blood to be losing it's just like the periods I thought I'd waved goodbye to ! I'm also getting a lot of headaches and sore / tender breast which seems  to be continual ... I have an appointment with my GP for July for an assessment but if anyone could tell me that this is a normal adjustment thing I'd be extremely assured.
Sorry for the long post,  but it's the facts as they are, and as I said to my GP this is for my sanity not vanity.

Thank you

[Mary G]

Patti, welcome to MM.  I'm sorry to hear about your grandmother, mother and cousin and understand you concerns.

It sounds like you are on the right track HRT wise but perhaps you need to review the progesterone side of it.  The breast pain and headaches are most likely due to taking so much Utrogestan, a lot on us on here take it cyclically so don't get these side effects.  Regarding the bleeding, perhaps you had some womb lining build up that is shifting - Utrogestan is very effective when used vaginally and there was obviously something there that needed to be shed. 

If you tolerate progesterone well then you might want to look at a continuous combined (bleed free) regime which means taking Utrogestan everyday with no breaks.  If the breast pain and headaches continue after a few months, you could switch to using Utrogestan cyclically which means 10 days every month but it would mean having periods again.  Unfortunately it's a bit of a trade off. 

The progesterone part of HRT is the tricky part and a lot of women on here have problems with it, myself included.  I am severely progesterone intolerant and only take a small amount every 5-6 weeks but I have regular uterine scans to check the womb lining. 

I hope that helps. 

[patti]

Thank you Mary G,

I really want this hrt to work,I dread having to go back to feeling like I did last year. My periods didn't stop until I was 54 , and for 18 months I felt great, no more jumping out of bed at night due to flooding, no more anaemia or cramping pain. But now at 57 I feel like I've taken a step backwards !

Stomach pain & blood loss has been awful today. So I'm still carrying on with the utro as normal tonight in the hope that after whatever needs to be shed, I will settle in to some kind of a cycle. Later, as you suggest cut down on the utro as I suspect that it is that causing the headaches and breast tenderness ( back to the sports bras at night) I don't think I can tolerate progesterone continuously.

Once again thank you ,I've learned so much from this forum, I wouldn't have had the courage to ask for HRT with my family history, until I found the knowledge on here and to go to my GP and ask for what I wanted - although at the moment seems to be a bit of hiccup !

[Hurdity]

Hi Patti



I agree that it might be preferable for you to go onto a cycle so that bleeding can be predictable and to minimise the side effects from near continuous progesterone. I would have thought that your headaches and sore breasts should have settled after two months if they are going to?

Re the bleeding - when you say it has happened twice on Day 26 - is this on the day after the last dose of progsterone - or before you've gone a night without taking it? If your lining has thickened (either after you went through menopause or during the time you are taking the HRT) then the 3 days break from progesterone will allow it to shed. This is a good regime for those who tolerate progesterone but get odd bleeding and spotting intermittently when on continuous progesterone. However if you are also getting the side effects I would definitely recommend taking the progesterone for 10 -12 days per month. 12 days of 200 mg is the licensed oral dose but some women are able to take less when used vaginally, and when on lower doses of oestrogen, with medical supervision (to check the womb lining does not build up).

You might also like to think about vaginal oestrogen too, such as Vagifem?

Sorry also to hear about your mother and other relatives and I presume you will be monitored regularly in the circumstances?

Hurdity x

Hurdity x

[patti]

Hi Hurdity,

My first cycle I started in Jan =days 12-18 I had light bleeding, plus days 27 & 28. I then started
Second cycle Days 1-3 still bleeding. Followed by days 21-23 spotting then days 26/27/28 bleeding
Third cycle Days 1&2 still bleeding. Ok then until day 11 started bleeding heavily and still am up to today - Day 15.

I'm hoping this is the purge, and things will settle down, but would definitely like to be able to take the progesterone for just 12 days instead of the 1-25 I'm doing atm ,as every morning I wake with a headache and just feel tired / fuzzy .

When would be best to start the 12 day regime and would the 100 mg be enough taken vaginally ? I don't fancy 200 mg !

Sore and tender breasts have always been a problem for me - I had a cyst in November last year and was sent for another mammogram/ultra sound but it was a small cyst just told to use voltarol gel when it gets too bad -( I thought all that would be done with after the menopause- obvs not!) I told the breast care specialist at the clinic how awful I felt and she told me she was on HRT, and she couldn't do her job without it.Which in way confirmed to me HRT was the only way to go, to have a quality of life .My GP surgery is good at appts to the breast clinic and have always had an appt within 2 weeks.
I'm hoping once I get the progesterone / bleeding sorted the breast soreness and tenderness will get better, if not I will just have to carry on with the voltarol.

By the way what is vagifem for ? And do you take with oestrogel or instead of ?

Patti x

[Hurdity]

Hi Patti - it is impossible to say what will happen as it is early days, and as you say hopefully the initial spate of bleeding episodes will diminish as the womb lining settles. The last thing you want is to have problems with the endometrium as well as having to keep a close eye on your breasts.

To take it cyclically - when you get to Day 26 stop the utrogestan as normal, reset your cycle ( assuming you are post-menopause) and when you get to Day 27 (say) count that as Day 1. Then on Day 15 start the utrogestan and continue for 12 days and hopefully your bleeds will become more predictable. In your position I would do 200 mg vaginally for the first few months if you can - since the longer cycle of 100 mg is still leading to spotting as well as bleeding.

re the Vagifem - that is vaginal oestrogen which plumps up the vaginal tissues which can get thin during menopause and lead to vaginal atrophy and dryness. Maybe you do not suffer from this? However I always try to make sure I increase my intake of Vagifem leading up to starting the vag Utro but I am on a long HRT cycle (under medical supervision) and only do the utro every 6-8 weeks.  This (long cycle) would not be appropriate for you at least not at the moment with irregular spotting and bleeding on your current regime. Vagifem can be taken alongside systemic HRT although maybe in your position it may be advised against having extra oestrogen - but very little is absorbed into the body.

Some women get temporary sore beasts with increased oestrogen and some with the progesterone. Mine always suffer with the progesterone - so taking it less often may be better for you in this regard too. I have always had lumpy breasts ( fibro-adenoma, mastitis when breast-feeding) so it is a bit of a worry for me when I get breast pain, but I always have regular mammograms and try to remember to have a good feel ....

Hope this helps and let us know what you decide and the outcome as to how you get on with any new regime

Hurdity x

[patti]

Thank you so much for your advice Hurdity,

I will go with the 200 mg utrogestan for the 12 days, hopefully bleeding will have abated and can get a cycle going -  so day 1 should be 25 March, day 15 then being 8 April. So fingers crossed !

Much appreciated

Patti xx