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[Findtyler]

Hello All

I have been using bio-identicle HRT since August 2017. I started with no testosterone left in my system and normal levels of eostrogen and progesterone. I was informed the meds would take approx 12 weeks to work. All was going in the right direction until my quarterly bloods in Jan 2018, when I was informed I wasn't absorbing the meds and advised to increase the dose.

I now take 1.00mg of Androfeme1, 200mg of Utrogestan (increased by 100mg by my G.P, without a pathology report as she didn't want me inserting oral tablets vaginally, as advised by my Consultant) and 3.00mg of Sandrena.

Has anyone else experienced not absorbing HRT and do you know why and if anything cam be done. I am 14 months into this process now and still waking up on the hour every hour. I seriously need to sleep. Not to mention the hives and dermatitus that keeps me awake.

Any feedback gratefully received.

[Daisydot]

Hi there  .I can't help you with this one but one of our experienced ladies will come along soon to help you I'm sure.all I can say is another dozy gp who thinks she knows better than a consultant outrageous.good luck xx

[dangermouse]

Have you tried applying it to other areas of the body or choosing a different site each time?

I think if you use the same one the fat cells may hold onto it too long. I think with oestrogen it's better on the lower body and for all transdermal are better where less hair follicles (thighs, back of knee, feet).

[Hurdity]

Hi Findtyler - what do you mean by "normal"? Do you have blood readings? Sorry but that means nothing if they have said that! Levels of oestrogen and progesterone will vary according to when in the menstrual cycle the measurements were taken and/or wherabouts in the menopause journey you are ie how long since last period. Also depending on how old you are 2 tests should be carried out ( if under 40 or very early 40's).

If levels were normal then why did you start HRT? Were you experiencing menopausal symptoms and have they returned? Most docs will go by symptoms, age and cyclical changes to decide on dosage of HRT and you shouldnt need to have blood tests. it can often be trial and error especially during peri-menopause.

If you are taking 200 mg progesterone every day orally then that is way above the recommended dose - although if you are having that much Sandrena you maybe need plenty of prog to protect your womb lining! I wouldn't want to take that much every day. When used vaginally it is exactly the same capsule! Although not licensed for vaginal use in UK it is in other parts of continental Europe and is backed up by research studies. Many gynaes prescribe it vaginally for women who experience side effects from oral use.

Hurdity x

[Findtyler]

Hi Hurdity

I will need to look at my pathology report which is scanned onto my hard drive to check for eostrogen levels. I'll upload tomorrow.

I don't have a known menstrual cycle as I take Cerezette. Although I am seriously considering coming off it to see.

I am 47 and am tested for thyroid, eostrogen, progesterone and testosterone.

I started HRT because I had no testosterone left in my system. Eostrogen and progesterone were normal until my last bloods, where I had lost most of my eostrogen, hence the increase in dosage. My menopausal symptoms were off the chart - sleep deprivation, hair loss, restless legs, migraines, weight gain, chronic fatigue, brain fog, clumsiness, low mood. Its the sleep deprivation that effects me the most.

I see a Consultant and asked him to put my prescription through my G.P as it's so expensive. I had adverse side efdects to taking the 100mg Utrogestan orally and my consultant said I could insert them vaginally. When I went to get my prescription filled via my G.P she wasn't hapoy with me inserting oral tablets vaginally and prescribed the vaginal caplets that only come in 200mg.

Do you know why I might not be absorbing the meds?

[Findtyler]

Thank you to everyone who answered. I couldn't work out how to respond individually. 

[Dotty]

If you are taking the mini pill and utrogestan then you are taking an awful lot of progesterone .

You don’t need the vaginal capsules . They are not licensed for hrt. You just use the 100 mg capsules vaginally.

You should listen to your consultant as he is the expert.

Who took the blood tests ? Blood tests are highly unreliable in peri menopause.

[Findtyler]

Hi Dotty

Thank you for coming back to me. My consultant takes the bloods to check my hormone levels. It was the bloods that determined my testosterone and now eastrogen levels were undetectable and the dose increased.

Do you know why I am not absorbing the HRT?

[Dotty]

Hi I don't know why you aren't absorbing them. I just know that blood tests are unreliable especially in peri menopause  but I'm not a doctor . I had a blood test after a month on testosterone and was told to increase the amount but I didn't have oestrogen tested . Most go on symptoms.

Have you tried a different place to put the gel . I put it on my shoulders and backs of arms. When I put it on inner thighs I found that my flushes came back.

I use 4 pumps of Oestrogel with 100 mg of utrogestan for 25 days each month.

[aspie65]

I am not absorbing oestrogel well either.  I have tried arms and thighs (but not shoulders, thanks for that Dotty, will try that tonight) and it makes no difference.  It is frustrating but I have no explanation other than I am just unlucky!

[Hurdity]

Hi again - are you in UK Findtyler?

As Dotty says that is an enormous amount of progesterone!

If you have been on the mini pill and have been on it for some time and are still on it - it oiften suppresses ovulation and also depresses oestrogen levels - not a good idea if you are heading for menopause,  or probably not at any time!

This is what it says in the SPC:

"Treatment with Cerazette leads to decreased estradiol serum levels, to a level corresponding with the early follicular phase. It is as yet unknown whether the decrease has any clinically relevant effect on bone mineral density."

I find it incredible that you are taking presumably 200 mg utrogestan every day vaginally as well as Cerazette. Your poor body!!! No wonder you have all those symptoms - which may well be due to too much prog. Not sure what effect Cerazete has on exogenous ( externally applied) oestrogen as opposed to your own endogenous oestrogen (that you produce)? If you are under a meno consultant ( NHS or private?) then there must be a reason for this eg very heavy and lengthy bleeding in your case, or maybe because you need contraception as well? If so the Mirena coil would be a better way of acheiving this than all that prog.

Presumably also you have no idea where in menopause you are?

Yes I would want to stop the Cerazette but you still won't know where you are in menopause unless you stop all HRT. The main thing is to replace oestrogen and reduce the amount of prog so that you feel good without too many side effects. I presume you haven't  had a bleed for some time and that probably doesn't appeal to you? However it may be the only way to reduce the amount of  progestogens in your system ie cyclical HRT where you have NO  progesterone for part of the month (16 + days) and then have a withdrawal bleed.

These are all things to discuss with your consultant and hopefully you can find an improved hormonal regime that enable you to function better than you are now, with less tiredness and brain fog.

Hurdity x

[Findtyler]

Hi Hurdity

Thanks for coming back to me.

I have my latest bloods but can't work out how to upload them here? I have redacted them if you know how to upload images?

Yes I am in the UK under Nick Panay. Who prescribed 1.0mg of Androfem1, 3.0mg of Sandrena and 100mg of Utrogestan. My G.P decided to change the Utrogeston dose from 100mg oral tablets inserted vaginally to 200mg vaginal pesaries - because she was concerned I wasn't absorbing the progesterone - depiste my pathology report saying otherwise. Today she wanted to prescribe 50mg of Sertraline for insomnia, although I can find no evidence to support this.

You are right about the Cerezette.  I take it for contraception and haven't had a bleed in over a year. I will gladly come off it of it means I get my health back.

I am concerned my G.P is putting my health at risk owing to a lack of expertise.

I wonder of the progesterone/Cerezette is the issue. I will certainly email Nick and ask.

[Dotty]

What were her reasons for not thinking you were absorbing the progesterone ?

[Joaniepat]

Findtyler, I was interested to see that Nick Panay prescibes AndroFeme. I hope you don't mind me asking, but do you see him privately or at his NHS clinic? (I am an NHS patient at his clinic in the Chelsea & Westminster.)
Thank you.
JP x

[Findtyler]

Hi Dotty
My G.P. said I would need to ask my Consultant as to why I am not absorbing the meds. I have asked my Consultant for an earlier appointment and will raise the point with regard to Progesterone. The trouble is I dont know how much is too much. So iys difficult for me to challenge. I spoke with a Consultant Psychiatrist I know who agreed Sertraline can cause not cure insomnia and not to take it, especially as I am waiting to see if the meds are working.

Hi Joaniepat - I see Nick privately as I wasn't able to see him on the NHS.