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[PMB63]

Good Morning Ladies.  I really need some advice before my GP calls at midday. I'm 55 and Post menopausal. I've been trying several types of HRT in the past 3 years, but don't get on too well with tablets due to my hiatus hernia and acid reflux. At the moment I'm on Evorel Conti patches, but they are not helping at all. I've been on Evorel sequi  before, too but again I personally feel they're not strong enough. I've also trialled Femseven Conti in the past, they just kept coming off though. Last summer I tried Tibolone for 5 months and again still suffered with hot flushes and anxiety. My GP suggested last time to perhaps trial Venlafaxine (Antidepressant), but I'm really hoping that there's another possibly stronger HRT I could try before that.  Could anybody give me some suggestions worth trying please, bearing in mind that I still have a womb and need progesterone too. I don't mind a sequi Regime again, as I think I felt slightly better on it moodwise. Thank you so much for reading my post. Much Love P xxx

[Dotty]

Oestrogel and Utrogestan ( progesterone). It's worked for me where other hrt failed.

[PMB63]

Thank you 😊.  How much Utrogestan would I need to take?  And do you take it orally?  ☺️

[Dancinggirl]

Hi PMB63 - some women do have issues with absorption with patches.  Why not try Oestrogel with separate progesterone e.g. Utrogestan.  Utrogestan is licensed to be used orally but can be used vaginally, if used sequentially ( used continuously it can cause irritation), many women use it vaginally as licensed in other countries but I wouldn't mention this to your GP as it's not licensed to be used vaginally in the UK yet, for some strange reason!!!!
Here is the info on Utrogestan:
https://www.menopausematters.co.uk/to_progestogens.php

Utrogestan is under 'micronised progesterone' and as it's normally used for IVF treatment may not be under HRT treatments so you may need to mention that to your GP. 

Oestrogel applied to inner thighs each day can be very effective and you can start with 2 pumps per day for the first few weeks and if flushes are not under control then you can up the dose to 3 or even 4 pumps per day.

Another very good option is to have a Mirena fitted - great as it usually means you don't have any bleeding and you can use as much oestrogen as you need to control the meno symptoms(use Oestrogel) - so this is a good no hassle HRT regime. The Mirena delivers progesterone more locally, less is absorbed systemically, so will often mean fewer side effects.
DG x

[Dotty]

I take 100mg of Utrogestan for 25 days of each month.

[PMB63]

Thank you for your replies ladies. At least I know what to ask for when the GP calls. I'll give that 3 months and keep fingers & toes crossed it will help to ease my symptoms.   

[Dancinggirl]

Dotty - PMB63 suffers from acid reflux so taking Utrogestan orally for 25 days a month orally (this has to be taken on an empty stomach at night as well) might aggravate her reflux. This is why I was suggesting she does the 12 days each month of Utrogestan vaginally, to avoid it going through the digestive system.
Perhaps you use it vaginally 25 days each month? Do you get some bleeding?
However, many women find it irritates the bladder and causes some vaginal discomfort when used vaginally on the continuous regime.

Good luck PMB63 - let us know how you get on.  DG x

[PMB63]

Well that phone call which I've waited 3 weeks for was a waste of time. The GP wanted to give me tablets HRT and when I explained about my acid reflux etc she said I should come in and discuss this with my own GP. Next available appointment is on Monday 30th April at 12. The GP who called me today is the one supposed to have a special interest in hormones/menopause at the surgery. It's so frustrating....  And she's asked me to bring in several blood pressure readings to my next appointment.  I can't understand why it was ok for her to prescribe the Evorel Conti and Femseven but she wouldn't prescribe Oestrogel.  I bet it's down to costs and tablets are probably less expensive.  😡🤬🤯

[Dancinggirl]

Oh dear, another GP that isn't up to speed. Perhaps try to find out if there is a menopause clinic anywhere near you and ask for a referral. DG x

[PMB63]

Thank you DG. I will definitely do that when I get to my appointment. The joy of it all.... I'll be a man in my next life  😢 xx