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[Kathleen]

Hello ladies.

Can I pick your brains again ladies?

 I have just started on a new regime of 2 pumps of Oestrogel and Utrogestan which I am taking orally .  These past few days I have been feeling so hormonal I could burst! It's as if I have a tense, nervous headache but in my body. I could cry, I am very irritable and anxious with lots of internal shaking, I also feel slightly nauseous. Yesterday I felt awful in the morning and was really despondent but after lunch I was suddenly calm but so tired I couldn't get off the sofa for the rest of the day and today I've just had two mega flushes.I seriously worry that I'm going mad.

Any thoughts ladies on what I should do? I wonder if I should increase to three pumps and try Utrogestan vaginally ?

This whole rollercoaster ride has me exhausted and I  don't know which way to turn  so any insights from you lovely ladies would be very welcome.

Take care everyone.

K.

[Dotty]

Whatever you decide to do only change one thing at at a time or you won't know which one is working.

I wish I could advise you what to do for the best as I know you are struggling.  It could just be your body's way of getting used to the new hormones.

[paisley]

Hi Kathleen
How long have you been on this regime now?

[Kathleen]

Hello Dotty and Paisley and thank you both for replying.

Dotty- I take your point about only changing one thing at a time, I must try and be more patient!

Paisley- I have only been on this regime for two weeks, so early days I guess. I did however use Utrogestan vaginally with a patch some time ago but I had to stop when I had some spotting.

Thanks again ladies, your thoughts are much appreciated.

Take care.

K.

[paisley]

I can't help on the utrogeston because I don't have to take that anymore because I have had a hysterectomy. Before hyster I was perimenopause & the progesterone part of the HRT made me crazy. I couldn't take it.
With reference to the oestrogen part I can help. As it has only been 2 weeks that is far too soon to know if it is working or not & I would not increase anything yet. When I start a new HRT I always feel worse before better. I have more flashes, anxiety, weepiness everything. I am just sensitive to everything. I know when you feel bad you think that increasing it might help but hormones don't work like that. They like stability & at the moment the oestrogel is trying to stabilize in your body & if you increase too soon you are messing that up. I started a new HRT 12 April on lowest dose & only just increased it 10 days ago & even increasing gives me side effects. I know how hard it is when you feel awful & being patient is really hard xx

[Kathleen]

Hello again paisley.

Thank you for your very helpful  comments which make perfect sense.  I hadn't thought about the hormones needing time to stabilise, I just panicked because everything was becoming more unpredictable than usual and that's saying something! 

Thank you for being the voice of reason and wishing you well.

K.

[Tempest]

So sorry you're having problems, Kathleen!

Having read many of your posts, I really do believe that what you're having big problems with is fluctuations and the HRT staying stable - along with a hefty dose of anticipatory anxiety over the whole HRT business.

I know DG said a while ago that maybe you should try taking a break from HRT altogether, and I think this might be good - quite a few women have been pleasantly surprised post natural menopause how stable emotionally they feel when they come off and are truly post menopausal. There are no proven added benefits health wise regarding cardio. and bone protection post 60 years in any case, nor to mental health in post menopausal women.The mental benefits are possibly seen in easing and stabilising the fluctuations that women experience during the perimenopausal period.

I have actually just read a comprehensive study that stated that using relatively high ERT in oopherectomised or post menopausal women can actually induce depressiion and anxiety symptoms, especially if the level is significantly physiologically higher than might be considered normal. So for this reason alone, I would be very cautious about moving up to 3 pumps given your known sensitivity.

You can expect possibly some withdrawal hot flushes for a few months, but might it be worth you giving this a try rather than keep riding this rollercoaster? I'm sure DG would be able to give you some good tips, and she has had some good succes with using Promensil to manage the hot flushes she did get when she weaned off.

I know i'm possibly playing devil's advocate here but truly - menopause symptoms should dimish as we age in the majority of women, this is why it is suggested to take a break every few years to see how things are. Hope you didn't mind me sharing my thoughts. Good luck whatever you decide, Kathleen! xxxx

[Conolly]

Hello again Kathleen,


Sorry you're having a though time. progesterone is tricky. I have taken Utro (although briefly) and I thought that the vaginal route was better re nausea and suicidal thoughts 😱. I think the available doses (100 mg and 200 mg) were tested for pregnancy purposes (keeping the embryo) and are probably high for the simple purpose of keeping a thin endometrium during oestrogen replacement therapy. I tried alternate days and I felt better. The scans were all normal during this 3 month trial.


Hugs
Conolly X

[jillydoll]

Hi Kathleen
A few weeks ago, I mentioned I was going to up my dose on femoston conti,
and I did, however, at first, I felt like I was going to have a period, you know,
the feelings, low stomach pains, feeling heavy around the low part of the stomach,
back ache, ect.. but I didn't have one, those symptoms have gone now,
I also had,I can only describe as like waves of adrenaline surges, these too have past,
nearly, anyway, and what I do have isn't as bad, so maybe it is your body getting used to
the new regime.
I know it's not pleasant, but before you do anything else, stay put on this regime
else your end up making a mess and you'll feel even more worse....
As you say, you've got to be patient, which is so hard when you feel rubbish,
I know, but hang on in there , and NO, your NOT going mad.....
Good luck honey......hope it sorts itself out, which I think it will in a short time,
Thinking of you....sending   
Jd xx

[Kathleen]

Hello Tempest, Conolly and jillydoll.


Thank you so much ladies for taking the trouble to reply to my ramblings! Everyone on the forum has a different experience and point of view so all opinions are welcome.

Tempest -  I had been using Tibolone until recently and in May I stopped taking it and was HRT free for a while. The first few days were unremarkable but then I began to feel better. My flushes all but disappeared and my mood improved though I continued to have disturbed sleep. I dared to believe that I had finally turned a corner. After about ten days I had a return of all symptoms and that's when I decided to see a Consultant. My regime since that time has been two pumps of Oestrogel and  Utrogestan and unfortunately I haven't noticed any improvement to date.

Conolly -  I may follow your lead and try Utrogestan on alternate days. I think I will also book  a scan to make sure my womb lining is okay.

Jillydoll. - thank you for reassuring me that I am not going mad lol. At the moment I would settle for normal! I do need to be patient but it is difficult, especially as my search for an effective HRT has taken so long and  I'm still  having problems.

Thanks again ladies, your comments are much appreciated.

Take care all.

K.

[jillydoll]

Hi Kathleen,
I was thinking about you this morning, and hoping you felt a bit better.
How you feeling?
Hope your ok, any improvement on things?

Jd x

[Hurdity]

Hello ladies.

Can I pick your brains again ladies?

 I have just started on a new regime of 2 pumps of Oestrogel and Utrogestan which I am taking orally .  These past few days I have been feeling so hormonal I could burst! It's as if I have a tense, nervous headache but in my body. I could cry, I am very irritable and anxious with lots of internal shaking, I also feel slightly nauseous. Yesterday I felt awful in the morning and was really despondent but after lunch I was suddenly calm but so tired I couldn't get off the sofa for the rest of the day and today I've just had two mega flushes.I seriously worry that I'm going mad.

Any thoughts ladies on what I should do? I wonder if I should increase to three pumps and try Utrogestan vaginally ?

This whole rollercoaster ride has me exhausted and I  don't know which way to turn  so any insights from you lovely ladies would be very welcome.

Take care everyone.

K.

Hi Kathleen

Sorry for late response on your thread  - have only just seen this - I don't often look at this board and haven't been on forum! Also sorry to hear about your ongoing problems - I know you have suffered and have followed your story over the years.

I know I'm going to repeat myself here, but you did ask for suggestions before visitng the consultant and several of us did suggest the only way to know if it was the progestogen that was affecting you was to return to a cycle. I know that this is unpalatable for many women especially many years post-menopause but once you get over your initial shockl you get used to it! However it's not for everyone.

Gel seems to be one of those oestrogen treatments that suits some women very well and not others. Also some women seem to absorb the oestrogen incredibly efficiently and reach quite high systemic levels after only a small amount. This also partly depends on your height and weight. Some women get very high levels (much higher than I do - on one pump.

Continuous progestogens also may be making your symptoms worse.

Not sure I would increase to 3 pumps - yet - or if at all - until you have been on this regime for several weeks and if you are still experiencing symptoms then maybe a blood test ( not on the same arm you apply the gel  and - ideally 12 hours after applying it maybe?) would be helpful but I don't know how accurate they are especially with gel.

Taking oral Utrogestan (presumably 100 mg?) may make you feel irritable and anxious - I really don't know about the tension and shaking - is this a symptom of too high a dose of oestrogen? Nausea certainly is - at least initially. The oral progesterone can also leads to nausea and the fatigue is mostly likely caused by the progesterone - and taken daily could make it worse.

As you only started HRT a relatively little while ( late 50's wasn't it?) I wouldn't stop at this point to see where you are - because you haven't yet reached the point where your symptoms have been eliminated and it sounds like you are someone who is a long term flusher - if you see what I mean!

I also would not take alternate day utrogestan and especially not orally. Those doses of utrogestan are not for pregnancy purposes and have been tested extensively for the doses needed to keep the endometrium thin. There is limited research showing that taken vaginally, half the dose may keep the lining thin when compared to the same oral dose, but oral doses will no be sufficient to protect the endometrium taken alternate days - and may not even be enough to prevent spotting for that dose oef oestrogen - if you are a super-absorber.

In your position I would seriously consider trying out a cycle for a while ( if you can grit your teeth and bear it) - perhaps with just one pump of oestrogen for a few weeks and then introduce the utrogestan vaginally for 12 days per mont initially and see how you get on.

What you don't want ( and I'm not suggesting this is happening) is to end up on a very high dose of oestrogen at your age in the mistaken belief that you keep needing to increase in order to eliminate symptoms.

Give it a go for a while longer and see how you get on.

The other alternative if this doesn't work is to change to Evorel sequi - you never tried that did you? That way you could tell if the 50 mcg patch on its own was OK and then introduce the conti patch - or 50 mcg patch + Utrogestan cyclically, or Mirena and patch/gel! The possibilities are endless as I think we said before!!!

I do feel for you as it should be easy to  get this right but those of us ( most of us) with our wombs tend to have more difficulty finding the right HRT because of the dreaded progestogen and deciding whether to try to put up with the possible side effects from continuous use, or having the benefits of oestrogen only, with putting up with a bleed!!

Hope this doesn't sound too gloomy - I so want you to feel as good as I do which is why I always promote my regime ( of course just the best for me)  as we all do!!!

Apologies for long ramble!

Hurdity x

[Kathleen]

Hello jillydoll and Hurdity.

Thank you so much ladies for your replies.

Jilldoll. - thanks for your kind thoughts. I  was very jittery yesterday and had a massive flush in the evening so treated myself to an early night. I'm feeling a little bit calmer today ( so far that is lol).

Hurdity - many thanks for your considered response as always. I would like to try a cycle as it's one of the few HRT regimes that I haven't tried in the last five years but when I asked  my consultant at the Nuffield  recently she said that she didn't agree with that system and ' you can't keep scanning women!‘. So I felt I had to give the Oestrogel and daily Utrogestan another go. I was told to try Utrogestan orally first but vaginally if need be. I did begin with orally but I feel so awful I'm experimenting with vaginally again now.  I suppose I could easily be progesterone intolerant but as I mentioned in another post how would I know as I have always needed to use it daily.  I take your point about trying a sequi  patch which would separate the oestrogen from the oestrogen and whatever progesterone is used but that may mean I still have only two good weeks out of four, hardly an attractive thought! If  I could find someone to let me try the gold standard of a long cycle I would sign up in a heart beat. I am too nervous to travel far which is why I was hoping that Dr Imogen Shaw in Cambridge would be able to help me but her suggestion is to use more pumps of the gel. She emailed me the other day to see how I was getting on and to tell me that my estradiol level is 274 pmol/L , she added that I could increase to three pumps but no higher but she didn't explain why. For the past eight years I have tolerated flushes, panic attacks, anxiety, poor sleep, night sweats and mood swings.  I struggled on for the first three years because my GP at the time assured me that I would get better after that, infact it got worse and for the last five years I have patiently worked my way through various HRTs  none of which have  been effective in eradicating that most basic of meno symptoms, the hot flush! I dearly wish that you were a doctor  Hurdity and could prescribe  the very successful long cycle that you have been enjoying, good grief if Louise Newson's  mother gets to feel good on HRT why not the rest of us lol! So sorry for the long reply but I wanted to update you thoroughly as you were kind enough to give my plight your attention. I do appreciate your views and I will give the whole topic some more thought later today.

Wishing everyone well today.

K.

[Lisa1966]

Hi Kathleen,I also went to a Nuffield hospital in Leamington spa,I suffer as you do with anxiety and depression,the man I saw said my levels needed to be between 600 and 700 to suppress fsh to below 30,to help with my symptoms,I am on 4 pumps of estrogel and my level is 120,I have emailed him results and am awaiting a reply,will let you know what he says xx

[jillydoll]

Really hope you get sorted out Kathleen,
It really is horrible when we suffer like this,
and my god, you've certainly had your fair share......
Don't give up looking for an answer, there HAS to be one out there for you.....

Take care, keep us posted,

Jd x