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[Sally S]

Hi!  I follow the Menopause Doctor on Insta and a lady called Liz Earle suggested that Oestrogen gel and micronised progesterone Utrogestan capsules were the gold standard if you can take HRT.  Does anyone feel that this is preferable to the oestrogen patch?  Also, if I took the Utrogestan, this is apparently safest to take with regards to any BC risks but it wouldn't cover contraceptive needs, I'm guessing?  So, would I have to give the micronised progesterone a miss and use something such as cerazette (12hr progesterone only mini pill that is synthetic)?  I'm planning on seeing my GP but would like all the info I can get in case they aren't up to date with peri-menopause matters as often seems the case. Thank you for any tips!😊

[Sally S]

Thanks for the info, Stella.  It sounds like trial and error- I probably have a way to yet unless I'm just lucky and find a combination that suits me.  I definitely want to go down the route of gel or patch as opposed to tablets as they seem a safer way to use HRT.  I'm only 44 but just tired of being tired amongst other peri menopause symptoms.  Also does this sound familiar to anyone.....I am suffering less with symptoms now, than I was four years ago when looking back, I think were the start of peri-menopause symptoms.  I still have a very short, two day period each month.

[Hurdity]

Hi there - I use patches and have done for most of the 11+ years I've been on HRT. I briefly tried gel a few months ago but didn't like it - althogh I'm sure I would have been fine with it had this been the only oestrogen I'd used. Gel is not any more "gold standard" than patches - what she means is that bio-identical oestrogen and progesterone and especially transdermal oestrogen ( patches or gel) is the most natural way to take HRT.

Definitely does not cover contraception. The mini pill as such is not licensed for HRT as it is not high enough progestgoen although some women have been prescribed eg double pills off licence - I think there might be someone on here on two Cerazette? You could have a Mirena coil fitted which covers contraception and also protection of the womb from oestrogenic stimulation - then you just add oestrogen patch or gel at the dose needed. Yes they are all synthetic unfortunately - Mirena and mini pills.

Hurdity x

[Sally S]

Hi there!  Thanks so much!  You are obviously a bit of an expert in HRT- I've seen a lot of your sound advice in other posts.  I didn't know that Cerazette would be ok for contraception but not high enough to protect the womb- thanks for that info.  I've just read tonight about cyclical HRT - are you aware if this is less likely to make you tired than the taking the progesterone continuously (I'm 44 and think I've been in peri-menopause for about 3 years.  I don't want to be anymore tired than I am if the continuous HRT may counteract the oestrogen!!!  Thanks, Hurdity! 💐

[Dancinggirl]

I can recommend having a Mirena as I found this the best HRT combination with Oestrogen alongside as gel, patch or pills. The Mirena is good in both peri and post meno but has the advantage when in peri meno of giving contraceptive protection. There tends to be less systemic absorption so will usually give fewer progesterone side effects. DG x

[Dotty]

Hi if you are in peri then you would take the Utrogestan sequentially. I believe that you can take the mini pill as well for contraception .

I use Oestrogel and Utrogestan and it works brilliantly for me. Try not to read the horror stories about it. Lots of ladies use it both peri and post menopause . X

[Dancinggirl]

I personally wouldn't do a sequential hrt regime together with the mini pill - this would be way too much progesterone and might really zonk you out.
If you do need Oestrogen to help with flushes and other fluctuations in your oestrogen levels, then the Mirena with seperate oestrogen would be the least hassle. You could start on a low dose of oestrogen and then increase as and when you needed. DG x
DG x

[Sally S]

Thank you Dancing Girl and Dotty!  That's really helped me decide which way to go.  I'd not considered the mirena coil as I've always been on cerazette or similar.  If the Mirena is releasing fewer Progestogens into the body than the cerazette pills I was on then maybe I will have less side effects....I can't take being anymore tired than I am!  My ideal would be the oestrogen patch and Utrogestan, natural progesterone but then I would have no contraception.  Hopefully this will not affect hair loss as I have been shedding a fair bit of hair since September and I now daren't get my hair highlighted next month now!  Glad all this HRT business is working for you both- how better you must both feel!😊

[SueLW]

Hello

At your age (or close) I had the Mirena fitted for worsening periods with peri-menopause.  It took a couple of months to settle for me, with spotting and feeling flat in that time, but after that it was great.  It will take care of your birth control needs and give you womb protection.  Then use the patch or gel to help you overcome the other symptoms.  Your own cycle will continue so you will get good and bad days but this is a very flexible method. 

I now use gel and Utrogestan but I'm 55 now and post menopause.  I've not ruled out another Mirena in the future.  But for now this is fine.

[Sally S]

Thanks, Sue!  Sounds like this is the way forward for the peri-menopause at my age.  Did you know when you'd gone through the menopause though?  I still have a small period each month at the moment.

[Dotty]

This is on Dr Newson's website:


If you are taking HRT then you can also take the progesterone only pill or have an IUCD or IUS inserted if you require contraception.

[Sally S]

Dr Newson's site is invaluable!  I just hope GP can offer up to date advice/views on all of this when I go next week otherwise I guess I'll have to down the private route which is unnecessary! Thanks for the info.