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[Jasmine_2015]

Hello,

I am just about to switch from Everol Conti to Oestrogel and Utrogestan. I am 28 and taking them for osteoporosis rather than the menopause (I've never had a period due to anorexia). I haven't been given any advice about dosage so am feeling a bit on my own. My next appointment with the gynaecologist is not until June although I'm hoping to get another appointment before then.

I was thinking I'd start with 2 pumps of the gel and 1 x 100mg Utrogestan continuously? Does that sound right? If doing it continuously do I stop taking it at all even for a few days?

I wanted to take it vaginally because I struggle with IBS so wanted to minimise any side effects. I'm hoping it's relatively easy to insert? A bit concerned about getting thrush too!!

Any advice on dose, administration etc would be very much appreciated. Also would there be any pros in taking a break? I would prefer not to have a bleed because I've never had one and worried about the bloating but I don't know what is best health wise.   

Thank you for reading, I do hope you don't mind me posting on here again given my slightly different background. I do really appreciate the support you have given me so far as I feel very alone and confused with things at the moment.

[SueLW]

2 pumps a day is the standard dose, but if I were you I would start with 1 pump for a week, perhaps 2 weeks, to ease your body into it slowly.

Vaginal Utrogestan is good.  But I still get PMS symptoms from it.  Bloating, fluid retention, mood swings, fatigue, random bleeding, stomach pain etc.  I've given it 6 months, but in early February I'm having a Mirena coil fitted instead so I can stop the Utrogestan altogether. I've had that coil in the past and so I'm hoping it will stop the PMS symptoms for me.  You could have the same if you don't get on well with Utrogestan. Many women are fine on it though, so don't expect problems. I'm just giving you alternatives if you need them further down the line.

If you do suffer any bloating, remember that it's fluid not fat.

[Jasmine_2015]

Thank you both so much. This is really helpful and reassuring. I will just have to give it a go and see how I get on. I think I will start with 1 pump initially but try and quickly increase. I should think I will need at least two pumps because my last oestrogen level on half an everol conti patch was only 52 although I'm not quite sure what I'm supposed to be aiming for!
I had started on half a patch to ease me into that but I have now had a break with no oestrogen so will be starting from scratch again.

I really appreciate you taking the time to respond, I can't tell you how comforting it is just to be able to talk to others and ask questions.

[LucyLoo]

Hi Jasmine,

I am taking oestrogel and utrogestan for osteopenia and severe PMS rather than for menopause symptoms. I am 42 and have had regular periods since having children, but in my twenties I rarely had periods due to being underweight. I haven't suffered from anorexia but in my twenties I didn't eat well and aimed to stay thin. I gained weight in my 30's and my periods returned but I think the lack of periods in my 20's are likely to have contributed to my osteopenia. I therefore wanted to say hi and that I really hope the oestrogel helps your osteoporosis.

I take 4 pumps of oestrogel. I started on 3 but found I needed 4 to combat my PMS symptoms. My oestrogen levels are now much higher than they were but I'm afraid I can't remember the numbers! I take utrogestan for 7 days per month vaginally before bed. I then have a period about 4 days later. I do have PMS symptoms and feel tired and grumpy when I take the utrogestan which is why I don't take it continuously. I find when I take the utrogestan I do feel a little bloated and my breasts swell (which are normally quite small) but it's not too bad and my clothes still fit (I can do my jeans up!)

I am personally considering the mirena coil as an alternative to the utrogestan. I did try and have it fitted twice last year but the doctors couldn't get it in due to my uterus being extremely backwards tilted! I'm now considering their recommendation of a hysteroscopy to have it fitted.

I really hope the oestrogel and utrogestan works well for you. I did get thrush when I started but it cleared up in a week - I think it was just the adjustment to the hormones, I haven't had it since. Also I find peppermint tea has helped my IBS hugely.   
 

[Jasmine_2015]

Hi LucyLoo,

Thank you so much for saying hello and sharing your experience with me. It's really helpful to hear that there are other options and ways of taking the hormones. I feel bad about not getting on with one regime and asking to change but it's reassuring to hear I'm not the only one who has to change things to find something that suits. It's also very reassuring to hear that you had to go up to 4 pumps of the Oestrogel because I have a feeling I may need quite a lot. Do you get advised by a gynaecologist or your gp about dosing for he oestrogen and Utrogestan or have you just adjusted yourself?

Thank you for the reassurance about the thrush too! I'm going to start tomorrow. It was meant to be today but then I convinced myself it was better to start on a Monday!! 

[Jasmine_2015]

Thank you Birdy, I shall definitely look into that!

[LucyLoo]

Hi Jasmine,

I originally went to Mr Panay's PMS clinic via the NHS, hoping to get prescribed HRT, but was prescribed the contraceptive pill continuously which I didn't get on well with (and at this point I didn't know I had osteopenia). I then decided to go private and went to Professor Studd's clinic which was expensive but I was pretty desperate. I saw a gynae called Neal Watson (and at my next appointment Mike Savvas) and they prescribed me the standard Prof Studd regime of 3 pumps of oestrogel and 7 days of utrogestan per calendar month. They also gave me a bone density scan (they luckily didn't charge me for it!) which is when I discovered the osteopenia which explained the hip pain I'd been getting.

The nurse at the clinic afterwards suggested I start with 2 pumps of oestrogel for a week and then go up to 3, which I did. However after about 2 weeks of the 3 pumps of oestrogel I felt exhausted and had PMS symptoms so I wondered if I wasn't absorbing the gel that well and needed more. I emailed Prof Studd's office, asking if I could try 4 pumps and he replied yes, so I went up to 4. Once I was on 4 pumps I felt a lot better. I do sometimes worry it's quite a high dose - I put 1 pump on each upper arm and 1 pump on each inner thigh every morning - but then I think I've read that it's still a lower dose than the amount of oestrogen in some contraceptive pills. I think everyone's so different and it's trial and error at the beginning, depending on how well you absorb it. My arms are pretty skinny so I think perhaps that's why I need more! I haven't had a second bone density scan yet but I'm hoping it's helping.

For me, the part of the HRT I struggle with is the progesterone as it gives me PMS symptoms. I feel good when I'm just on oestrogen.

Best of luck with starting your regime tomorrow Jasmine. In my experience so far, I think when you first start with new hormones there can be some side effects but once your body adjusts you will hopefully feel good.

[Jasmine_2015]

Hi Lucyloo,

Thank you so much for getting back to me. I have been considering trying to go to a private gynaecologist. Interestingly I asked my gp last week to refer me to dr Panays clinic on the nhs but she wasn't sure if it would go through the panel as they have to submit all referrals to a panel these days. I might look into those others you mentioned, it's good to get a recommendation because it's so expensive!

Thank you again!