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[Fairywoods]

Hi,

I'm 52 and think I'm very late perimenopausal (was having erratic periods, sometimes 3 months apart).  I've been taking Oestrogel/Utrogestan for 3 and a half months and I want to stop and see how I am without it, as now experiencing swollen legs, swollen boobs and weight gain.  I have been taking 2 pumps Oestrogel and Utrogestan 200mg for 12 nights vaginally.  Do I stop at the end of the 12 nights of Utrogestan? (currently on day 4 of the Utrogestan).  Do I continue with the Oestrogel until I have finished the 12 nights of Utrogestan?  Or should I stop the Oestrogel immediately?  I am thinking it's probably right to take the rest of the Utrogestan to make sure I have a bleed.

I was hoping I would feel better with HRT but the side effects are really getting me down.  Thanks for any advice x

[pepperminty]

Hi Fairy woods,

there is also the option of adjusting the regime, or trying a different method, such as patches. Or reducing the dose to a minimum and see how you go? But I understand wanting to stop as I did the same , but went back failrly quickly due to the return of symptoms. It can take a while to find the right combination.

Peppermintyx

[Fairywoods]

Thank you Pepperminty.

I have read so much on this site and also on Menopause Doctor (Dr Louise Newson) and there's a lot of positives for HRT, but I'm just fed up with it right now.  I really hate not knowing if the side effects I'm experiencing are down to the HRT or things that would be happening anyway.  At least if I stop, I can reassess and see where I'm at - I cannot bear the swelling and weight gain and also my knees are aching which I have never experienced before.  I want to lose weight this year, not put more on  .  I may well try HRT again when I am definitely post menopausal.

Do you know if I should finish the 12 nights of Utrogestan and if I should stop the Oestrogel staightaway now or when I finish the Utrogestan?  Thanks x

[Emerald2017]

I guess after finishing the cycle with utrogestan, you can give up your hrt completely.

[CLKD]

Can't help. Sorry.  Maybe ring a local Pharmacist for advice?

[Hurdity]

Yes if on sequential HRT and wanting to stop HRT, then always finish the utrogestan course so that you have your final withdrawal bleed (that's due to the HRT anyway).

What a pity it's not suiting you. Maybe the dose is too high for you - some women absrob the oestrogen from the gel very well but others barely at all. I'm not sure what the symptoms of very high oestrogen are as I haven't had them that I know of.

I started HRT in late peri-menopause and for me it was the best time to start. I began with patches medium dose and have been on patches at more or less this dose ever since ( 12 years ago). I did put up with flushes and sweats for a while before taking HRT though because I wanted to do it "naturally" but I feel I am doing it with bio (= body) identcial HRT as you are doing.

Even if you stop now - don't be put off for ever necessarily and maybe revisit this option further down the line and if symptoms become difficult to cope with?

Hurdity x

[Fairywoods]

Thank you Hurdity - you've made me think a bit more and I would be very grateful for your opinion on my questions below.  I think I may try reducing my doses before throwing in the towel.

I tried reducing the Utro to 100mg vaginally last night and I feel SO MUCH better this morning.  I am going to reduce the Oestrogel from 2 pumps to 1 pump tonight too and see how I go as I'm wondering if it's too much Oestrogel that's giving me water retention and swollen boobs.  The Utro is definitely too much for me at 200mg (terribly tired with increasing low mood the longer I take it) and I'm thinking maybe I am absorbing the Oestrogel well and that's why my boobs are swollen - maybe having been on it for nearly 4 months now, I'm 'topped up' a bit and don't need so much?  Who knows.

Hopefully if I continue with Utro at 100mg for the 12 nights and Oestro at 1 pump, I will still get a decent bleed.  I am slightly confused by the different things I have read regarding bleeds.

I have read that if you don't take enough Utrogestan then it might not trigger a bleed.  But I have also read that if you get spotting in between your bleeds (which I don't) then that's a sign of a too thick womb lining.  So I'm kind of confused that if you don't take enough Utro to trigger a bleed then surely you would get spotting in between as your lining would be building up?

If I take this reduced dose and don't get a bleed and don't spot during the following month then maybe that would mean my lining hasn't built up enough to bleed anyway?  The reason for this confusion is that I had a bleed first month, then no bleed second month (no spotting either), then a bleed last month.  This makes me think that my womb lining isn't building up that much anyway as I didn't have a bleed the second month.  Before I started HRT I was getting erractic periods sometimes 3 months apart which makes me think that at 52 I was very near menopausal.

I know using only 100mg for 12 nights is going off license but I think you and others do this and even extend your cycles (not that I'm intending to do that yet).  Do you arrange for scans to check your womb lining with this regime?

Thank you very much for any thoughts.

[Hurdity]

Hi Fairywoods

Usually it is more likely - say - if you are not quite taking enough progesterone - that you would still get a bleed if the lining has built up sufficiently, but that it wouldn't all come away so that the lining might thicken despite taking the progesterone. Once it has thickened too much then that's when you can get spotting and bleeding in between periods and at the "wrong" time eg during the prog phase - because the lining then comes away sporadically. However from what I've read you can't say at any particular thickness it will start to come away as this will vary amongst women.

As I expect you know progesterone changes the structure of the lining that has built up from oestrogen and starts to get it ready for pregnancy. When the progesterone is stopped this signals no fertilisation and the lining comes away. However the dose of progesterone needed to change all the lining is dependent on the dose of oestrogen (more prog needed the higher the oestrogen dose), and also the duration - eg if you took prog for 3 days this woluldn't be enough for most HRT doses - which is why there is a recommended minimum duration as well. Hope this helps explain?

Yes you could try reducing the oestrogen dose as well as the utrogestan dose to 100 mg ( if using vaginally) - this  latter would be off licence so with permission of your doc if it work. Then see how you feel and take it from there?

Do let us know how you feel and what you decide and hope your symptoms ease soon.

Hurdity x

[Fairywoods]

Hi Hurdity, thank you very much - I wasn't aware of exactly what the Progesterone did and from what you say I really shouldn't reduce the dose unless my GP agrees.  I saw my GP for my 3 month review a couple of weeks ago but she was running 40 mins late and so I didn't get much of a review.  I did ask if I could reduce to 100mg Utro but she wasn't happy for me to do so as it's off license.

I think I will stop HRT for now, once I have finished this Utrogestan phase.  I can't continue feeling so tired for two weeks every month.  Before HRT, I was tired due to night sweats but this is far worse.  Even though I am taking the Utrogestan vaginally it makes me feel utterly exhausted and depressed which isn't like me.  So stopping for now seems best, here's hoping the withdrawal after only 4 months on HRT won't be too bad 

Big thanks to you and everyone on here for sharing your knowledge and experience xx

[pepperminty]

Hi Fairywoods,
Have you tried provera instead? it is an alternative to utrogestan.

PMX