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[Vicky81]

I think you just need to choose a regime and give it a chance - it is reasonable to test a new hormonal treatment for 3 months or so (unless there are intolerable side effects that clearly started only after initiation)

It can take weeks to achieve ovarian suppression, and I hesitate to use that term with slynd because whilst it stops ovulation in the majority, it still permits a degree of ovarian activity otherwise it could not be used as a sole agent in birth control as all those young women would end up with osteoporosis. Same as a single dose of desogestrel.

If you want true ovarian suppression I would suggest 150mcg of desogestrel (2"cerazette pills) daily, alongside whatever estrogen you choose.

The post above is semi correct in very simple terms that taking continuous progestogens negates some but not all the health benefits of estrogen by down regulating receptors.

However there is always a tradeoff to be made - if you want ovarian suppression and hormonal stability for overall quality of life, mental health, avoiding bleeding etc the progestogen does have to be taken continuously.

I am on a combined pill for ovarian suppression and I accept that in order to reap the benefits.

If you preferred you could do a cyclical regime but this wouldn't shut off your own hormonal fluctuations and could lead to chaotic bleeding and more mood instability.

Sorry what do yiu mean down regulating receptors?

[Vicky81]

I’m sorry you’re feeling so anxious. I have a lot of problems with progesterones making me drowsy so I take it in the evening- I find about 6pm is good. I thought I’d suggest that as you said you had taken it in the morning. I think it will take at least a few days for you to get used to it- maybe even a few weeks or more for the drowsiness to settle completely. I don’t have any experience with slynd in particular but it’s next on my list to try. I think it’s good for people who are sensitive to progesterone so hang in there and hopefully it will slowly improve. You probably need to give it some time for it to suppress the bleeding as well. Good luck x

Kizzie have yiu tried cerazette? Did it make yiu fatigued??? I only want to try 75mg

[Vicky81]

Liz did cerazette make you fatigued? Which one gave you fatigue?
Bombsh3ll what did yu make of cerazettre? Did it make yiu fatigued? I dontvknow what to do now cos of the suppression thing you said xx

[Vicky81]

I think you just need to choose a regime and give it a chance - it is reasonable to test a new hormonal treatment for 3 months or so (unless there are intolerable side effects that clearly started only after initiation)

It can take weeks to achieve ovarian suppression, and I hesitate to use that term with slynd because whilst it stops ovulation in the majority, it still permits a degree of ovarian activity otherwise it could not be used as a sole agent in birth control as all those young women would end up with osteoporosis. Same as a single dose of desogestrel.

If you want true ovarian suppression I would suggest 150mcg of desogestrel (2"cerazette pills) daily, alongside whatever estrogen you choose.

The post above is semi correct in very simple terms that taking continuous progestogens negates some but not all the health benefits of estrogen by down regulating receptors.

However there is always a tradeoff to be made - if you want ovarian suppression and hormonal stability for overall quality of life, mental health, avoiding bleeding etc the progestogen does have to be taken continuously.

I am on a combined pill for ovarian suppression and I accept that in order to reap the benefits.

If you preferred you could do a cyclical regime but this wouldn't shut off your own hormonal fluctuations and could lead to chaotic bleeding and more mood instability.

Do yiu think I shoukd try a 75mg cerazette today just to see? .that's what Mary G was on and it suppressed.  Just to see if it makes me fatigued or not.....as I have til 22nd til they wabtvme back at work and I'm in a mess wondering about what to take now.
Cerazette sounds better the way you describe bomb...... shoukd I try?

[Vicky81]

Update - I'm going to start 75 cerazette tomorrow I've just taken Slynd.....abd I'm absolutely bulk crying ....all u ladies recommended cerazette so il try this but I want to know did it make any of you fatigued?
I've chosen to do this too as bomb saud earlier the suppression side is a bit sketchy so I don't need this at all
...worried about work and getting myself straight ......I've honestky just cried so hard after taking the Slynd I couldn't breathe. 
Any thoughts? I hope I'm making yhe right choice .....I think I am after whst yiu ladies have saud about it xx

[Vicky81]

Just start it now, there is nothing to gain by waiting.

It is unlikely to stop the bleeding straight away but it should lighten and tail off over the coming days.

It might take a few weeks but if you take the slynd consistently every day with no breaks, most women are bleed free after the first few months, and those who aren't generally only have light occasional bleeding or spotting.

Bomb can j adk did cerazette ever give yiu fatigue ? Thanks hun xxxxim starting it tomorrow you see

[dangermouse]

Vicky, Bomb is much better at explaining the science in detail but the down regulation means that when there is too high of something, the receptors down regulate to try to keep levels at whatever they are perceiving they should be - so not necessarily balanced otherwise we’d all have perfect hormonal balance forever!

Whatever you decide to do, try to change your self talk that you ‘must’ be ok for work next week etc. what that does is make you feel in a panic, whereas if you say to yourself:

I’d really like to feel ok for work but I might not by next week and that’s ok as I am looking ahead at the long term relief. I know that it will take time for regimes to settle and the less I focus on it needing to work, the more in control I will feel.

This is the true statement whereas the ‘must get better’ is not. Work can be a good distraction from what you have been overplaying in your head so also tell yourself that, because it is a fact.

When feeling in a panic, for now, just keep repeating to yourself that everything will be ok, not perfect, but ok. You will notice feeling calmer and more able to cope.

[bombsh3ll]

I didn't have any bad effects with cerazette (I had been on marvelon for several years which contains a double dose of cerazette plus estrogen) it just didn't meet my needs.

I went on it during the pandemic when I temporarily lost access to my combined pill. A single dose failed to shut me down, I had regular periods through it and after 3-4 months had developed an ovarian cyst, producing estradiol levels consistent with being 12 weeks pregnant!

I had no symptoms and only discovered this after taking a blood test.

I then went up to 2*cerazette daily which is supported by the FSRH for ovarian suppression. This shut me down nicely, (estradiol levels of 44pg/ml and quiescent ovaries on scan) and I still had no symptoms, however I was and will never be willing to live with such low estrogen levels long term due to the health risks, so as soon as I could I went back on combined pill Zoely.

In your position, I don't know your age, I am 45 but if you are under 50 and healthy I would seriously look into Zoely which is a combined pill with body identical estradiol and a really kind progestin NOMAC that is favoured by those with mood disorders and progestogen intolerance.

Because this is 17 beta estradiol not ethinylestradiol it doesn't meaningfully elevate SHBG which I know you have been concerned about. Mine is actually at the low end of normal.

[Vicky81]

Aww thanks both ....but I think il give cerazette a ho today jhydt to see I'm z bit scared of any side effects but il let u know xxxx thsnk you xxxx
I'm 44 by the way bomb.
You both gave great advice.
So zoely suppressed your ovaries abd still does? Abd the estrogen in this won't up my SHGB? X