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[Hurdity]

Hello KC
I found your post fascinating, especially in relation to mcg equivalents to the OCP, as I was on Marvelon OCP pill (brilliant for years) which is a 30 mcg.
You say a patch 150 contains 150 mcg.  Sorry to appear stupid, but a patch lasts for 3.5 days, so would that be the equivalent release of approx 42.86 mcg per day ?
How many pumps would this equate to daily ?
Do apologise for bothering you, but this specific information is exciting me, as I have been unable to source it elsewhere in a comprehensive form.
Regards
JJ

Hi JayJay - you might also like to look at these links which give the brands and types of HRT that are available in UK.

The info on this site (Menopause Matters) gives the different doses as low, medium and high, - look at the diffferent tabs for oestrogen, for peri or for post and you will see the equivalents as it cannot be exact - just approximate

https://www.menopausematters.co.uk/treatment.php

Dr Louise Newson also lists the different types:

https://www.menopausedoctor.co.uk/menopause/hrt-the-different-ingredients-brands-and-strengths-available

Finally Dotty posted this link from the BMS which gives more info about the dosage especially for higher doses of gel:

https://thebms.org.uk/wp-content/uploads/2018/08/HRT-Practical-Prescribing-AUG2018.pdf

The thing is we don't usually have equivalents for the pill because the treatments are mostly in relation to HRT. Nevertheless there are some CCP types which are especially designed for peri-menopause as they contain estrdaiol the same as in HRT, rather than the stronger synthetic ethinyl estradiol for example. These are called QLAIRA and ZOELY (although not sure if the latter is still available).

The actual amount of oestrogen in the patch is way higher than the daily release rate and is not strictly comparable with other types of HRT on the basis of dose, except in terms of low medium or high.

Ah I see you're 59 so the pill is not appropriate!!

Hope this helps

Hurdity x

[Hurdity]

The progesterone is the creams is micronised so exactly like Utrogestan but in more normal quantities, rather than the overdose you get hit with on the Utro.

It used to make my cycles return to 28 days so defo not placebo. There is a lot of nonsense written about compounded creams and sadly those who haven't used them believe it, when they could in fact greatly help them.

Like any hormones though you have to get the balance right and that is tricky to do when they're surging about so much in peri and early post meno.

The point is the progesterone needs to be at higher doses in order for sufficient to be absorbed in order to protect the womb. In these circumstances it is essential that proprietary tested brands are used. Of course it is way more than "normal" amounts of progesterone as this is produced in pulses of smaller amounts by the ovary ( not sure how frequently) so we don't get a hit all at once.  If there was a way of mimicking this naturally with progesterone Lower doses in regular pulses) we would all be very gratefull!! ie like a Mirena or something slow release - or vaginal capsules that took a couple of days to release the prog.

OTC creams like I said are extremely weak which is why they're OTC. Compounded creams should not be used for endometrial protection because they are so variable in how much prog they contain -  this is the view of all the menopause societies. They are also extremely expensive and beyond the reach of most women and I would not want women reading this to feel that going down this route was the only way forward to achieve symptom relief. I am conscious that affordability is mentioned regularly when there is talk about eg buying HRT (with a prescription) from one of these online pharmacies at much greater expense than a normal prescription, and consultations with private doctors at compounding phamarcies is prohibitive for most. In my view this is and should remain a niche approach - until and if such time as standardised creams are available on NHS. Great if you can afford it and are happy with it!

Hurdity x

[Hurdity]

Dangermouse, well said, that is the most sensible view I have read on here regarding compounded progesterone, ever.  So many women put up with the dreaded Utrogestan (which is actually for pregnancy) when they could benefit greatly from a better form of micronised progesterone at a lower, more tolerable dose.

I think many of us are in agreement that lower doses of utrogestan should be available - well a 50 mg dose, and licensing for vaginal use made official. However the dose of Utrogestan for fertility/pregnancy purposes is 600 mg per day vaginally. Like I said in my previous post the dose of Utrogestan is higher than it needs to be especially when taken orally because it breaks down in the body so needs to be high in order that sufficient gets to the womb.

We do need proper studies too for vaginal doses for endometrial protection. There have been quite a few preliminary studies done - I've posted these - but why there is no furtheer work on this and no licensing in UK is beyond me 

Hurdity x

[KiltedCupid]

Hello Kilted
Do you know, I hadn't even thought of looking at the leaflet . . .
Your link is most helpful, so thank you.
Jay Jay

No problem JayJay. I hope it helps to clarify doses for you. I found it really useful.

[JayJay]

Hi
Have saved the link, and will be talking to gp tomorrow about blood tests.
Hopeful !
Thank you
JJ

[KiltedCupid]

Oh that's great JayJay. Fingers crossed you'll get the tests you need and you're then in a position to fully evaluate where you are. If you haven't had vit b&d, thyroid or ferritin and iron recently, I'd ask for those too. Good luck.

[Hurdity]

JayJay

Did you see my post in response to yours  about dosage - I did several posts in response to various comments but mine to you was further down so you might have missed it? The link I gave are from UK sites and about UK products whereas the one Kilted Cupid gave, although with some very helpful and relevant information, also refers to products not available here but in US only, hence my post!

I hope all goes well at the docs....

Hurdity x

[dangermouse]

Progesterone cream wasn't being discussed in the context of endometrial protection against high dose oestrogen HRT. However, some private doctors may use it in this way with bespoke doses of oestrogen, and some GPs prescribe off license testosterone to women.

It's a bit like how hairdressers use bespoke chemicals to dye hair, rather than the off the shelf safer bulk products tested in the factory.

It's a nice sentiment not to let women think they can't get what they need from the NHS (and any decent private doctor should not be doing that) but it's just as damaging to suggest that anything prescribed outside of the NHS is ineffective. Particularly as the NHS' motivations become more and more financially driven. We need more choice, not more restrictions.

[KiltedCupid]

Progesterone cream wasn't being discussed in the context of endometrial protection against high dose oestrogen HRT. However, some private doctors may use it in this way with bespoke doses of oestrogen, and some GPs prescribe off license testosterone to women.

It's a bit like how hairdressers use bespoke chemicals to dye hair, rather than the off the shelf safer bulk products tested in the factory.

It's a nice sentiment not to let women think they can't get what they need from the NHS (and any decent private doctor should not be doing that) but it's just as damaging to suggest that anything prescribed outside of the NHS is ineffective. Particularly as the NHS' motivations become more and more financially driven. We need more choice, not more restrictions.

Agree Dangermouse, all private gynaes should have a moral compass and in the cases of women who have little or no help from NHS medics, I'm sure the private sector is a blessing. I myself have considered the Marion Gluck or Jan Toledano clinic in a last ditch attempt to find a prog I can use rather than have a hysto. I'm not in London and don't have the time right now, but it's on my radar.

[Mary G]

Well said Dangermouse and KiltedCupid, we need as much choice as possible and the whole point of this forum is to make others aware of what is on offer. 

I use bespoke 50mg body identical progesterone every day as part of continuous combined HRT and it's absolutely brilliant, a real life saver in my case and it means I no longer have to consider a hysterectomy.   It also works well on the endometrium and my last scan after nearly a year of using the regime was 3.3mm - it doesn't get much better than that.

This type of progesterone doesn't have the same horrendous side effects that I had with Utrogestan but unfortunately it is not available on the NHS because it is expensive, not because it doesn't work, it very definitely does work.

I think a lot of women would be prepared to pay for an HRT regime that works and gives them their life back.   OK, there are some who can't afford it but many can and/or would be prepared to forego something else to pay for it and to be able to live again.  It costs me £40 which is a small price to pay to feel good.

I wish I had know more about this type of progesterone years ago.

[KiltedCupid]

Well said Dangermouse and KiltedCupid, we need as much choice as possible and the whole point of this forum is to make others aware of what is on offer. 

I use bespoke 50mg body identical progesterone every day as part of continuous combined HRT and it's absolutely brilliant, a real life saver in my case and it means I no longer have to consider a hysterectomy.   It also works well on the endometrium and my last scan after nearly a year of using the regime was 3.3mm - it doesn't get much better than that.

This type of progesterone doesn't have the same horrendous side effects that I had with Utrogestan but unfortunately it is not available on the NHS because it is expensive, not because it doesn't work, it very definitely does work.

I think a lot of women would be prepared to pay for an HRT regime that works and gives them their life back.   OK, there are some who can't afford it but many can and/or would be prepared to forego something else to pay for it and to be able to live again.  It costs me £40 which is a small price to pay to feel good.

I wish I had know more about this type of progesterone years ago.

That sounds great MaryG, I'll definitely rule out the MG or JT route before a hysto, I've nothing to lose. Also, just generally a good thing to have more options. Wonderful that you're feeling so good on yours and what an endo reading!

[Mary G]

Thanks KiltedCupid, 3.3mm is a very good reading but I used to go down to 2mm immediately post bleed on the 7 day 100mg Utrogestan regime despite cheating like mad!

Before making a decision on a hysterectomy, it would definitely be worth ruling out bespoke progesterone.   Because it is absorbed differently, it has a more beneficial effect and even if you are definitely progesterone intolerant, it will be a continuous dose which will be much lower than your own progesterone was before a period pre menopause.  You could well find it doesn't cause PMS.

Send me a PM if you would like further details.

[dangermouse]

I used to be a client of Jan Toledano, she is very thorough so you feel that you do get your money's worth.

That's great Mary G that you are getting 50mg of prog, as I know you very much need your oestrogen for your VA.

We do tend to have an issue in this country with investing in our own health and well-being, assuming it should all be covered by the Government. If I could afford it I would only use private healthcare (where possible) to take pressure off of the NHS.

Anyway, all very positive as more options give people hope!

[JayJay]

Thanks KiltedCupid, 3.3mm is a very good reading but I used to go down to 2mm immediately post bleed on the 7 day 100mg Utrogestan regime despite cheating like mad!

Before making a decision on a hysterectomy, it would definitely be worth ruling out bespoke progesterone.   Because it is absorbed differently, it has a more beneficial effect and even if you are definitely progesterone intolerant, it will be a continuous dose which will be much lower than your own progesterone was before a period pre menopause.  You could well find it doesn't cause PMS.

Send me a PM if you would like further details.



Hello Mary
Interesting post.
May I ask which 50 prog you are on, and how you obtain it if is not on NHS?

Thank you
Jay Jay

[jaycee]

BeaR, Once again i am confused re,hair loss and thinning, you said on Sammijanes post that testosterone is well known for hair growth,yet further down testosterone is said to affect hair loss if its too high
I think if there seems to be imbalance  surely Drs should give you a blood test,it would save all the changing and trying different patches etc,and be able to balance the two betterMine has been getting worse and worse so now i have stopped everything,vagifem and livial
My daughters hair is also falling out,it seems to happening a lot with HRT