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[coldlittleheart]

I've started hrt in July, I was given progynova 2mg and utrogestan 100mg. My GP eventually agreed to switch me to Oestrogel which I have started two days ago, but I am not sure about the dose on that, the prescription says 1 pump then increase to 2 of 1 is not sufficient. I noticed that my hair has been shedding more in the past week or two, and I am always exhausted. I already have a chronic condition that causes fatigue so things are feeling worse. I am hoping things will improve with Oestrogel as it is a little more flexible than tablets? I am not sure what to do, I am currently on one pump, and I am not sure it is enough. Not sure how long to wait either. I suspect there will be a slight drop in my estrogen levels on one pump since I was on 2mg progynova?

So I had spotting which got heavier on the 9th sept. That lasted about 3 days. It started again 3 days ago. I'm not sure how long this is going to last or how long is ok. Question: Do you use Utrogestan vaginally if you have a little bleed? I read that bleeding is not unusual in the first few months so I am not overly worried but I don't know if the progesterone will get absorbed as well if there is bleeding and whether I should take it orally when there is bleeding? What do you do? I am all new to this HRT thing, and I find it a little confusing. Any help please?

[Dotty]

Hi

The equivalent to a 2mg tablet is 2 pumps of Oestrogel so it's likely that you are not getting the same amount of oestrogen.

Bleeding can happen in the first 6 months of any new hrt regime. After that you would need to get it checked.

I take Utrogestan orally so cant really help you on your questions about it,

Keep asking questions 😄

[coldlittleheart]

Hi - yes it can definitely be confusing!

2 pumps of gel would give you closer to the 2mg Progynova dose.

That's what I thought. 2 pumps would be 1.75mg if i remember correctly?

The side effects you describe (hair shedding and tiredness) are typical of taking Utrogestan continually. Some women report that it improves over time but certainly in my own case the longest I've ever been able to last has been a month!

That's another confusing one because one of the reasons I asked my GP for HRT was because I had mood problems, very very low mood, continual anxiety - which I had all my life but got much much worse in the past year or two - and flooring fatigue. The fatigue was always there because I have fibromyalgia and CFS but it's also been worse in the couple years. I was tested for thyroid function, iron/ferritin, other nutrients, all was ok. So I don't know if it is the Utrogestan that's making me so tired or if it's something else.

I started off taking Utrogestan orally but it upset my stomach.

As for hair shedding, that in itself is depressing. I've had shedding issues for a few years, before I tried HRT. It seemed to be down to menopause and also low ferritin, I had finally managed to increase my ferritin levels and my hair stopped shedding. Then last year, my GP put me on Kliovance, I felt a bit more energetic, less anxious, better mood, but after 5 weeks or so my hair started shedding. Mood went down again. I looked on here and saw that norethisterone is a very 'male' sort of progesterone, and that femoston was usually better tolerated, so my GP prescribed that, but it did absolutely nothing for me, my anxiety levels came back up, my mood went down, my hair was still shedding so I gave that a few weeks and stopped.

Then after a year of trying to wing it the best I could, I just lost the will to live. I read about how well some people get on with Oestrogel and Utrogestan, and I asked my GP if I could try it. Well, A GP. Who gave me progynova 2mg and utro. But that also upset my stomach. It took awhile longer before my hair started shedding. But I am still so tired all the time.

Do you think it would be worth consulting soon? How long do I leave things. It would be nice if we were prepared to deal with this, it just happens and we're left wondering why we feel so crazy and so rubbish suddenly.     

Thanks both of you, I will try increasing my oestrogel.

[coldlittleheart]

Stellajane, you do have a point, the ony time I had oestrogen alone was when I first started progynova, the pharmacy didn't have utro in stock, so I had about 5 first days of oestrogen only, but that would have been too soon to see any difference. I didn't realise that 10-12 days Utrogestan every two months was enough to protect. Do you use 100mg or 200mg? As I am bleeding now anyway it seems not a huge problem if I could get away with only 6 periods per year.

I will leave a message for my GP to ring back so that they know what I am up to. But it seems a good idea to try and see if it makes a difference in how I feel. Then like you I might not need a higher dose oestrogen Thanks!

[coldlittleheart]

The thing is, you don't appear to have ever tried a period on oestrogen only so you're not able to judge whether that would help. 

If I had to take progesterone every day (of whatever type) I would simply have to stop taking HRT.

For this reason I remain on a cycle, using 1 pump of Oestrogel daily and Utrogestan vaginally for 10-12 days every other month, following which I have a short bleed. I'm always glad to see the back of the progesterone but its worth it for the weeks of oestrogen only when I feel great.

Something to consider maybe?

Stellajane, I have spoken to the GP who specialises in menopause at my surgery. She is going to look into whether she feels that using utrogestan like you do is ok as far as protection, although she was a little wary of how off licence this was going, as in using utrogestan vaginally, also she didn't know whether she was happy with inducing a bleed when I no longer have a bleed as it isn't natural. I can see what she means but then hrt is not actually natural either as we're meant to have a drop of hormone levels as we get older. But she wasn't against the idea at all, and suggested that for the time being, I increase oestrogel to two pumps and see how things go. We'll see what she says when she gets back to me.

[Hurdity]

Hi there coldlittleheart

If it helps - the Utrogestan capsules that are prescribed orally in UK are exactly the same capsules that are produced in France (by Besins) - where they are described as for oral or vaginal use.

I summarised (or rather posted the academic summaries to) a whole load of studies about the vaginal use of Utrogestan (and other progesterone brands) so I will bump this for you when I've found it - and you might consider sharing with your doc if she doesn't have the info. At the end of the post I've also linked to the French database of medicines where utrogestan are described.

Hurdity x

Edit - have bumped the thread and here's a link to it too:
https://www.menopausematters.co.uk/forum/index.php/topic,43633.15.html

[coldlittleheart]

Hi there coldlittleheart

If it helps - the Utrogestan capsules that are prescribed orally in UK are exactly the same capsules that are produced in France (by Besins) - where they are described as for oral or vaginal use.

I summarised (or rather posted the academic summaries to) a whole load of studies about the vaginal use of Utrogestan (and other progesterone brands) so I will bump this for you when I've found it - and you might consider sharing with your doc if she doesn't have the info. At the end of the post I've also linked to the French database of medicines where utrogestan are described.

Hurdity x

Edit - have bumped the thread and here's a link to it too:
https://www.menopausematters.co.uk/forum/index.php/topic,43633.15.html

Thanks for the link Hurdity, I will send it to her. She did actually say that she thought the vaginal preparation is not the same as the oral, I said yes they are, and a lot of private consultants prescribe it vaginally, she doesn't seem to have any issues with that really, as I explained to her, it  reduces side effect. I should have made myself clearer, what she is checking on, because she didn't know whether it provided sufficient protection against cancer, was the 10-12 days utro every two months, and then she went on to say that inducing a bleed etc wasn't natural after it had stopped.

Stellajane, thanks for the tip about the private scan,  I have not even seen a gynecologist so far. Is the scan very expensive? I have private health care I wonder if that would be covered. It is true that it isn't natural to take HRT or to induce a bleed, but as you say, whatever we take is not natural and what's the point in living longer if you have no quality of life, it becomes existence rather than life. We'll see how things go with two pumps, I will see what she says, As I said above, it was the dose you are on that I told her about that she wanted to double check, I don't really have a problem with her checking as she wants to be sure that she is not going to cause problems.

PS Bleed has stopped again yesterday.

[coldlittleheart]

Great, thanks Stellajane. When did you have your first done? 2 years after you started hrt?

[coldlittleheart]

Stellajane, that's really good to know. and reassuring. I will report back when I speak to the GP again.