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[paulapo]

Hi all well the provera has not worked and has left me in a depressive state etc, doc has told me stop my oestrogel and provera and is referring me to see a gynaecologist. Basically any form of progesterone doesn't seem to work for me. I feel so much better once progesterone is out of my system but obviously that's only short lived until I have to start it again. I've tried continuous and 12 days out of 28  cycle. I'm wondering if it's safe to just take my oestrogel until my app with gynaecologist comes through or is that not recommend? I can't go back to my hot flushes again and fuzzy heads etc as work at a children's disability short break home and a team leader so have to have my wits about me. Any advice would be a massive help please .

[CLKD]

Why a Gynaecologist?  Ring the Surgery and ask for a referral to a Menopause Clinic.  Unless the Consultant you ar being referred to deals with Menopausal women and appropriate treatments you may find yourself no further forwards!

I would ask your GP regarding whether to keep on with the prescription.  Also find out how long you will have to wait for the appt..

[paulapo]

Hi we don't have a NHS menopause clinic where I live, you have to go private and pay £200+ for you want to see a specialist or referral to Gynaecologist, I'm hoping that referral will be a specialist in the menopause also or I will have to go private. I still have oestrogel ur unsure if I can take with no progesterone.

[CLKD]

Some have to travel to get proper advice!  One shouldn't have to pay.  That actually ain't a lot in the big scheme of things.  Make sure that the Gynaecologist knows about menopause and treatment or it may be better to pay.  GPs have little knowledge about how little gynaes know/don't about symptoms so paying would lessen the time you need to wait.

Let us know!

[paulapo]

I had a 5 day bleed 2 weeks ago. I'm going to reduce to 0 over the best few weeks as have a private app to see a specialist that does bio-dentical Hormones etc. I rang the gynecologist secretary and she did say that they they don't have menopausal specialists at the hospital which prompted me to go private. Fingers crossed I have some luck .

[CLKD]

Will you take a list of symptoms to the appt.?  Let us know how you get on?

[Hurdity]

Paulapo - it is not necessary to see a private doctor that prescribes "bio-identical hormones".  I'm not sure what sort of doc you have booked with or where you are but better to go to the gynaecologist that you are being referred to at least at first. This private doc - will only prescribe what is available on NHS ie oestrogen gel ( or patches) and progesterone (ie utrogestan). If they are prescribing  compounded creams supposedly on an individualised basis, then please do not waste your money -as these are unnecessary and unregulated.

If there is no menopause specialist at your local hosptial it is your right to be referred to your nearest menopause clinic - if you are prepared to travel (eg mine is about 65 miles away but I'm lucky to have good gyane GP locally), although waiting lists can be long.

Have you tried Utrogestan? Vaginally? Or thought of a Mirena coil? Or if you are post-menopausal stretching your cycle so it is a it longer than 28 days, to minimise progestogen intake - maybe your doc can approve this or at least consult someone on your behalf?

I would really pursue the available options before going down the private route if you can - although the only additional thing you might be able to get from your private appt is testosterone - which is indicated if you have low libido/response and not taking meds which can depress it eg some ADs, and oral oestrogen. But please beware of the very expensive BHRT con!

Let us know how you get on

Hurdity x

[paulapo]

Hi my doc won't let me go longer then the 12 days Utrogestan and 18
Days off, she's not happy to which is why she had referred me to a gynecologist, I can ask if she could refer me to clinic as gynecologists aren't menopause specialist. My doc is back Monday so will see if she can refer me to clinic.

[paulapo]

Sorry forgot to say that I've tried Utrogestan, patches, Provera and tablets and no luck, I've tried to give my self a good reasonable amount of time for body to adjust but I just get slowly worse with pmt type symptoms, severe depression and more. I can't do this progesterone anymore . Quite happy to lose the womb tbh .

[Mary G]

paulopo, just over a year ago I was in the same place as you - progesterone causes silent migraines in my case.   I could not tolerate any form of progesterone and got to the stage where I couldn't take Utrogestan again, full stop.  I also found that as I got older, actual process of bleeding was making me feel ill.

I was desperate and staring down the barrel of a hysterectomy.   I was pretty much out of ideas so in a last ditch attempt to find a solution, I had another consultation with my migraine specialist.

After much consultation and subsequent discussion which included my gynaecologist, it was agreed that my problem was hormone instability which was causing the migraines.   I then found a specialist who prescribed bespoke progesterone and I've never looked back.   She agreed with my migraine specialist that I desperately needed hormone stability and to stop bleeding.   She said I must take progesterone every day and I was horrified!   

She assured me that because of the way the bespoke progesterone is absorbed and because it is half the dose of Utrogestan (50mg) it would be nothing like my dreadful experience with the synthetic progesterone or Utrogestan and that this progesterone actually complements the oestrogen and stops the oestrogen spikes that cause my migraines. 

She was absolutely right and I've been successfully using this regime for well over a year.   I also use oestrogen and testosterone alongside 50mg progesterone every day.

I've had several uterine scans since starting this regime which came out at 3.3mm so it's definitely safe and it definitely works with no side effects whatsoever in my case.  I still can't believe my luck!   

If you have problems with progesterone and you have tried everything else, it's worth looking at this option before deciding on a hysterectomy.

It's not available on the NHS I'm afraid but if you Google bespoke progesterone you will find a specialist in your area who can prescribe it.

I hope you and others find my experience useful.

[kdee69]

paulopo, just over a year ago I was in the same place as you - progesterone causes silent migraines in my case.   I could not tolerate any form of progesterone and got to the stage where I couldn't take Utrogestan again, full stop.  I also found that as I got older, actual process of bleeding was making me feel ill.

I was desperate and staring down the barrel of a hysterectomy.   I was pretty much out of ideas so in a last ditch attempt to find a solution, I had another consultation with my migraine specialist.

After much consultation and subsequent discussion which included my gynaecologist, it was agreed that my problem was hormone instability which was causing the migraines.   I then found a specialist who prescribed bespoke progesterone and I've never looked back.   She agreed with my migraine specialist that I desperately needed hormone stability and to stop bleeding.   She said I must take progesterone every day and I was horrified!   

She assured me that because of the way the bespoke progesterone is absorbed and because it is half the dose of Utrogestan (50mg) it would be nothing like my dreadful experience with the synthetic progesterone or Utrogestan and that this progesterone actually complements the oestrogen and stops the oestrogen spikes that cause my migraines. 

She was absolutely right and I've been successfully using this regime for well over a year.   I also use oestrogen and testosterone alongside 50mg progesterone every day.

I've had several uterine scans since starting this regime which came out at 3.3mm so it's definitely safe and it definitely works with no side effects whatsoever in my case.  I still can't believe my luck!   

If you have problems with progesterone and you have tried everything else, it's worth looking at this option before deciding on a hysterectomy.

It's not available on the NHS I'm afraid but if you Google bespoke progesterone you will find a specialist in your area who can prescribe it.

I hope you and others find my experience useful.

Hi Mary
Very interesting. I've googled as you suggested but I'm struggling to find anything other than the bio identical suggestions. Where is your private clinic may I ask?

[Rhiner]

Hi Paulapo,

In response to your use of oestrogen without prog, I did this for around 10 weeks under my meno specialist, as I needed to ensure that the dose of oestrogen, In my case Estrodot, was correct before introducing prog.

MaryG - 50mg does sounds great, didn't think this was available. I use 100mg Utrogestan 2 days on and one day off and that keeps lining good (tried alternate days before this).

Rhiner

[Hurdity]

Rhiner - we would all love there to be greater choice when it comes to prog doses and it has long been suggested that a 50 mg dose would be a brilliant option for some of those using low oestrogen doses. However you are right - there is no such dose available ie no product made with this dose. What Mary G is talking about is a "bespoke" preparation of some sort produced by a (most likely expensive) private clinic, and as such only available to the few who can afford such individualised treatment from that particualr clinic. Preparations like this are not regulated nor standardised and have not been trialled and as such are not recommended by the general medical profession and the menopause societies as they come under the banner of BHRT (as I understand). Great for those who can afford both the initial consultation, the ongoing costs of the medication and the monitoring of the womb lining that is required to ensure protection ( ie regular scans) but not for the majority of women unfortunately.

The good news is that there has been some research on the alternate day vaginal use of utrogestan 100 mg with regard to endometrial protection (that you previously used) - I posted some info on another thread and here is the (updated) link:
https://www.fertstert.org/article/S0015-0282(05)00403-6/fulltext. This would still require monitoring and doc approval but at least it is known that a licenced product available on NHS was used.

Your 2 days off and 1 day on also sounds interesting - so just a bit less than daily. How did this make you feel? Also why did you stop the alternate day (which is equivalent to 50 mg per day)? Was it due to bleeding? Personally I feel it would still be too much - to have on a continuous basis.

Hurdity x

[Mary G]

kdee69, for reasons I don't want to go into, I never name the specialists I consult on here but please do send me a PM.

To give you an idea of cost, I paid £300 for the consultation and the actual medication costs £1 per day.  Like I said, I was desperate and would forego something else to pay for it in order to be well and sane. 

[KiltedCupid]

Rhiner - I'm currently using alt day conti Utro and not having any problems, would you mind saying why you changed? I'm always interested to hear others' experience and this regime is new for me so any tips would be helpful.