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[Orba]

Hi ladies,
I posted yesterday about my woes with  Utrogestan and after being doubled up with cramps all yesterday after bleeding on/off for a month I bailed out last night and didn't take last nights dose.( Hubby was also worrying about me ,bless im)
I had been on continuous HRT for over 3 months.
SO was reading up on Bio-identicals.
It seems logical that your blood is tested first to see what hormone doses you need.
It seems I have a problem with the Progesterone element,as years ago I tried cyclical patches and was good on the oestrogen patch but depressed/aggressive on the Progesterone one.
Obviously this would be down the Private route as the NHS do not tailor make HRT, but how can one size HRT fit all ?
Thanks 😬

[CLKD]

Pity that one size doesn't fit all and pity that that route isn't considered more carefully.  I am sure that if you put bio-identical into the search box, something will pop up.  Make notes ;-)

I may have repeated myself but do you keep a mood/symptom/food diary which might help?

[sheila99]

Maybe try utrogeston on a sequi regime? Possibly on a long cycle. You may find you have problems with one progestin but not with another. I was fine with evorel (had to change because of allergic reaction) but get tired with utrogeston, for this reason I will continue with a cycle when I'm meno. If you're not already using it vaginally you could try that. Unfortunately you won't know what suits you and what doesn't til you try. Usually you know within a few days if you're not going to get on with a progestin.

[Mary G]

Orba, please read my thread on compounded hormones in the Alternatives Therapies section on here.

You will see that I completely ran out of progesterone options and bespoke (compounded) 50mg progesterone was literally my only option other than a hysterectomy.   I'm pleased to say that my HRT regime is continuing to work very well.

I hope you find the thread interesting.

[Orba]

Pity that one size doesn't fit all and pity that that route isn't considered more carefully.  I am sure that if you put bio-identical into the search box, something will pop up.  Make notes ;-)

I may have repeated myself but do you keep a mood/symptom/food diary which might help?

Yes I did lots of reading on the web ,positives and negatives with some writers saying natural not always best ,so confused right now !
Yes diary a good idea thanks x

[KaraShannon]

I'm on Evorel Sequi which I was told was bio identical, although no blood testing etc.  I was doing really well on it.  Not so well recently since I was given a generic brand.  No idea if it should have any differences but they did ask me repeatedly if I was sure I wanted the generic brand so there might be something in it.

[sheila99]

Different brands use different carriers so you may absorb one better than the other. The progestin may be different but that should be clear from the patient information leaflet.

[Orba]

Thanks for replies ,it's all been helpful.
I still have the option of trying the mirena coil but can't have that fitted until after lockdown. 
Have felt much better today after skipping last  nites progesterone though .I
Ive decided to stop everything and see what happens. . .

[CLKD]

Let us know how you get on?

[Hurdity]

Hi Orba

Not sure I read about your woes?

However the good news is that if you are taking utrogestan along with some sort of patch or gel or tablet oestrogen then you are already taking bioidentical hormones, which actually mean that they are biologically identical to the hormones your own body makes. It's a question of tweaking your regime to suit you if you want to stick with bio = body-identical hormones?

Please don't be distracted by some of the guff about compounded bioidentical hormone therapy (cBHRT) in contrast to what you are taking, which are regulated hormones (rBHRT). The former is not endorsed by the medical profession nor this website (run by a leading NHS gynaecologist) and the basis of it is flawed ie that you can tailor hormone doses to your actual levels according to the results of blood tests. This is partly because absolute levels do not actually correlate with symptoms, and in any case are inaccurate and are just a spot result, and there are many on this forum who have never had hormone tests and happily using these hormones. Of course there are websites and clinics urging you to part with your money ( a lot of it in most cases!) but this is not necessary!

If you want to read about it properly then here is the a summary statement from the British Menopause Society:
https://thebms.org.uk/publications/consensus-statements/bioidentical-hrt/

Incidentally the NHS most certainly does not say that one size fits all! If you have read this anywhere it's put about by those who will be urging you to go down the cBHRT route! For a start there are numerous regulated preparations available and once you start using separate oestrogen and progesterone there is ample room for individualising your regime which is actually what menopause clinics aim to do.

As for the "natural" idea, not sure what you mean by this? Neither rBHRT nor cBHRT are "natural" in the sense that they are all produced in a lab from raw materials. Personally I have only ever used bio-identical hormones (from NHS ie rBHRT) but many are also perfectly happy with some of the synthetic progestogen preparations out there.

Maybe actually you need to be on cyclical HRT if you are bleeding with cramps? I don't know where you are in menopause? Perhaps still peri-menopausal? Not sure I've seen your other threads as I haven't been on here much recently!

I hope your cramps ease soon but don't despair. If you are suffering from flushes and sweats you will be able to find a regime that suits you without having to take unregulated treatments and spend lots of money!

In the first instance you could send an e-mail consultation to Dr Currie at only ?30 and see what she says - perhpas then taking her reply to your own doc?

Hope this helps

Hurdity x

[Orba]

Hi thanks for replies  very kind .
Hurdity- thanks for advice.  I had been on Utrogestan for 3 months when bleeding started that's why I was investigated ( had a history of Polyps and CIN 3 )
The consultant recommended using a Mirena coil instead but can't have one fitted until lockdown lifted !
My last period was 2017 so menopause has been reached.
This was my 3rd attempt at HRT over 2 years . have tried cyclical patches but progesterone patch made me feel depressed. Evorel continuous patches  caused migraine so GP  advised stopping. So the combo of Utrogestan and estradiol  was the 3 rd shot.  I was aware the Progesterone was micronised. Maybe  it's the Progesterone element I can't tolerate.
Anyway after another episode of bent over double cramping and bleeding at the weekend I decided to stop taking everything and see what happens.  I feel ok ,just relieved not in pain. I expect hot flushes to return and have started taking St Johns Wort for low mood.
I will be 54 in Oct. 😕

[CLKD]

Many cannot tolerate progesterone in any form.  Do read Mary G's threads in the alternative 'room' and elsewhere ;-). 

It shouldn't be necessary to need to pay for any advice but sometimes it is the quickest route.  No one should be bent over with cramping ! 

[Mary G]

Orba, CLKD is right, there are women who never find a form of progesterone they can tolerate.  It is nearly always the progesterone component of HRT that forces women to give up on it altogether.  Oestrogen is easy to replace whereas progesterone is very difficult and the synthetics often cause side effects.

My advice would be to try the Mirena coil or better still, the low dose Jaydess coil.  Once you have exhausted all NHS progesterone options, that is the time to consider bespoke progesterone.   It's made HRT viable for me because I got to the stage where I could never take Utrogestan again.  Also, I did not want to be bleeding for God knows how many years, it was making me feel ill.  Fortunately, because the dose is correct, I can take my bespoke progesterone every day with no side effects.   

As CLKD says, you should not have to pay for a private consultation but perhaps you want to.   Why not put yourself on the fast track if that is what you want to do?   Perhaps you could obtain the coil from the NHS and have it fitted elsewhere?  I did that on one occasion.

Sometimes women feel they need a consultation with a specialist who is not under time pressure and can spend lots of time listening to them.  Just a one off appointment can really help.  It's your choice.

[CLKD]

   Mary G - also Orba - start that diary to chart progress ;-)

Having had very painful, clotty periods for many years, no way would I go through that again! 

[Hurdity]

Hi thanks for replies  very kind .
Hurdity- thanks for advice.  I had been on Utrogestan for 3 months when bleeding started that's why I was investigated ( had a history of Polyps and CIN 3 )
The consultant recommended using a Mirena coil instead but can't have one fitted until lockdown lifted !
My last period was 2017 so menopause has been reached.
This was my 3rd attempt at HRT over 2 years . have tried cyclical patches but progesterone patch made me feel depressed. Evorel continuous patches  caused migraine so GP  advised stopping. So the combo of Utrogestan and estradiol  was the 3 rd shot.  I was aware the Progesterone was micronised. Maybe  it's the Progesterone element I can't tolerate.
Anyway after another episode of bent over double cramping and bleeding at the weekend I decided to stop taking everything and see what happens.  I feel ok ,just relieved not in pain. I expect hot flushes to return and have started taking St Johns Wort for low mood.
I will be 54 in Oct. 😕

Hi again Orba. You raise two different issues. Firstly whether or not you are progesterone intolerant and your trying utrogestan is an attempt to see if you are OK with this (bioidentical) progesterone. Secondly the cramping and bleeding which has nothing to do with progesterone intolerance.

Personally I would want to sort out the second of these ie heavy bleeding and very painful cramping are not to be expected on any HRT.  Bleeding when you first start continuois combined HRT is expected yes but not such that you are doubled up with cramps. Have you had endometriosis in the past? Could this be the cause of pain.

I understand waiting to get the Mirena fitted although it should still be possible even under the present restrictions to some services. After all it is a birth control measure too.

When was your last investigation ie scans etc and did you have hysterosocopy or biopsy and was the lining thick?

Anyway I hope you are feeling better, but if you dfeel you want to return to HRT I would ask for further investigations if it was a while ago eg a year, before restarting and sounds like the Mirena might be your best bet?

All the best and let us know

Hurdity x