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[PMDD]

Hi everyone,

I need some advice please.....I feel like I don't know where to turn 

I am on long term prostap injection to induce menopause for PMDD (since 32, i'm 42 now).....I was ok for a good few years with no add-back HRT, but last year my body was 'shouting' for something, and after many failed attempts due to not tolerating them, and a resurgence in PMDD symptoms.....I found myself able to tolerate Evorel Conti......I was made up!!

Occasionally I would get palpitations, and my gyn told me to add a squidge of oestrogel into the mix, when i had a fluttery spell.....again all was fine.

Fast forward to April this year, and I get a bleed....first one in 10 years, and then this month another one (heavier this time, but OK). Plus, i constantly feel like I am about to start a period, that slight dull ache.

So, GP decides to send me for Internal Ultrasound, and this finds my womb lining to be 14mm. What is normal for HRT peeps? I've read that post-meno should be less than 5mm......is this what I am classed as?

Could I not be absorbing the patch, as the gel seems to have a 'better/quicker' effect, and surely the pg in the patch should have prevented the lining build up, as i've only been on them a max of 6mths? Does anyone else not absorb well from patches?

I am speaking with my gyn at some point this week, as no face to face still.....but I have never managed to tolerate oral progesterones without being severely mentally unwell.....do I have any other options?? Or, is this likely to end up in a hysterectomy?

Will I have to come off the evorel/oestrogen completely, or is it a case of adding in extra pg in some way?

Also, and i do apologise for the million questions, even if you can answer one I would be grateful, has anyone used high dose topical bioidentical pg, as I am reading may reports that it is the gradual increase that causes the intolerance, so if you can go straight in with high dose, you may have a few days ropey, but then 'reap the benefits'......i know.....wishful thinking 

Thanks for getting this far 

[sheila99]

I was told it shouldn't be more than 4mm, I was peri. I don't know much about prostap and how it effects your lining but evorel conti is designed for post meno so perhaps has insufficient progesterone for you? Some people don't absorb well from patches and it can vary between brands as the carrier is different. If you want to be bleed free perhaps a coil is your best bet. Mirena seems to be used most commonly but there also Kylena and jaydess which both have lower levels of p. You may find you are OK with one type of progesterone but not with another. Utrogeston can be used vaginally, it's only licensed for oral use in the UK but for both ways in the rest of Europe. In peri it should be used sequentially so you have a bleed but again I don't know if conti is OK if you're on prostap.
Hysterectomy can cause it's own problems, I would try to find a non-surgical solution before going down that route.

[CLKD]

As suggested avoid hysterectomy until absolutely necessary!  Some Consultants want to whip it out without considering any after effects, as far as they are concerned, job done.  However 

   many are unable to tolerate progesterone in any form.  Could you go to a menopause clinic as UK gynaecologists aren't always very knowledgeable about menopause treatments. 

[PMDD]

Just had a call from my gynae's secretary (who is lovely), and she has arranged a telephone appointment with the consultant for Friday afternoon.....

I am no good at all when i don;t know what's happening.....my nerves are shot! 

[CLKD]

Make the list of what you need to discuss so that you don't forget anything!

[PMDD]

How long can you safely try to get 'rid' of hyperplasia?

[shrosphirelass]

Good luck with your appointment PMDD. Hopefully they will outline all the options availalbe to you. Evorel conti is not working well for me as I am constantly bleeding. I have been on it for 4 months and don't know if the lining has built up in that time. Perhaps it doesn't suit you either.

[PMDD]

Hi Everyone

My tizz-wozz has subsided now i've chatted with my consultant this afternoon.....so wanted to let everyone know the outcome.

So yes, my scan results are back and yes my endometrium is showing signs of thickness, but no abnormalities otherwise....it is 13mm. My Gyn Dr (menopause specialist), thinks I am not absorbing the evorel conti particularly well, and would like to change over to Oestrogel plus Utrogestan 100mg PV at night.......I did have to confess that I purchased some of the utro online and had already started it a couple of days ago, as I was worried about not tolerating it, so wanted to check before speaking with him. I know it is very early days but previously even one dose of oral progesterone gave me signs of becoming mentally poorly. I am hoping it continues, as actually I feel really quite well.

He is not thinking of hysterectomy, or even hysteroscopy at this point, due to the fact that it has come on very quickly, and we have been playing with doses to try and get a good effect. He says he sees it fairly often, and that utro (if tolerated) plus oestrogel is his 'gold standard' treatment nowadays......or mirena plus oestrogel, but said it is a very personal trial and error process.

He is going to see me next week for a face-to-face, to administer my prostap, and to give me a continuation script of the new regime.....and will book me in for a re-scan in 8 weeks time to check progress.

Oh, and my mammogram was clear.....thank goodness!

Questions now.....

How far 'up' is far enough for the utro? Does anyone have any tips?

What side effects will I experience if I am not tolerating it very well?

Thanks for listening to me 

[PMDD]

Oh, and after months of chasing Evorel Conti round the UK and beyond.....I now have them sitting in a cupboard 

[sheila99]

Push it up as far as you can just before you go to bed - gravity... I get fatigue, others get different symptoms.

[CLKD]

Well done on persevering!  Thnx for the update.

Let us know how you get on ;-)