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[laszla]

I was recently “told” by the GP that having been for 3 years on a sequential course, I should now move on to continuous HRT. For most of these three years I have been on 2 pumps of estrogel daily, and  7 days of utrogestan taken internally, ie. the Studd regime which I elected to follow because I do very badly on the progesterone, it’s essentially like having debilitating PMS every month.
My GP practice is averagely awful in terms of menopause support, main GP is accommodating but expects me to come in armed with knowledge and tell her what I want, other GP who stood in for her last time is medieval and pretty much told me for no good reason I should look to be coming off it within a couple of years (I’m only 54 and am very much in it for the long haul having a mother who has the triple whammy of heart disease, osteoporosis and cognition problem).
I have no faith in their guidance and while I am attempting to get a referral to the meno clinic at Chelsea & Westminster (a request GP has so far ignored), I need to find out about the continuous regime. Firstly, is it really necessary to switch to continuous – I totally see the appeal of not bleeding but my (very possibly flawed) understanding is that continuous regimes entail taking utrogestan (alongside estrogen) throughout the month, the idea of which terrifies me? I also know I need to get a scan to make sure my 7 day utrogestan regime hasn’t caused any problems. I also take a dab of testogel most days.
How do the more advanced specialists who are happy to tailor treatments according to the individual  deal with this – are there compromises that can be made whereby you can take progesterone more regularly thus avoiding a period but not everyday in order to avoid a mental breakdown? Or is it possible that taking the progesterone more regularly over the month actually lessens its negative effects?
I know about the mirena coil but would greatly prefer not to use an internal device.
Thanks for any advice.

[sheila99]

You're gp isn't watching (I assume 😁) so will never know how you're taking it. Many women who are intolerant carry on with a sequi regime because of it. The cancer risk is very slightly higher but imo not enough to change. I'm late peri and intend to use sequi indefinitely because of fatigue on utrogeston. Maybe ask the neolithic gp if she is aware the Nice guidelines have changed and there is no longer an age limit.

[laszla]

No, she doesnt need to know and thanks for confirming that some use sequi indefinitely. I know lots of women, very rightly, tinker around with standard regimes to find something that suits them so I'm wondering if there exists a sort of halfway house between sequi and conti whereby you take progesterone regularly but on a low dose, or perhaps on alternate days, in order to avoid a period - or is this wishful thinking?
And can you still use estrogel and utrogestan on a sequential regime I wonder?

[sheila99]

Yes, you can still use gel/utro on a sequi regime. I use a long cycle of 6 weeks so have more 'good' time, late peri now. Hrt withdrawal bleeds for me are short and light with few pmt symptoms which I prefer to more utrogeston. According to newsonhealth but not the manufacturer  you can halve the dose if used vaginally so 100mg every other day for conti. Perhaps wise to arrange your own scan after a few month if use less than recommended.