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[MillyRue]

Hi There,

I'm 45 and been experiencing perimenopausal symptoms for I think looking back a couple of years but really intensified over the last few months to the point I sought some help.

I have seen my GP and been prescribed some hrt and have been taking sandrena 1mg and utergesterone 200mg daily (12 days a month). I only started on 24th April but I'm worried that I've been having some intolerance to the progesterone as I am experiencing much worsening pms namely depressive mood, tearfulness and breast tenderness since taking the utergesterone.

I have a history of bad pms particularly during the last 2 weeks of my cycle. I'm still very regular but have been having perimenopausal symptoms, night sweats, anxiety attacks, joint pains, cyclical depression.

I asked my GP about taking half the utegesterone vaginally to minimise the side effects but she advised they don't recommend this, they have put me on a waiting list for a mirena coil, she has also suggested trying the progesterone daily at half the dose but I'm wary of taking it for longer.

I was wondering if anyone had started out their hrt journey with similar side effects that have eased (especially the depression as this is what's most affecting me). It's so early I know and I want to persevere but the thought of the depression worsening freaks me out.

Thanks 😊

[Jilly62]

Hi - I'm a bit further down the road then you, I'm 59 so well into my menopause.  I was prescribed Utrogestan (combined with Sandrena gel) when I started on HRT.  I took one tablet orally every day and felt terrible, I had brain fog, fatigue, low mood.  Couldn't work out what it was, and after blood tests, covid tests finally linked it to the Utrogestan.  I got advice from this forum that I could try taking it vaginally every 48 hours.  This is backed up by Dr Louise Newson on the Menopause Doctor website.  It's not licensed to use this way, but I've felt a lot better since doing it.

good luck!

Jill

[CLKD]

Your GP is correct but some ladies do use it vaginally 'off licence'.  Which works as many are intolerant to added progesterone.  This is of course not require for those after hysterectomy.

 

[MillyRue]

Thanks Both, that's really helpful 

Can I just ask a really dull question but what does unlicensed to use mean, is that just a UK thing? I've seen evidence based websites (like Louise Newson's) advocating the use of vaginal utergesterone but talk about doing it under guidance of a clinician but I'm guessing GPs can't prescribe off licence, or can they?

[sheila99]

It's licensed for vaginal use in the rest of Europe but not on the UK. I assume it just hasn't been tested this way here but your gp has to stick to the licenced route. . The manufacturer says it's the same dose whichever way you use it but Dr newson says you can halve it. I get fatigue from it but not depression but I do find it is much worse when I'm producing my own progesterone. When my own cycle doesn't happen the fatigue is very much less. So I wonder if you're symptoms are worse because you have too much progesterone rather than not tolerating utrogeston. If you use less than the recommended dose the advice is to do it with the agreement of your gp or to arrange your own scan to check the lining isn't building up. Personally (and this is my opinion not advice) I think as long as you have a proper bleed it will be OK.

[MillyRue]

Thanks so much for this. That makes sense, I did wonder about my own progesterone as I'm obviously producing enough to have regular periods still.
I'm really reluctant to have a coil fitted if possible.
I have also booked a consultation with a specialist, even though my gp has been great I feel like I want that discussion with someone who has more experience in that area. Ironically I'm using my NHS covid bonus money to pay for the appointment!

[CLKD]

   sheila - we are a Mine of Info on here 

MillyRue - let us know how you get on.  MayB take a list to any appts.?

[MillyRue]

Yes, so much knowledge and advice here, it's fantastic 

I'll let you know how it goes x

[Letmein]

I tried various combination of HRT in the past but couldn't tolerate the progesterone side of it.

I saw a gynae consultant privately who agreed that I could start on a reduced protocol with 100mg vaginally 10 days every 4 weeks and see if I gained enough benefits from the oestrogen (my only symptom that I can't manage is insomnia). If so, we will look to move to the mirena in 3 months time.

She reassured me that this reduced in take if progesterone for 3 months is not going to increase the risk of womb cancer and even longer term, would be unlikely although it would be better to have regular scans.

Trying to get the go to do the prescription on this basis wasn't straight forward even with the letter from the consultant but they finally agreed. Only in day 5, so have a bit to go to decide if it's worth it.