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[Keeleyruth]

 Hi,

I'm seven yrs into peri, tried a number of different HRT combinations over the last 5 years and am unfortunately, only feeling worse.

I have currently been prescribed Oestrogel (1 pump a day) and Utrogestan vaginal tablets for 7 days every 2 weeks but do not feel any better taking this new HRT combination.

My question is - How would I know if I need to increase my Oestrogel pumps per day? I have seen on this forum that some ladies take up to 4 pumps a day and am wondering that I may need to increase my daily amount as I still suffer with severe peri symptoms.

The progesterone side of my HRT also makes my anxiety hit the roof and my mental health nose dives, without fail, to the point where I have attempted to start to self harm. I was placed on the Utrogestan to help alleviate these symptoms and am 4 weeks into this new regime.

Any advice would be greatly appreciated as I am lost........... I have reached out to family for support and am currently trying to get back in touch with my GP for further help 

[CLKD]

Morning.  Are you able to explain how you feel, what kinds of problems you are suffering with?   Think why you began HRT initially, has it helped any of those symptoms?

Some ladies need extra pumps - it may be that you could try an extra pump twice a week, spreading it out - hopefully someone who has knowledge of your regime will be along.

[Hurdity]

Hi keeleyruth

That is an unusual HRT regime. Prog would normally be prescribed for 12 days per 28 day cycle. If you are sensitive to this hormone then taking it for two lots of 7 days surely only increases the likelihood of side effects since your body responds to the increase, then the withdrawal 7 days later and then again a couple of weeks later.

I can imagine it also having an effect on your bleeds. Perhaps you can tell us a bit more about why you were prescribed an unusual regime because I can't imagine this helping with anxiety. Also about your bleeds - how often they occur.

What are the peri symptoms you sre still suffering? The classic way to tell if the oestrogen dose is working is the alleviation of flushes and sweats. If you are also taking anti-depressants then maybe you won't have experienced these since some ADs also help with flushes, so then it's more difficult to work out re other symptoms.

With these other symptoms (depending what they are) it can be more difficult to work out but surely yes discuss with your doctor whether increasing the dose might be beneficial. One pump is a low dose (depending on how well you absorb it as well as body weight/size to some extent) so if you are very near menopause then it might be worth trying an extra pump or half pump if that's possible as CLKD suggests?

Hurdity x

[Keeleyruth]

Sorry Hurdity, I got confused  this happens ALOT! I take the Utrogestan for 14 days out of the month not 7 every two weeks!

This is the second month I have taken it. The first month did not bring about a bleed but this month has, it lasted 7 days, was dark brown in colour (not red) and extremely painful. The last period I had before this was in September 2021.

These are my peri symptoms. I have experienced most of them for over 5 years now and not found the right combination of HRT that alleviates them yet.

They include -
Fatigue
Acute joint pain - Only in last year but now suffer every time I exercise
Itchy skin 
Bloating
Brain Fog
Poor concentration
Anxiety - 100% worse when I take progesterone
Hot flushes - Worse when stressed or flustered
Night Sweats
Mood swings - Worse when I take progesterone
Incontinence - Only occurred over 2 years
Depressed - Only seems to kick in on progesterone days
No sex drive for years

I was given anti depressants, moved up progressively from 20mg - 60mg of fluoxetine a day but felt no better so gradually reduced my dosage back down to 20mg. My GP has now changed this to Sertraline, 50mg daily but don't feel like I benefit from AD's at all.

[Keeleyruth]

Hi,

I'm seven yrs into peri, tried a number of different HRT combinations over the last 5 years and am unfortunately, only feeling worse.

I have currently been prescribed Oestrogel (1 pump a day) and Utrogestan vaginal tablets for 2 weeks out of every 4, but do not feel any better taking this new HRT combination.

My question is - How would I know if I need to increase my Oestrogel pumps per day? I have seen on this forum that some ladies take up to 4 pumps a day and am wondering that I may need to increase my daily amount as I still suffer with severe peri symptoms.

The progesterone side of my HRT also makes my anxiety hit the roof and my mental health nose dives, without fail, to the point where I have attempted to start to self harm. I was placed on the Utrogestan to help alleviate these symptoms and am 4 weeks into this new regime.

Any advice would be greatly appreciated as I am lost........... I have reached out to family for support and am currently trying to get back in touch with my GP for further help 

[CLKD]

It is probably hormonal if the ADs aren't helping.  As oestrogen levels drop muscles may become lax = aches and pains, also the body may become dry: inside and out.  = itchy skin, we use 'nivea' or a good hand cream on the dryer areas, as well as suitable vaginal atrophy treatment: = bladder problems.

[sheila99]

You may want to add testosterone but your oestrogen levels need to be optimal first (usually needs a referral to a menopause clinic). If you're not taking utro vaginally I would do so. How much do you take? 100mg for a block of 14 days or 200mg? Some women take as little as 100mg x 7 days but this needs to be with medical guidance/scans to check your lining doesn't build up. I think you would benefit from another pump of gel too. Hot flushes are a good indicator you are deficient, they usually go in a couple of weeks. Your other symptoms are likely to take longer, often it's 3 months.
If you really can't tolerate utro you might want to change to a regime with a different type of progestogen. Some people in your situation have been OK with provera but it's really a matter of trying it to see.

[Keeleyruth]

I take 200mg of Utrogestan vaginally for 14 days out of the month at the moment. I do believe I need testosterone as I have no sex drive at all and haven't for years. I am currently on the waiting list for private treatment at Newson Health clinic and pray my appointment comes soon!

[sheila99]

I'm sure she'll be able to help. Utro should be for 12 days, days 15-26. Newson thinks it's OK to halve the dose if used vaginally so 100mg x12 days (manufacturer says the dose is the same). As you're on such a low dose of gel you shouldn't have a problem on the lower dose. I think it's unlikely you feel better until you increase gel though. Could you try your gp again?

[Jop4321]

I was prescribed and started on 2 pumps oestrogel daily and 100mg progesterone daily which I take every say of the month (maybe it's because my periods stopped over 12 months ago?) I have been sleeping better and hot flushes have improved but feeling more tired than usual so i tried increasing to 3 or 4bpumps a day x 4 days but this made me feel exhausted. I have reduced back to 2 pumps and jyst reallybtired but pleased i am sleeping better and the flushes have decreased in severity and arecless frequent.