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[laszla]

Having taken 2 pumps estrogel and utrogestan 100 mg for 10 days per month for over 4 years, as well as testogel, a few months ago via blood tests I learned that I was essentially absorbing no estradiol. I increased to 3 pumps while awaiting meno specialist appointment, estradiol went up a little and when I finally managed to see a specialist he further increased the dose and changed me over to estradot 100 twice weekly.

Since then, my bleed - which is normally moderate and accompanied only by some mild twinges- has now turned into a cramp armageddon that has been going on for days, I am practially doubled over and the bleeding is heavy and is lasting much longer than usual.

I am really confused and scared because trying to think rationally about this all I can come up with is that perhaps increasing progesterone dose might result in heavier or painful bleeds as uterus is shedding more but my prog dose is identical to before and at the bare minimum dose. Last uterus scan was all fine.

At the same time, while the good (first) half of the month on the higher dose of estrogen was slightly better, the second half has been terrible in terms of rock bottom mood.

I also take agnus castus for those sort of pms symptoms - and have always found it very helpful for years but not this time.
I don't understand what could be happening and whether an increase in estrogen could account for this searing pain (not that I know yet whether I am absorbing via patches as I won't be tested until my follow up at Chelsea in 2 months).
But I cannot face another month like this.

[Nas]

Hi Lasla,
I am sorry to hear you are struggling with this.
I was in a similar situation to you, whereby I wasn’t absorbing the gel, despite upping the dose. I then switched to eastradot, but those cramps you describe within hours of applying the patch were unbearable.

I then switched to evorel, much better, but erratic bleeding.
Now switched to femeston, that’s another story!!

Firstly you have increased your Oestrogen dose. This could account for the cramps etc, perhaps it’s too much Oestrogen? You can’t compare like for like with HRT i don’t think. You weren’t absorbing the gel, now you have gone straight to 100 patch. Your body could be in overdrive? How about reducing to 25 and building up that way? I was going to suggest cutting the patch in half, but Estradot are tiny aren’t they? If you can get hold of evorel, although bigger, you can cut lengthways.

I see you are under Chelsea? Maybe contact them via the patient portal?
They will probably say give it time, but worth a shot at getting in touch.

Do pain killers work? Feminax? Alternative paracetamol and nurofen?

Really hope you get things sorted, it’s a god awful journey I know.

Xx

[VictoryV]

Hi Lazla,
Sorry things are difficult. Not sure if this helps as I don’t know how you tolerate progesterone. This month I increased Utrogestan to 200mg for 12 days vaginally, like you I expected a heavy cramping period. The opposite has happened, light, no pain and on day 2.
I can’t explain why.
I hope things get better soon.

[laszla]

Thanks both of you for your input. Nas how interesting that the estradot triggered cramps in you - mine came only on my bleed rather than as soon as I started taking it 3 weeks or so ago.
It's true that I increased my estrogen but I did do it in increments over a few months but of course the possibility of too much E2 is a possibility.
I am taking paracetemol but will give feminax a try, thanks for reminding me of its existence.
I think you're right that C & W would tell me to give it time and since I am due to see them in May perhaps I will give this new regime a second month and see whether the agonising cramps thing repeats in 4 weeks' time.

Victoria I am progesterone intolerant* which is why I have always taken this very low dose of 100mg for 10 days.
That's so interesting that your period was much lighter on an increased dose, I will ask the clinic about a possible connection when I see them.
*  I am starting to wonder whether what I took to be progesterone intolerance is not actually just very bad PMS/PMDD.
Those nasty symptoms of terrible mood swings etc. occur in the days when I take the utrogestan so I concluded that my symptoms were progesterone intolerance but I am starting to wonder whether that was a red herring/coincidence

[VictoryV]

Hi Lazla, I increased to 200mg this month to find out if I’m intolerant as the previous 3 months we’re getting progressively worse on the Utrogestan days. At best I expected to feel emotionless for 12 days, get 2 days of withdrawal blues followed by a heavy painful bleed. The plan was then to get a Mirena coil.
My ‘test’ indicates I’m not progesterone intolerant as I felt great on the 12 days, haven’t had the blues and light pain free bleed. 

The only spanner in the works is the 4am nocturia started the first night I didn’t take the Utrogestan, same again last night. 

[laszla]

Gosh Victoria, your test strongly suggests to me that some us are mistakenly identifying as progesterone intolerant when that is not the case at all.
I'll test one more month on my current regime just to make sure that this hellish month wasn't a freak one-off and then think about increasing my utrogestan intake