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[laszla]

Ladies - am 55, postmeno, on HRT since 2018 and discovered only at the end of 2021 that my absorption of oestrogel was pitiful, increased it to 3-3.5 pumps of my own initiative, had micro improvement in how I felt and blood levels of estradiol, then went to clinic at Chelsea & Westminster where they prescribed estradot 100 as consultant said I probably needed at least 4 pumps of estrogel which is a lot of gel - he wants me at 400-800 pmol because of osteopenia (I also have too low BMI) and very bad anxiety - I don't have hot flashes, night sweats etc.
I also take utrogestan for 10 days vaginally.

I tested 2.5 months later, estradiol had again plummeted to somewhere in the 100s (my absolute max on 3.5 pumps was 260ish)

I decided to switch back to estrogel in early May and went for 4 pumps daily which were covered by my Chelsea prescription.

For the first half of the months I felt for the first time in years a glimmer of hope, a whole actual few days of feeling human.
I braced myself for the 10 day stretch of utrogestan as the second half of the month is always worse but miraculously it was alright, no major wobbles of mood and I though I was in the clear.

The day after last utro pill my bleed began (Monday) and every day since then has been hell, a crash of mood and energy, can hardly stand up and feelings of rage and desperation.

Obviously this is a huge disappointment as well as incredibly confusing - for example having been fine on the utro week seems to blow any progesterone intolerance theory out of the water and I have always wondered whether taking progesterone coincides with, rather than causes, the bad phase of the month.

Can anyone suggest what weird chemistry might have caused this and if there's some way I can intervene next month as I don't think I can withstand that again (and won't be able to see the clinic before then or even the month after that).

I take agnus castus, with the approval of Chelsea & W, which I have always found helpful in part 2 of the month, but not this time.

I also take testogel but seems to have absorption problem with that too as FAI low in all tests.

[Marchlove]

It sounds like a progesterone  withdrawal issue, poor you.

Take hope though that at least the estrogen absorption issue seems have been sorted and you also felt good on the Utrogestan. So yes that does blow the progesterone intolerance theory out of the window for you!

Hopefully more knowledgeable ladies will be along, but I think you have two choices, either going for a lot longer cycle or having a continuous regime.

It’s a shame you can’t get an earlier appointment to try and get this sorted. Do contact them though and arrange for one as soon as you can.

xxx

[Gnatty]

If it's a withdrawal issue could it be you might be better on a continuous regime? Maybe ask at your next appointment.

[Vicky81]

I had this withdrawal on utrogestan......
I switched to provera....absolutely fine x

[laszla]

Ah, the joys of HRT: just when I'd wrapped my head around progesterone intolerance, only now I learn of prog withdrawal!!
Thanks ladies, I will look into this and changing the cycle or even type of progesterone are definitely options.
Marchlove I will try getting an appointment sooner but despite the consultant having written on my post-review letter in March to have an urgent 2-3 appointment with him (which would be now at the latest), the bookings team are denying/ignoring this black on white instruction and are fobbing me off with an October phone consultation. That in itself is not helping my mental state.
x

[Marchlove]

No, I can imagine not!

You probably will have to decide yourself what to do going forward.
Have a think and feel about it when you start to feel a bit better.
Ask yourself, how good was I really on the E only?
My gut feeling with you would be to do continuous, but you might feel different.
Either way you have to try one or the other so basically it’s which one you want to try first.

In a lot of ways, although you might not feel so at the moment, you’ve at least got some answers.

Keep trucking xx

[laszla]

Marchlove, I agree that I need to assess how good the E only phase was.
While I am pretty sure that it was markedly better than when I was either on less estrogel or estradot 100, the only way to properly assess is to have at least 2 more rounds of the same regime because this past month was only the first of a 4 daily estrogel pumps regimen.
But of course that is scary because of the crash of the period week but that too could have been a one off and so I think I really need to repeat the whole thing to have a clearer idea. But as you say, some answers are beginning to emerge

[Marchlove]

It’s difficult to think reasonably when in some turmoil, but that does sound like a good idea.

I think you’ll have a clearer perspective after that of how to proceed forward.

Let us know how it goes xxx

[joziel]

I agree with whoever wrote above... That it would be good to try a continuous regime. You don't HAVE to be menopausal to do that, there are reasons to do it before. I am peri and have endo - and endo sufferers need continuous progesterone to suppress the endo, even during peri for eg.

Some people just do better with steady and continuous supply of hormones and no big changes. It would be a pretty easy thing for you to try experimenting with at least...

I also reckon you will feel better when you get your estrogen levels up some. As probably things are a bit out of balance at the moment.