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[Starshell]

Hi All
About 3 weeks ago I changed from Novofem to 2-3 pumps Oestrogel and 100 progesterone tablet
I really wasn’t too good on the Novofem especially before I had a bleed, with awful rage and anxiety and GP suggested the new regime and to take the progesterone continuously every evening
I think on the whole I feel a little better but after an initial week of great sleep I am struggling sleeping again and also having more hot flushes than on the Novofem, I also feel the progesterone is causing indigestion at night which could be why I am struggling sleeping
Improvements have been I am a little calmer with no rage but still have anxiety at night but think it’s better during the day
Am I expecting too much?
I am worried about not having a bleed by taking the progesterone continuously
Are there any tweaks people could suggest?
I have changed regime at what has been a very stressful time at work and home so maybe it’s hard to tell how well it’s working!

[joziel]

Is Novofem a combined pill?

3 weeks is pretty early in terms of things settling. I wouldn't worry about not having a bleed. I am peri (44yo) and on continuous due to endo - it is best for endo folks to have continuous progesterone to keep the endo suppressed. If it's too soon for you to go onto continuous, you'll keep getting breakthrough bleeding. Then you can go onto sequential.

There's nothing to worry about with not bleeding - just like women on the POP don't bleed often. You'll know if things are not right because you'll get bleeding anyways. If you are on continuous and not getting a bleed, it suggests you're getting enough progesterone and you're fine.

In terms of the anxiety at night... welcome to my world  , and that of loads of other women. I really have no idea why doctors and science can't help us to understand more why taking estrogen seems to result in anxiety, insomnia and anxiety-at-night - but it seems to be sooo common. You could try just 2 pumps of the Oestrogel rather than 3 - since less estrogen will reduce that some. You could also look up my other recent posts, and look into histamine intolerance - as it seems that increasing estrogen also increases histamine.

[Starshell]

Thanks for your reply Joziel 😊
No the Novofem was sequential and caused a bleed, quite a heavy one at time so I will not miss that if it’s stopped!
Thanks for your advice. I might try 2 pumps of the gel, may even try the progesterone vaginally, I read that some on here do, can’t see me getting indigestion that way 😂
Funny you say about the histamine intolerance, I am feeling a lot more sensitive to red wine lately and I believe that is high in histamine! Will look into the more!

[joziel]

Yes.. so the thing is that the mast cells have estrogen receptors on them and when we start to take HRT, it activates the estrogen receptors on the mast cells - which go crazy and release histamine.

That comes from a Tina Peers podcast interview I just listened to, this one: https://podcasts.apple.com/gb/podcast/friday-five-histamine-intolerance-viral-research-and/id1230372957?i=1000540874755

It is also related to long Covid... everything starts to come together - tis amazing.

Anyway, I'm about to try a 2 week low histamine diet. Which sucks and means I can't eat many of the things I usually eat and love. But I think it's more important to figure out if this is causing the issues I'm getting at the moment with anxiety at night and pounding heart and feeling shaky and palps and all the rest of it....

[Starshell]

Good luck with the diet Joziel. Do report back and let us know how you get on?
When I wake up in the night and start overthinking and worrying I say to myself, okay you can think about this, but not now, in the morning
The I pretend I am in a spa having just had a lovely long massage, have no where to go and can have a lovely sleep, sometimes it works, sometimes it doesn’t 😂

[joziel]

Thanks. Yes, sometimes I can doze through it better than other times. I don’t think I’m at my most relaxed at a spa though 

[Kenny]

Hi , I am in the same position as you, only one pump only, and continuous Progesterone .I am very nervous about changing from my existing one Kliovance , not changed yet .

[Hurdity]

Hi Starshell

Why have you been changed from Novofem to your current regime? Is there a reason to put you on conti HRT?

If you had a heavy bleed on Novofem and you are not post-meno (do you know where you are in menopause?) then you will most likely bleed on the new regime but your bleeds may be more unpredictable. It is usual to remain on sequential HRT while still peri (except eg for reasons like endometriosis) - or at least try the 25/28 regime where you have 3 days off from the progesterone, to allow for a bleed.

Also 2-3 pumps gel may be quite high depending on absorption and 100 mg taken orally may not be enough to suppress the lining, even if you were post-meno, though if per and you have your own cycle you will be producing your own progesterone.

Personally unless there is a good reason to take it continuously I would take it sequentially 200 mg 12 days per 28. You could also try vaginally which is miore effective at same dose.

Hurdity x

[Starshell]

Thanks Hurdity
I asked my Dr for a review as had been on Novofem for three years and felt it wasn’t as effective for me and my moods before the bleed were awful
My GP said hardly anyone prescribes tablet HRT now and to try the new regime, I asked how to take it and she advised continuously, I did question this and she said if you aren’t ready for continuous you will get breakthrough bleeding and then we can swap you to sequential
I have not had any bleeding at all yet after more than 3 weeks. But I am getting more hot flushes, I think maybe I will try the progesterone vaginally and see how I get on
Maybe I am looking for something that will make me feel fabulous and this could be unrealistic! X

[joziel]

Starshell if you are getting hot flushes, it suggests your estrogen levels might be a little low still. That is something that is caused by low estrogen, not anything to do with the progesterone. If you're not getting a bleed and you have no progesterone side effects, I wouldn't recommend switching to taking it vaginally - once you've found something that works, stick with it in this meno world 

Everything your doctor has says is totally right there. The thing with the oral HRTs is that they are a fixed amount of estrogen so if you need more, it is hard to increase...