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[Keep On Swimming]

Hello ladies,

I have a question (another one, hahaha!)...

Sorry for repeating this post, but I'd really like to chat to others in the UK (I'm in France and not sure the HRT regimes we have here are as modern as at home) about the progesterone-only pill and oestrogen gel.

My gyne just made me come off the POP and gel for a week to see if I was post meno (it was brutal, I don't advise it!). I'm not (FSH 7,4 + oestradiol 158) but she agreed to let me go back on the gel but ONLY 1 PUMP a day and the pill. She said that if I had a coil fitted (tried it, can't deal with the contractions) I'd be able to increase the gel no problem. She says that the POP + 1 pump will protect me from pregnancy but 2 pumps won't. She hasn't given me progesterone because she says there is enough in the POP.

Does this sound right to you all? It sounds a bit hardcore to me that I'm only allowed 1 pump of the gel and that that's my only option (apart from getting the Mirena) until I'm post meno.


Thanks for reading my post!
xxx

[Dotty]

Hi you can use up to 4 pumps of gel. However some ladies need more and can use more but it’s usually under a specialist.

The only way you know if you are post menopause is to go 12 months without a period. Blood tests can’t say if you’re post menopause.

The progesterone only pill does not provide enough progesterone for hrt.

[Keep On Swimming]

Thanks Dotty,

I did wonder about the usefulness of doing that darn blood test after just 1 week (and having to go cold turkey from the gel and POP).

I'm wondering what to do about what my gyne has prescribed me because she is firm in that that's my lot until I'm post meno... but I don't think 1 pump is going to swing it until I'm post!

Maybe I should try to see another gyne here in France or try to get an online appointment with someone at home. I'd like a second opinion. Ho hum, just another thing to fret about!

[shoppingqueen]

Hi
It’s not standard to say one pump only- the issue is likely the progesterone. If you use utrogestan or another (Provera in the Uk) then up to 4 pumps. I think I’d be thinking another gynae or online to Uk as you suggested. Have you asked her why she’s limiting it? Are you flexible on the POP? I know what you mean about the coil so it’s what you use for contraception 🤔 I suspect she would increase the gel if you had progesterone to oppose but if you only want to take the POP then it won’t be enough to keep the lining down. It’s the contraception and HRT that’s so limited, isn’t it? A shame there isn’t a pill with enough prog and contraception that we can use with the gel. When I was in that position I had to have a coil which I also disliked x

[Keep On Swimming]

Hi shoppingqueen,

Thanks for your reply!

I need to be on the pill because it deals with my adenomyosis pain. My gyne's issue with more than one pump + the POP is that I wouldn't be protected from getting pregnant. She didn't offer me extra progesterone and when I asked about it she said there is enough in the POP. I suppose if I need 2 pumps I could go back to her and ask for extra progesterone - would that act as a contraceptive as well as providing more womb lining protection?

Actually, it was my gyne's colleague who prescribed the gel 1 month ago because mine was on hols and I was so bad with the meno symptoms I couldn't wait to see my own gyne. She said that I could start with 1 pump and increase to 1.5, then 2. Now my own gyne is saying the opposite!

I don't feel I trust the advice I've been given.

I'm planning ahead because I know that sooner or later, 1 pump isn't going to be enough. I think I'll try to see someone else here, then talk to someone in the UK.

xxx

[Dotty]

Hi the progesterone only pill is enough for contraception. If you take extra oestrogen then you need extra progesterone to protect the womb lining. So you can use up to 4 pumps of oestrogen with Utrogestan for 12 days of the month. You carry on with POP for contraception. x

[shoppingqueen]

Glad you had the answer there Dotty as I was unsure about whether you can take the POP and use utro and gel abd the POP still work. I wish I’d known that years ago as I had taken the POP and was very happy on it. The coil was not for me. 
Keep on swimming- that’s a good plan. The point is you shouldn’t be feeling confused post a consultation. I have thyroid issues and I hate when I leave the specialist and have more questions than when I went in!! Hence, I found a different Endocrinologist. Keep us posted! Be good if you can up the gel, add in some extra prog (utrogestan) and the POP still does its job 👍. You could tackle the gyne to explain further or possibly see the first one you saw?
 x

[Keep On Swimming]

Hi shoppingqueen,

Thanks so much. Yes, you've summed it up nicely - I need to know that I CAN up the gel dose if needs be, so that means added progesterone, and maybe barrier method for a few years (yoohoo!) because the adenomyosis pain is bad when I'm not on the POP.

I'm going to look into a second opinion here in France and try to talk to someone who lives in my village in NI, just remembered she runs a meno clinic in Belfast - how did  I not remember this before?

Will keep everyone posted as I'm sure I'm not the only peri woman on the POP with adenomyosis!

[Dotty]

https://www.newsonhealth.co.uk/wp-content/uploads/2021/07/Contraception-during-menopause-and-perimenopause-v21-02.pdf

Have a look at this document...bottom of the second page .x

[shoppingqueen]

Very interesting Dotty! Does the HRT that doesn’t lead to periods mean a continual such as utro daily or Conti pill etc do you think?
I wish I knew I could have taken the POP 🙄 x

[Dotty]

Shopping queen….I’m not really sure what that means to be honest 🤔.

[shoppingqueen]

Hi Dotty
Sorry- it was clear as mud 😂 I think I’d referred to wording on page 2 where it said ‘HRT leading to periods’ so I assume that meant sequi regimes so is the opposite true of Conti? I better read it again I’ve confused myself 😂😂 x

[shoppingqueen]

It’s under the can HRT be used for contraception at bottom of page 2. It implies a Conti routine means you’re ok for contraception or maybe I’ve completely misread it with my brain fog! I wasn’t aware of that! I know the caveat is ‘usually’ though. I’m assuming then that any sequi routine requires contraception? Xx

[Dotty]

Hi Shoppingqueen…sorry I don’t think I was very clear in what I said either 🙈.

I read the bit on page 2 but I didn’t really understand what it meant .  I think any Sequi regime with bleeding means that you need contraception. If you’re not bleeding on a regime it implies that you don’t need contraception maybe….I really don’t understand what it means. x

[shoppingqueen]

Thanks Dotty I’m glad it’s not just me!! 😁 x
it’s no wonder we get confused and the mixed messages from different gynaes. It seems good though that you can use the POP alongside. It’s not an issue for me right now, and I’m 55 next year and was told by my doc no need for contraception then- but who knows 😂! I read 54 on a different doc 🫤 x