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[Keep On Swimming]

Hello all,

I'm in a bit of a pickle and I was wondering if anyone else is in France and perimenopausal so we could compare notes...

In a nutshell: after having told me for years that I would get nothing until I was through the meno, my gyne here in France, finally realising how peri symptoms were ruining my life, put me on Estréval (estradiol) gel 0.1% / 1 pump per day. I have been on Cerazette - Optimizette over here (I have adenomyosis, can't abide the coil, so I need the POP to stop bleeding and pain) since I was 45 and have no problem with it.

The oestrogen gel kicked in on day 5 and it is fantastic. It's my most prized possession now!

Here's the problem: when my gyne gave me the gel early Nov she said: "this is just a compromise until you are through the meno, no increasing the gel because it will mean your pill isn't effective". I asked about additional progesterone but she said: "you have enough in your pill". I didn't feel reassured so I wrote to Dr Currie (excellent help and very kind) and also had a tel appointment with a meno clinic gyne in N. I. Both specialists reassured me that my POP is indeed effective with the gel BUT that I have to have additional progesterone every day (when you are on Cerazette you take 100mg every night).

I haven't been back to challenge my French gyne with my UK-based meno info. I have an appointment with a different gyne here tmw but my kind GP gave me Utrogestan which I started last night and I'm feeling dreadful today: I took it at 10:30pm and by 11am I was seriously woozy, then slept soundly but woke feeling faint, nauseous, drunk and spaced out. It's 2 o'clock and I'm only just starting to feel a bit more normal.

I don't want to take another Utro tablet tonight! Does this get better as the body adapts? Would vaginal use reduce these symptoms? I'm so ultra sensitive to medicine that this reaction isn't surprising really.

So, I'll see what the new gyne says tomorrow. But, which advice to trust? I feel totally stuck between both countries, with a leaning towards the UK advice because I think the meno care is much more advanced than over here. Actually, the meno specialist in N.I. says they have quite a few expats living in France under their care.

I'm sorry because this is also in a different thread but I really wanted to put "France" in the title to see if I could talk to anyone else over here who is also scratching their heads!

Best wishes, thanks for reading my message.
xxx

[CLKD]

Gynaecologists are reliably un-reliable for much menopause knowledge.  Stick with what Dr Currie has suggested.  If you feel so unwell on that regime, perhaps put the product name into the search box to see how others manage?

Then let us know  .  We have a couple of members in Spain I think.  Could your Specialist in NI contact the others to suggest an ex-pat link-up?  If he were willing he could contact each to put the idea forwards. 

[Keep On Swimming]

Hi CLKD!

How are you doing? Thanks for your reply.

I'm still gobsmacked that gynes don't know much about meno care... It just doesn't make sense! Apparently the gyne I'm seeing tmw is a meno specialist (the only one in my city it seems!). I'll see what she says about the treatment prescribed here (just the gel) but I think I'm going to have to stay with the meno clinic in NI because I don't feel reassured with the info/treatment I've got here. I'm sure there are other Irish ladies in my shoes over here too!

That's a great idea to ask the meno specialist in NI to put us all in contact with each other! I'll write to her and see what she says.

Watch this space...

[Mary G]

I'm next door in Iberia!  Mostly Spain sometimes Portugal.  Are you anywhere near the Spanish border?

I agree that gynaecologists are not experts on HRT, their skills tend to focus on obstetrics and health of the uterus.   HRT is a different ball game apparently so I go to the gynaecologist for transvaginal womb scans to check lining measurement, check ovaries, overall womb health, smear etc and I do my own thing on HRT.   

Can you buy Oestrogel without a prescription in France?  If not, I'm pretty sure you can use NI prescriptions in France, you certainly can in Spain and Gibraltar - another place I frequently visit.

[Keep On Swimming]

Hi Mary G!

Thanks for your reply. I'm in Brittany - far away from you!

When you say you do your own thing re. HRT, where do you get your advice from? I mean, which country? And how do you know what dose to take etc.?

My gyne here is happily giving me oestrogen gel, it's just that she has skipped the progesterone part! I would like to try to find a gyne here who has a UK-type approach to HRT so I'm giving one more gyne a try here tomorrow and if she is singing from the same French hymnbook as the other two gynes I've seen, then I'll stick with the meno clinic in NI (although it's private and expensive).

I'm not sure I can get a prescription from home filled here - it's in English. Do you just walk into a Spanish chemist with your prescription in English?

Thanks so much for your reply! It's confusing feeling torn between advice from two countries.

[Mary G]

Keep on Swimming, I have probably covered some of this on your other thread but here goes.

I'm 61 and about 15 years post menopause so I've been using HRT for years.  I used to be a patient of the late, great Professor Studd in London who introduced me to Oestrogel and Utrogestan.   I loved Oestrogel but hated Utrogestan so four years ago I decided to try a compounding clinic (also in London) and started using a bespoke 50mg progesterone alongside 1 pump of branded Oestrogel.   

It was a huge success but because of Brexit, the pharmacy could no longer post to Spain so I had to have the progesterone sent to friends in the UK who then had to forward it on to me here.  I decided to save money and hassle and tried using a branded progesterone gel which I buy in Spain and it's been a huge success.  I have been using this new regime for 5 months now and my uterine scan a few weeks ago showed a womb lining measurement of just under 5mm so just below the danger line.

So basically I worked it out by myself but with the assistance of regular scans to make sure I don't reach dangerous womb lining levels of over 5mm.

So I would keep getting the Oestrogel from the gynaecologist in France and see how you get on with the progesterone and be prepared to change it if you need to.

I hope that makes sense!

[Keep On Swimming]

Mary G,

Thanks for explaining - it does make sense, thank you! That's great you are doing so well on your regime!

I'm not going to take any Utro this evening and then start vaginally tmw. It really made me unwell today. I'll see how the new gyne shapes up tmw but I'm not holding out any hopes, hopefully get a uterine scan, then contact the meno clinic in Belfast again to see if they are ok for me to take Utro every other evening and go back to my own gyne for regular check ups.

This is taking up SO MUCH headspace!

Thank goodness you girls are all here to explain, share, listen, repeat...!

All the best. Hasta luego !

 

[Dotty]

https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

If you look on p6 it gives you the progesterones you can use for hrt.

I believe you can take 2 x Cerazette per day to give you the right protection. x

[Keep On Swimming]

Hello ladies!

Dotty, thanks for your suggestion. I've asked the meno clinic in NI about that and I'm waiting for a reply.

Ok so, update: it took me 2 full days to feel better after ONE oral Utro 100mg so I'm never taking it orally again! I saw the new (young) gyne yesterday for a second opinion. She wouldn't give me one because she says she isn't specialised in meno care (I know, you all told me - don't go to a gyne for meno care! She actually said that me wanting HRT is like wanting to have my cake and eat it! I couldn't believe it - there really isn't peri meno care over here) but she did give me an ultrasound and my womb lining is 2.6mm and she was happy with that, explaining that it has to be under 4mm.

I'm going to let myself enjoy the hols then probably try Utro vaginally but I'm terrified to go anywhere near it because it made me so ill (2 days in bed!). I think Cerazette + Utro is too much of a progesterone hit for me. I wonder are there lower doses available?

Have a lovely day everyone.
xxx

[CLKD]

Typical response, at least you knew that she might not be au fait with menopause treatment  . You also know not to worry about your womb!

I don't understand that 'have my cake and eat it' suggestion  .  Many forget that it's H(hormone)R(replacement)T(therapy)  !!  There isn't meno care in many places unless one is lucky enough to have a knowledge Doctor or access to specialist care. 

See how you feel by not taking it.  Enjoy the Hols!

[Keep On Swimming]

Hi CLKD,

She meant that I "want" the POP and HRT, she means I want to have menopause treatment but I'm not through the menopause... I tried to explain that in the UK HRT is for both peri and post menopausal women.

By the way, I "want" the POP like I want a hole in the head! I need the POP to stop the adenomyosis pain and bleeding!

Whatevs!

[Keep On Swimming]

Morning all,

I don't know where to put this question so I'll put it here!

Just had a horrible night of the sweats/Big Dipper whooshes of anxiety and nausea and I'm getting scary flashbacks to the horrible pre-oestrogen gel days. I'm a total mess this morning and very inefficient...

I've only been back on the gel for 2.5 weeks, so this is normal right? My gyne did tell me that HRT isn't miraculous and won't fully stop symptoms but ease them (which is true, I have been generally sleeping better, night sweats greatly reduced and anxiety/nausea gone - apart from last night, sob).

Could this be because my own oestrogen levels have plummeted a bit? If so, does it settle again?

Freaking out a bit I think!

Thanks for reading!
xxx

[Mary G]

Keep on swimming, that's a very good womb lining measurement and it's well below the 5mm danger line (immediately post bleed or continuous combined) although private clinics in the UK are very strict and the same as your gynaecologist in France and will not prescribe HRT if over 4mm.

Just a thought, but I don't think you need the extra Utrogestan, you are monitored by a gynaecologist, you are using one pump for gel with the POP and your womb lining is well below what are considered dangerous levels ie 5mm. 

It sounds like your gynaecologist did the scan herself like they do in Spain which is good.

[Keep On Swimming]

Hi Mary G,

Thanks for your reply.

You see, this is what I've been wondering... Is there no way I could get away without the extra progesterone (just as my French gyne has prescribed) and just be monitored regularly? But if that was the case, why have I been told by 2 UK meno specialists I absolutely need the extra progesterone? It just seems like a lot of progesterone to be taking.

And I'm on one pump of 0.1% gel which is actually the same as two UK pumps of 0.06% - so I'm not low dose, but medium dose, right?

xxx

[Keep On Swimming]

Mary G,

Sorry, I'm a zombie today.

Yes, over here women see gynes too (on the national health). Our GPs don't deal with gyne issues. The scan was done by a different gyne because I wanted a second French opinion about being prescribed the gel without P.

xxx