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Menopause Matters magazine ISSUE 75 out now. (Spring issue, March 2024)

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Author Topic: Progesterone Intolerance  (Read 1386 times)

Julesie

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Progesterone Intolerance
« on: March 18, 2023, 04:45:52 PM »

Hello,

I'm 47 with perimenopausal symptoms for 4 years.

13 years ago a GP told me I was 'allergic to my own hormones' and offered me a book on fish oils to read. I declined and requested a referral to a gynaecologist. He commented that I would be seen as a 'difficult patient' as I had mental health issues. He elaborated no further and left the practice to work elsewhere but I did get my gynae appointment.

She got me to fill out 3 months worth of PMS obs forms and pointed out that there were no cyclical problems despite having obvious PMS and that I had mental health issues instead. I received a diagnosis of General Anxiety Disorder and depression shortly after.

I went back to see her again a few years later as nothing had resolved. I was offered a hysterectomy but no more information. No discussion regarding any hormonal issues or progesterone intolerance or PMDD. I obviously declined after thinking about it, I had a business to run and nothing to go on.

Over the years since I was diagnosed with perimenopause and given Evorel Sequi but the progesterone part made it worse. I was upped to Evorel 50 oestrogen and Utrogestan 100mg. I tried, I really did and came off and went back on, going back to Sequi and off again.

I had repeated 'gastritis', IBS, flushed face, fatigue etc only for it to go again and then return.

8 months ago I was asked to come off 13 years of Venlafaxine with assisted Prozac of 2 months and HRT... cold turkey...to 'see what was going on'. I went to A&E with 28 symptoms. I was diagnosed with ADHD/ADD at the same time. I thought my prayers were answered.

I was prescribed Xaggitin XL 18mg 3 months later with ropey initial side effects but these got better. I found my Evorel 50's and Utrogestan in the cupboard and decided that the perimenopause symptoms were too much to handle at the same time. My sweats disappeared in two days.

I started to get gastritis so I took Lansoprazole, WindEze, Colofac and Gaviscon Dual Action with no effect. No appetite, depression, anxiety, palpitations etc. It did all die down a little in order for me to accept a titration of 36mg. Four days later I had to stop because my symptoms were that of a Bipolar 2 rapid cycling patient.

My dad passed away in January and I've lost my business of 7 years.

I ended up in A&E for the third time yesterday due to severe symptoms that I believe are due to a long standing progesterone intolerance. The oedema was pulsating my feet and hands, an elephant sat on my chest, dizzy, nausea, confusion and piddling like a racehorse.

I'd been on Utrogestan for the previous month (for 15 days of the cycle) and only 8 days into the next. My longest ever stint on it.

My obs were all fine including bloods, inflammation markers, heart, liver, kidneys. I'd had previous tests for a suspected stroke in A&E previously with brain and ECG scans.

The advanced nurse practitioner was an angel and going through IVF for a second time so she understood my predicament. She is writing to my GP to recommend a referral to a gynaecologist...it's the same lady I saw twice before.

This time I can now confidently say that perimenopause, PMDD and progesterone intolerance are all connected and that I would like to discuss...hysterectomy/a different approach?

Have you got any ideas what I could do or ask/request?



« Last Edit: March 18, 2023, 04:49:36 PM by Julesie »
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Flossieteacake

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Re: Progesterone Intolerance
« Reply #1 on: March 18, 2023, 05:09:32 PM »

Hello Julsie and welcome to the forum. I am utterly shocked and appalled at the terrible way your GP spoke to you and for telling you to just stop venlafaxine. Venlafaxine is one of the most difficult antidepressants to taper off let alone to stop it cold turkey. For you to be told you will be thought of as difficult because you have mental health difficulties is so rude and dismissive!

You really have been through such a lot and it sounds like you were never sent to the right specialists for you too. You needed a menopause specialist rather then gynaecologist for the meno issues and the Dr really should have sent you to a psychiatrist too.

Just as well that useless GP left and you do not have to see him any more.

I can fully understand the progesterone being intolerable for you because I too have a lot of difficulty with progesterone. You tried so much with the progesterone but it does seem you cannot tolerate it. Your mental wellbeing has to come first and if taking it causes such awful side effects then it would not be sensible to continue with it.

I just cannot believe you were asked to come off the ADs to see what is going on! What a neglectful GP that is. It is great you have your ADHD/ADD diagnosis as that will mean you can get the right support.It sounds like the Xaggitin has been wonderful for the ADHD/ADD which is wonderful to hear.

I am so sorry to hear you lost your dad. My heart goes out to you. Sorry to hear you lost your business too. You have been through so much.

Firstly I would ask for a referral to an NHS menopause clinic because they will be the best people to help you. Gynaecologists do not have the same knowledge. There is an option that some menopause clinics offer were you can take oestrogen only and have regular womb scans to check the lining of your womb. This is for progesterone intolerance. If you are okay with having regular scans then this may be an option for you.

Please do not let them think you are difficult. You cannot help feeling the way you do and just because you are not a textbook case does not mean you do not deserve support.

You could also have a hysterectomy if this is what you feel is best for you. There are many threads on here were women have had this done.

I am glad you have joined us. You will have lots of support on here. :)
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Julesie

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Re: Progesterone Intolerance
« Reply #2 on: March 18, 2023, 07:26:47 PM »

Hello,

Gosh, what a lovely detailed and compassionate reply. I've never had support as others don't understand other than my husband. I don't know what I'd do without him. It's been quite lonely even though I have family and a few friends.

I tried twice to come off Venlafaxine 36mg, the lowest dose I ever really took. I couldn't go up and couldn't come down. I counted the tiny grains over a 1 year period and still couldn't do it for the side effects. In the end I just followed orders.

The ADHD meds were not helpful unfortunately, I think I may have written it down in a way that was misleading. I wish I'd never asked for them! They made matters a hell of a lot worse.

I shall indeed ask on Monday for a referral to both the gynaecologist and a menopause clinic. I'm very grateful for your advice. I'd be over the moon to take just oestrogen but I would have to tell in time if my own progesterone is also troublesome but at least it's not a major operation to find out.







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Flossieteacake

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Re: Progesterone Intolerance
« Reply #3 on: March 18, 2023, 07:44:11 PM »

Hello,

Gosh, what a lovely detailed and compassionate reply. I've never had support as others don't understand other than my husband. I don't know what I'd do without him. It's been quite lonely even though I have family and a few friends.

I tried twice to come off Venlafaxine 36mg, the lowest dose I ever really took. I couldn't go up and couldn't come down. I counted the tiny grains over a 1 year period and still couldn't do it for the side effects. In the end I just followed orders.

The ADHD meds were not helpful unfortunately, I think I may have written it down in a way that was misleading. I wish I'd never asked for them! They made matters a hell of a lot worse.

I shall indeed ask on Monday for a referral to both the gynaecologist and a menopause clinic. I'm very grateful for your advice. I'd be over the moon to take just oestrogen but I would have to tell in time if my own progesterone is also troublesome but at least it's not a major operation to find out.

I just feel so angry with how you have been treated. I was on the highest dose of venlafaxine and I think it took me about six months to ween myself off.

I am so pleased you have such a lovely husband. It makes the world of difference. It is hard to find people who understand.

What a shame the ADHD meds made things worse. I know some mental health conditions mean ADHD medications make them feel worse.

I hope your GP is supportive when you have your appointment. In the meantime please feel free to post here for support and of course, after the appointment too. 🙂
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Flossieteacake

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Re: Progesterone Intolerance
« Reply #4 on: March 30, 2023, 11:59:06 AM »

Hello Julesie. I have been thinking of you. I hope you are okay.
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sheila99

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Re: Progesterone Intolerance
« Reply #5 on: March 30, 2023, 12:31:03 PM »

I'm sorry things are so difficult for you. You could take less utrogeston but this comes with a health warning as you're at greater risk of endometrial cancer if your lining builds up. Do you still have a regular cycle of your own? I use a long (6 week)  cycle as I get fatigue on utro and this gives me more 'good' time. Some take as little as 7 days x 100mg vaginally but if you do this I'd really recommend a scan after a few months to check. If you have a good bleed it's safer and it's also safer the lower the oestrogen dose as there isn't so much build up. Do you use it vaginally or orally? You can use less if vaginally as more gets to where it's needed. Have you tried provera? Some are OK on this when they can't tolerate utro. Agree with the advice to see a meno specialist not a gynecologist as many are clueless on meno. There can be a long wait for an NHS referral.
 There's a long thread on compounded progesterone which the nhs doesn't approve of but does have a place for those who are intolerant. If you can't find it with the search let me know and I'll try.
Finally you might consider an email to Dr Currie who runs this site, at £30 it's the cheapest and quickest specialist advice you'll get.
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Julesie

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Re: Progesterone Intolerance
« Reply #6 on: April 07, 2023, 09:38:31 AM »

Hello,

I ended up in A&E again last night with stroke like symptoms 35 hours after applying a Conti patch. I simply cannot take progesterone and have a referral now waiting to see the meno clinic and the gynea. I believe that I have the return of endo and cysts.
« Last Edit: April 07, 2023, 09:51:10 AM by Julesie »
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Flossieteacake

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Re: Progesterone Intolerance
« Reply #7 on: April 07, 2023, 11:28:39 AM »

Hello,

I ended up in A&E again last night with stroke like symptoms 35 hours after applying a Conti patch. I simply cannot take progesterone and have a referral now waiting to see the meno clinic and the gynea. I believe that I have the return of endo and cysts.

So glad to get an update from you as I have been thinking of you. I am so sorry you had such a terrible experience again. I would agree you cannot tolerate progesterone at all. Are you getting any support for the endo? Are you okay? You have been through so much.
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Julesie

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Re: Progesterone Intolerance
« Reply #8 on: April 07, 2023, 04:02:42 PM »

Hello,

I ended up in A&E again last night with stroke like symptoms 35 hours after applying a Conti patch. I simply cannot take progesterone and have a referral now waiting to see the meno clinic and the gynea. I believe that I have the return of endo and cysts.

So glad to get an update from you as I have been thinking of you. I am so sorry you had such a terrible experience again. I would agree you cannot tolerate progesterone at all. Are you getting any support for the endo? Are you okay? You have been through so much.

That's nice to hear, bless you. I had endo and 2 x 5cm cysts on my right ovary 15 years ago and had a successful laparoscopic ablation and aspiration with no returning symptoms...until now. It's obviously been growing since last time and probably fed by hormone surges.

I've read all about the symptoms of this disease causing gastro problems due to pressure/adhesion on surrounding anatomy. The medical consultant said that he doesn't know why I take PPI'S Lansoprazole or Omeprazole because it's not gastritis after all as bloods show no inflammation. I reckon I'll stick to Gavisvon then!

I took off the Conti patch last night and not take any HRT until Tuesday after the Bank Holiday when I can talk to my GP again. I did ask him for antidepressants in an email last week but haven't reviewed them as yet. Unless he wants to hold off till I see the consultants...ugh!

My previous gynea will probably read my notes and offer me my original hysterectomy with bilateral oopherectomy that I declined all those years ago and I'll gladly take her up on it!

In the mean time I'm left with relying on my GP and my recent admission to get a quicker referral in order to fix this.



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Flossieteacake

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Re: Progesterone Intolerance
« Reply #9 on: April 07, 2023, 06:42:22 PM »

What a lot you have to contend with. I really am sorry. It is very unfortunate you went through the procedure and it seems to have returned. I can understand why you are thinking of having the hysterectomy with bilateral oophorectomy as this is causing you to feel very unwell. I hope you do not have to long to wait to see the gynae to discuss this.

When you sent a message to the GP to ask for antidepressants, do they know your history with venlafaxine? I do not think you should need to wait before starting antidepressants due to your history of depression.
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Julesie

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Re: Progesterone Intolerance
« Reply #10 on: April 07, 2023, 07:36:03 PM »

What a lot you have to contend with. I really am sorry. It is very unfortunate you went through the procedure and it seems to have returned. I can understand why you are thinking of having the hysterectomy with bilateral oophorectomy as this is causing you to feel very unwell. I hope you do not have to long to wait to see the gynae to discuss this.

When you sent a message to the GP to ask for antidepressants, do they know your history with venlafaxine? I do not think you should need to wait before starting antidepressants due to your history of depression.

He knew of the Venlafaxine and subsequent Fluoxetine in order to wean me off it. I had to start Xaggitin XL ADHD meds and didn't want me taking AD's until I was successfully titrated. Now that I have stopped them due to side effects I sent him an email outlining this as he remarked previously that too many medications muddies the diagnosis waters. I took it that was ok for me to request this.
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Flossieteacake

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Re: Progesterone Intolerance
« Reply #11 on: April 07, 2023, 08:18:45 PM »

I apologise. I did not realise you were still with the GP who suggested you wean yourself off venlafaxine in just two weeks. What a shame you cannot see a different GP as they do not seem to have any understanding of mental health at all. I hope you hear back from him soon and you are given an AD that suits you.
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Julesie

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Re: Progesterone Intolerance
« Reply #12 on: April 08, 2023, 10:11:58 AM »

The thing is my GP is a really efficient person, kind and considerate and I think the pressures environment has changed how he works. I've asked him to provide me with what I thought I wanted over the years and he came through every time. I even requested a parathyroid scan once and he said yes! Part of my problem is hypohondria from health anxiety which is part of ADHD so all of this is a merry go round situation.

Google is helping me to ask pertinent questions such as 'is this bile reflux' to the stroke Dr two days ago and she said not likely because of x,y and z. I enjoy learning about certain conditions that might be relevant to me but I get caught up in it after a while and change my mind. I think knowing more about disease is both fascinating but also quite depressing! I would have loved to have been a Dr with a speciality.

I understand the current climate with the NHS and it's that that helps me to not go totally insane. I have to help myself meet them halfway. I don't drink, smoke, vape, take illicit drugs or live a lifestyle that could otherwise add to my situation.

I'm lucky because three patients in that A&E department the other night were way worse off than me. One had a fall and dislocated his shoulder after a drink or five, one had a miscarriage after IVF and one poor chap had pleural effusion with infection and cystic fibrosis. I'm traumatised  :-\
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sheila99

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Re: Progesterone Intolerance
« Reply #13 on: April 08, 2023, 01:48:40 PM »

I may be wrong on this but if you have endo won't you need progesterone even if your uterus has been removed?
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Julesie

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Re: Progesterone Intolerance
« Reply #14 on: April 08, 2023, 04:58:10 PM »

I may be wrong on this but if you have endo won't you need progesterone even if your uterus has been removed?

Good question but I can't have progesterone but it's not necessary I believe.
« Last Edit: April 08, 2023, 11:20:02 PM by Julesie »
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