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[sheila99]

I think the 3 monthly routine is referring to tridesta only, not that you can use any other sequi hrt on a 3 month cycle instead of a monthly one. Some women with intolerance problems do use less than the recommended dose but if you go down this route it's really important to have regular scans as a thickened lining carries an increased cancer risk.

[Ermin2trude]

Both NICE and the NHS state that 3 monthly cycles can be prescribed but don’t say it has to be tridestra. I do know of people offered a 3 monthly cycle by their GP using utrogestan.

[lilbebel]

I’m interested to explore the three-month cycling in more detail. Do any of you know how it works in terms of when the progesterone is introduced in the cycle, and at what dose and for how long? I understand it might be tailored to each individual but my understanding for one month cycling is that it’s 200 mg of Prometrium for 12 days and then none for the rest. The problem with this is that I absolutely cannot tolerate 200 mg of Prometrium ever in one day. When I tried 200 mg of Premier transvaginally, I had night, terrors, profuse, sweating, high anxiety, insomnia, and ended up with a respiratory infection and sore throat for a week. I’m really intolerant to the stuff.

[lilbebel]

Interesting update. I stopped Prometrium for 4 days and got increasingly more distressed each day. Today, I took 100mg Prometrium at noon as I was so anxious and within an hour, I was yawning, relaxed and having a nice nap. It seems my Estrogel may be the culprit and not the Prometrium. I wonder if the dose is wrong or if the delivery method is wrong for me. Perhaps a patch with a slow steady delivery would be better. I had wanted to stay on bio identical HRT but now I’m wondering. It’s all so incredibly confusing.

[meno-mel]

I think the oestrogen part of patches is usually bioidentical, so you could ask for an oestrogen only patch?

I use Estradot50 patches for oestrogen, it's bioidentical oestrogen in a patch, no progesterone, you take that separately. So is Evorel50 but I can't recommend that as it did nothing at all for me either good or bad, I don't think I absorbed it, I feel the effects of Estradot50 though and it sticks better, less itchy, more expensive for the NHS, harder to get than the cheap and nasty Evorel, but many women find Evorel OK as well, so I get why everyone has to try it first.

Then I use utrogestan 12 days a month which I think is the same as your progesterone except the brand?

At first I couldn't tolerate 200mg a day taken orally, so I took only 100mg a day last month vaginally and still had the same period at the same time, it seemed enough but the menopause clinic said no, it has to be 200mg.

Now I'm using 200mg utrogestan a day rectally and I'm getting fewer side effects than 100mg vaginally last month.
Perhaps I'm growing more tolerant to it.

I got a throat infection the day after starting utrogestan this month and it's a bit irritated down there, but less irritation than taking it vaginally.

PS it was a long battle to get bioidentical HRT, the GP had started me on Evorel Conti because I was the all important 1year+ post menopause. However it contains northisterone, definitely not bioidentical and I started having periods again, so I went on the list for a scan for unexplained bleeding, that should happen next month. In the year and a half that I've tried HRT I've never agreed to any non bioidentical HRT, they tell you it's bioidentical anyway, it took me from March 2022 to June 2023 to finally be prescribed a bioidentical progesterone. I warned my GP I couldn't tolerate progesterone when she first suggested HRT, she assured me that is no longer a problem, modern treatments don't give the extreme PMT that older ones did, B*ll*cks, it's total and utter b*ll*cks, don't believe them.

[Ermin2trude]

Hello,

Progesterone is the calming hormone that works on the GABA receptors in the brain.

For some women on here, more oestrogen seems to calm their anxiety, for others it’s more progesterone and less oestrogen. I believe this is to do with the natural levels of each hormone circulating around the body, the ideal ratio is 2:1 progesterone to oestrogen. If we had zero hormones left naturally, 100mg progesterone:50mg oestrogen should theoretically be perfect. Sadly our own bodily systems don’t work like that.

For me personally, I need more progesterone and less oestrogen otherwise my anxiety and depression is off the scale. I can’t tolerate oestrogel at all, but estradot patches work brilliantly. I tried Evorel (awful), estraderm (not enough room to stick them on……..they’re huge), but estradot (which is bio identical ) works really well for a consistent low dose. It might be worth trying.

[discogirl]

Hi Ermin2trude

I follow your posts with interest.

You're so right, the 'one size fits all' approach does not work with most women.

[lilbebel]

Thank you Meno-mel for sharing your experience. I also got a throat infection and upper respiratory infection when I took 200 mg of Prometrium. I seem to be okay on 100 mg however. I think bioidentical is important for me.

Interestingly, my doctors here only ever offered me bioidentical and I didn’t have to fight for them at all. I suppose that makes me lucky.

I agree with you that HRT is  still not a walk in the park for many women. There is a lot of trial and error and less than perfect options. I do think having the option of bioidentical is great progress compare to the past. You’re correct that utrogestan is Prometrium here in Canada and the United States.

Ermin2Trude it seems we may be similar in our physiological responses and harmone ratio requirements. I was very interested to read that you couldn’t handle Estrogel. Can I ask you how it affected you? Also, how much is in the estrodot that you mentioned? If the pill doesn’t work out for me, I will bring this up at my next visit. And how much progesterone do you take? Synthetic or bio identical?

I met with a new gynaecologist this morning and she was wonderful. So supportive and really listened to me. She has started me on Estrace (she explained a slightly higher risk as it has to go through the liver, but I don’t care because I need to feel well and function and get my life back), oral bioidentical estradiol 1 mg and she said that some women can’t handle the Estrogel. She said it could be causing surges of Adrenal stress hormones because I’m so small and don’t have much body fat. The gel might be going into my bloodstream too fast and too hard and causing horrible panic and anxiety. I took my first pill at lunch today with food and so far, I feel calm without the horrible  Icky panicky feeling of impending doom.

It’s very early but I’m hopeful. She also said that we will give it a few months and if I’m not responding, she has a colleague who is a meno specialist in the nearest city and she will refer me. Very productive meeting and for the first time in this awful journey, I feel supported by a doctor. Makes a huge difference. It’s been so helpful talking with you all and getting your input and shared experiences. Really invaluable.

[meno-mel]

   she said that some women can’t handle the Estrogel. She said it could be causing surges of Adrenal stress hormones because I’m so small and don’t have much body fat. The gel might be going into my bloodstream too fast and too hard and causing horrible panic and anxiety.

Oh that's interesting, I wonder if that is my problem too? I became underweight during the pandemic, through inactivity really which kills my appetite but I also had really bad nausea during that part of my meno journey.
Whatever the reason I get what could only be described as surges of fear and anxiety when I'm too skinny. My weight is medically "normal" now, I'm still thin but the surges are absent atm.
I don't know if it happened more after starting HRT, I put on weight with HRT because my nausea has finally gone, the nausea was awful.
I was told a few years back I have a benign tumour on my adrenal gland and two on my liver as well, so I guess adrenal problems might follow?
The (private) doctor who told me in 2018, advised me to get it checked again after a year, but I haven't bothered to do it privately and the NHS leave things like that well alone, they won't even look!
Did she share any more details about it?

[Ermin2trude]

Hello,

So oestrogel……….anxiety, heart palpitations, dizziness, vertigo, tinnitus, depression, migraines, allergies, difficulty breathing, dry eyes, hair and skin, itching, panic attacks, pressure in head, crying spells………

I am also small and underweight. I always have been even though I eat like a horse.

I started on estradot 50 and almost immediately most of the symptoms listed above went away. I reduced the patch to 37.5mg and it improved further. Went to 25mg……absolutely fine. Now I’m trialling just progesterone (bio identical utrogestan 200mg daily) and not having oestrogen at all. So far so good. My plan though is to stop HRT completely. Pre HRT I was really happy and my symptoms were manageable. With HRT my mental health has deteriorated and I don’t recognise myself. Both my husband and myself think we should prioritise my mental health so shortly I will be heading over to the alternative therapies section on this site.

Good luck on your journey though and I’m glad you are getting support from doctors etc now.

[CLKD]

Criky some ladies have to jump through hoops to find a regime that helps!   That's awful.

Something struck a chord: Whatever the reason I get what could only be described as surges of fear and anxiety when I'm too skinny.. I was told that was because I wasn't eating enough; however due to my phobia I ate as much as necessary in order to remain upright = intense nausea which my brain mis-interprets.   . My GP gave me propranolol to ease anxiety surges which helped me to eat more. 

I don't remember hormones being so troublesome during puberty.

[Kathleen]

Hello ladies.

I just wanted to say that I have always struggled to get my HRT right and I am also a small person being five foot two and eight stone. Surges of one sort or another are a daily experience for me. This means of course that I sometimes feel fine and sometimes I feel rubbish.

In the early days I tried tablets and also Livial (Tibolone) but most of the time I have been using patches, or gel.

I have read different opinions on which is the most calming hormone, Oestrogen or progesterone. It may well be that we respond more favourably to one over the other. I also believe that our progesterone production stops first as we only make this when we are actually ovulating.

I will continue to experiment and hope to achieve some stability in the future, fingers crossed and all that!

Take care ladies.

K.

[lilbebel]

Well, day three back on Prometrium and my mood is alarmingly low again. I don’t think it’s a coincidence. It seems that oestrogen gives me anxiety and progesterone makes me severely depressed.

What a wonderful combination, not.

Ermin2trude I am seriously considering stopping a HRT like you. I haven’t been able to stop crying all day. I’m quite certain it’s the progesterone. I’m fine for a day or two on it, but then after a few days, bam. So fed up.

I’m wondering if it’s the case that some women just can’t handle hormone replacement therapy. It’s touted as the be all and end all, but that only makes me feel like a total failure. I’d be interested to know the thoughts of others. Does anyone else think or no from their own experience that HRT just made things worse psychologically.

[meno-mel]

Well, day three back on Prometrium and my mood is alarmingly low again. I don’t think it’s a coincidence. It seems that oestrogen gives me anxiety and progesterone makes me severely depressed.

What a wonderful combination, not.

Ermin2trude I am seriously considering stopping a HRT like you. I haven’t been able to stop crying all day. I’m quite certain it’s the progesterone. I’m fine for a day or two on it, but then after a few days, bam. So fed up.

I’m wondering if it’s the case that some women just can’t handle hormone replacement therapy. It’s touted as the be all and end all, but that only makes me feel like a total failure. I’d be interested to know the thoughts of others. Does anyone else think or no from their own experience that HRT just made things worse psychologically.

Oh lilbebel, I know what you mean about feeling worse, then the medical staff are disappointed with what you are telling them, sometimes disbelieving, never pleased!
I have considered quittng HRT constantly since I started it, the menopause clinc always offer me hope that there is a solution and I can try it right now. If I just put myself through the worst hell on earth for a couple more months they are sure I'd be fine. So I endure the torture of putting myself and my husband through the progesterone part for three months running and I tell you it takes a few days afterwards each month for my husband to treat me normally and not like a raging bear to be very careful around.
Do the side effects lessen? No.
Thanks for the hellish experience menopause clinic, what's next?
Now they want me to get a mirena coil! Not happening.
I had a coil in my thirties and it made me go a bit crazy with PMT at first, then as we got used to my negative personality change I was bleeding constantly on it as well when I went for the two month review and asked for it to be removed. It was the doctor's turn to say no.
I was told I had to give it three months minimum, but the two month review was the last (and only) review, so I ended up with the thing inside me making me a dozy compliant zombie for 2 or 3 years, can't remember exactly how long, by then I had no periods with it so that was a benefit.
The difference I felt when it was out was like night and day, within a few hours my head began to clear, it didn't even take until the next day for me to feel like I was returning to my body, I'd completely recovered within three days.

[lilbebel]

Meno-mel it is so emotionally draining on top of the mental and physical torture we go through. I don’t think I’ll even be able to survive three months of this and that’s not hyperbole. I’m so emotionally exhausted I have no room left to keep on coping and “allowing time to adjust “. It’s like a special kind of hell dealing with HRT in my experience. I see it has been the same for you. So sorry it’s this hard for you as well. The doctor mentioned at the marina coil to me too, but that is never going to happen. I don’t think they understand the severity of progesterone intolerance and some women. It’s not even a hidden fact. 23% of women can’t take it. That’s a lot of women. I haven’t taken any of my hormones today and I’m trying to listen into my inner wisdom and instinct and I think it’s telling me to stop. I can’t keep doing this. I feel like I’ve been in the ring with Mike Tyson after several rounds.