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[Penguin]

Hi
Am 49, still in peri and been on one pump estrogel daily and 200mg utrogestan vaginally since end of December.
I'm on day 18, so started utrogestan on Sunday and usually it is my best time of the month for me. Only dip when I stop the utrogestan and get progesterone withdrawal symptoms.
This month, however, I am on the second day of feeling anxious, tearful and down, plus waking up two nights in a row st 3am worrying about things and can't get back to sleep.
Can't work out what to do, up the estrogen for a few days, or be a bit naughty and just do 100mg of utrogestan for a couple of nights. Something has changed/ is out of whack. My anxiety is all health related and I've been doing so well but scared I'm going to spiral now. I can handle rhe physical symptons but not the mental ones. I've just added half a pump of gel and taken a low dose of diazepam to take the edge off. Would really welcome views as to what this might be, too high or low what??? What can i try?? I'm so confused.

[Nas]

Hey penguin,

Sorry you are not feeling great right now. I’m really hoping some of the lovely knowledgable members will be along soon to offer advice.

It might be that your own hormones are fluctuating, so adding a bit of extra oestrogen is probably a good move. One pump is still a small dose, so you do have scope to increase slowly.

Are you dealing with any stressful / worrying life events at the moment ?

Would taking 100 utrogestan upset your bleeding pattern?

Really hope you get back on an even keel soon.

Hang on in there 🌺

[SarahT]

Hiya Penguin,

Sorry it's so difficult for you atm. I am certain peri does add too many fluctuations into any hrt regime. Most women's cycles,even way before peri hits, would cause fluctuations, for me severe pms as the hormones to up and down. Now, add in the hrt hormones along with our changing natural cycles and it can be a perfect storm.
For myself, the higher oestrogen the better ( patches for me). My moods were the worse of my symptoms. My gp explained that during peri,pms symptoms can get a lot more severe, leading to pmdd in some cases. I upped gradually to 125 strength of estradot and added in a low dose of AD.
I was told I could have the AD on the luteal phase of my cycle when the moods were whether worse. This has evened out my cycle, almost suppressing it in the bid for mood stability... After 3 months I feel better tannin the last 18 months.

So my view is peri fluctuations. Maybe as Nas suggests a slight gel increase? X

[Penguin]

Thanks both. I've done the half gel increase a couple of hours ago but perhaps too soon for it to work. I'll do more during the daytime tomorrow I think my estrogen must be low as I'm dry everywhere too nipples included which is horrible.
I really want to take less utrogestan tonight, just the 100mg, but I'm scared I may get an early bleed. I've only ever taken lower at the start and end of the cycle to ease myself into it. Perhaps I should wait til tomorrow and then do two pumps in the morning and see what happens, what do you think, is that a really big jump?

[Penguin]

I need to find a way to get the GP to let me take less utrogestan I think, surely I don't need the same amount with the amount of gel I'm on. Or perhaps I could have regular scans, I wonder how regular I'd need to have them to keep my womb safe, any ideas? It seems the big jump amd drop of progesterone is causing issues.

[trandall]

Hi Penguin so sorry you’re experiencing this change, I am 2/3 years into the journey and on patches for over 2 years. I also suffer health anxiety and like you could manage the physical but struggle with the mental health side. I have found that every so often things change and it’s like resetting your mind each time. I use meditation and tools I picked up from CBT my work arranged for me. Maybe try some things to support your mind before trying to balance the meds and this could help you with any future wobbles you get. Take care 💕

[SarahT]

Hey Penguin,

Just thought, when I started hrt I was on a 50 patch and 100 utrogestan. So why were you put on 200? With a smallish amount of gel?  I think you may have answered your own thoughts there. May be worth querying this. Trandall is right in that health anxiety has such a bad impact, every time we crash or change we feel like we are back to square one again

[Nas]

Agree penguin,
You shouldn’t need the 200 utrogestan for one pump, surely? It’s because you are still peri I’m guessing?

Is there any guidance on the BMS website about the recommended doses of utrogestan anywhere?

Regular womb scans would be great. Would they do then though?

[Penguin]

Hey Penguin,

Just thought, when I started hrt I was on a 50 patch and 100 utrogestan. So why were you put on 200? With a smallish amount of gel?  I think you may have answered your own thoughts there. May be worth querying this. Trandall is right in that health anxiety has such a bad impact, every time we crash or change we feel like we are back to square one again

Were you on the utrogestan 12 days per month like me? It does seem a lot for one pump of gel and I've not been about to increase thus far without getting bad indigestion. I'd love to increase though.

[Penguin]

Agree penguin,
You shouldn’t need the 200 utrogestan for one pump, surely? It’s because you are still peri I’m guessing?

Is there any guidance on the BMS website about the recommended doses of utrogestan anywhere?

Regular womb scans would be great. Would they do then though?

I hasn't thought to check the BMS site,  I just went on what my GP said. I asked if I could take less because the withdrawal at the end wipes me out with anxiety for a good week, but he said a flat no.

I'd pay private for the scans if I had to, but I'd need to know frequency. No way the GP would agree to do them, they won't even test my estrogen levels. I'd asked because if I knew my levels were low, then I'd find a way to ride through the indigestion on the higher dose,  but I've always thought that getting the extra side effects means my estrogen had gone too high.

[Penguin]

Hi Penguin so sorry you’re experiencing this change, I am 2/3 years into the journey and on patches for over 2 years. I also suffer health anxiety and like you could manage the physical but struggle with the mental health side. I have found that every so often things change and it’s like resetting your mind each time. I use meditation and tools I picked up from CBT my work arranged for me. Maybe try some things to support your mind before trying to balance the meds and this could help you with any future wobbles you get. Take care 💕

That's the thing, its the unpredictability of it all that does me in. Even getting dry nipples today (which I then poked and prodded until I made them sore) really freaked me out. The slightest change from the norm does me in. Amd I'm sure I'm more prone to the HA when my hormones are off like now. The same 'symptom' doesn't bother me at all, yet when I'm anxious I see it as a sign of terminal ilness and imminent death. It's horrible.

[Nas]

It would be good to gain clarification on the utrogestan doses for one pump.

I’m sure I’ve read of cases where women who don’t do so well at the end of their utro phase, can switch to continuous 100 doses.

Not sure how that works with your own cycle though?

Any scans would definitely need to be private.

Do you ever use Mumsnet? Well, there’s a menopause site on there and a user named jinglinghellsbells. She’s VERY knowledgeable on utrogestan and doses etc and does a load of research on menopause etc.

If you did increase to 2 pumps, you’d probably have to stick with the 200 utrogestan.

[SarahT]

Hey Penguin,

It seems so long ago I was on utrogestan ( lasted 2 months, felt awful so Had the coil fitted) and sure I was on a 14 day on them. But it was 100 with a 50 patch at that point. And yes, still peri then and now. Your 200 does seem a bit odd.

When I up the oestrogen I did go slowly, I would be a bit jittery for a couple of days, then that passed, encouraging onto the higher dose. Is indigestion linked to the hrt  you think?  I have  hiatus hernia, which causes acid reflux and indigestion but take Omperazole on prescription to cease symptoms, as well eliminating certain foods and drinks which aggrevate it.
HA definitely a vicious circle x

[Penguin]

It would be good to gain clarification on the utrogestan doses for one pump.

I’m sure I’ve read of cases where women who don’t do so well at the end of their utro phase, can switch to continuous 100 doses.

Not sure how that works with your own cycle though?

Any scans would definitely need to be private.

Do you ever use Mumsnet? Well, there’s a menopause site on there and a user named jinglinghellsbells. She’s VERY knowledgeable on utrogestan and doses etc and does a load of research on menopause etc.

If you did increase to 2 pumps, you’d probably have to stick with the 200 utrogestan.

Hoping I can offset the progrsterone this month with extra estrogel and I'll just take the hit with indigestion- will get stocked up on the rennies.  Problem is, when the side effects from the estrogel increase pop up I panic and immediately think it must be something sinister even though there is a clear cause. I'll check out the BMS in the morning though, might see the wood for the trees after a good night's sleep!

[Penguin]

Hey Penguin,

It seems so long ago I was on utrogestan ( lasted 2 months, felt awful so Had the coil fitted) and sure I was on a 14 day on them. But it was 100 with a 50 patch at that point. And yes, still peri then and now. Your 200 does seem a bit odd.

When I up the oestrogen I did go slowly, I would be a bit jittery for a couple of days, then that passed, encouraging onto the higher dose. Is indigestion linked to the hrt  you think?  I have  hiatus hernia, which causes acid reflux and indigestion but take Omperazole on prescription to cease symptoms, as well eliminating certain foods and drinks which aggrevate it.
HA definitely a vicious circle x

Yes I think it is linked, upper tummy wind / discomfort happens same time each month in lead up to when I'd ovulate regardless of estrogel dose, then its gone in a few days. However, when I did try and increase it happened then too. Then once I start the utrogestan I get the reflux, well its the silent type, phlegm in throat and slight burning back of tongue and throat. I think with a hernia it'd be there all the type or can it be exacerbated by hormones if you have a hernia?

I am goimgvto increase tomorrow, do one pump and a squidgy in the morning,  then if I feel okay after lunch I'll do another squidge. Does that sound okay?