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Author Topic: HRT or the pill or depo injection?  (Read 4819 times)

Cosmicgirl

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HRT or the pill or depo injection?
« on: October 19, 2023, 11:02:34 AM »

I'm 48, peri and have been on Everol Sequil patches for 3 months now - I'll admit they've helped a bit with the anxiety, insomnia and the night sweats but this month I've really struggled with the low moods. I also still get very heavy, painful periods and my cycle has been 14, 25 and 26 days so far - my cycles have always been short but I thought the HRT would regulate them to a standard 28 days (before going on HRT my cycles had lengthened, so I'm disappointed to get my period more frequently again especially when it's so horrible).

Not sure if it's even possible or if it'd help with my symptoms but I'm wondering if it might be worth asking the GP if I could switch to the pill or the depo injection instead. I feel so clueless so if anyone has an opinion or experience of this please share before I possibly look like an idiot suggesting it to the doctor.

At the back of my mind too is that in Feb we're off on a big holiday with lots of travelling and very basic toilet conditions and I can't help worrying about it if coincides with my period I'm going to flood and leak everywhere.
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CLKD

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Re: HRT or the pill or depo injection?
« Reply #1 on: October 19, 2023, 12:13:25 PM »

Depo - meaning what.  Depomedrone is a steroid injection  :-\

Browse round.  Make notes.  There is medication to ease prolonged bleeding, mayB speak to a Nurse Practitioner to find out when it's best to take it?

We have a holiday thread here somewhere ;-).
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sheila99

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Re: HRT or the pill or depo injection?
« Reply #2 on: October 19, 2023, 01:47:04 PM »

Hrt doesn't control your cycle in the way a bcp does. Some people use a combined bcp in early peri instead of hrt but if evorel sequi doesn't fully control your symptoms there may not be enough oestrogen in it for you now. Your best option might be a mirena alongside an oestrogen only patch, gel or spray. This way you can increase oestrogen as you need to and the mirena is the most effective way to be bleed free. It also acts as contraception if you need it.
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Cosmicgirl

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Re: HRT or the pill or depo injection?
« Reply #3 on: October 20, 2023, 02:00:43 PM »

Depo - meaning what.  Depomedrone is a steroid injection  :-\

Browse round.  Make notes.  There is medication to ease prolonged bleeding, mayB speak to a Nurse Practitioner to find out when it's best to take it?

We have a holiday thread here somewhere ;-).

Sorry, it's the controception injection Depo-Provera, I was on it many years ago and had no periods which was great as I suffered so badly with them.

Think I will make an appointment with the nurse practioner and see what she suggests. Shella I've heard so many horror stories about the mirena that I've never even considered it but maybe I need to explore it some more.

I feel I've walked into this menopause malarky with my eyes shut, I spent years wishing for it as it'd mean the end of periods without fully understanding what it actually involved  ::)  Thank you both for your help x
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CLKD

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Re: HRT or the pill or depo injection?
« Reply #4 on: October 20, 2023, 03:32:12 PM »

Tnx for the explanation.

Many of us walk into peri-menopause with very little knowledge.  Most thought it was the finish of periods plus a few hot flushes  ::). However! It's The Change - does what it says on the tin.  Browse round.  Ask away - we talk about most things including menopause  ;)

Do read the 'bladder issues' and vaginal atrophy threads.  If U feel the need, do get a referral to a dedicated menopause clinic as there are waiting lists  ::).

Some find that keeping a mood/food/symptom diary of use to chart progress.  Let us know how you get on!
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Hurdity

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Re: HRT or the pill or depo injection?
« Reply #5 on: October 21, 2023, 07:54:45 AM »

Hi cosmic girl

The contraceptive pills that are designed for peri-menopause are called QLAIRA or ZOELY and these provided bio-identical estradiol which is the same as our own body's oestrogen. These should suppress ovulation and therefore control bleeding but as it might take a few cycles to settle then in view of your holiday in Feb, then sooner rather than later would be best. Otherwise as sheila said the other option is the Mirena coil will also do both and at least minimise, if not completely stop bleeding.

Hurdity x
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Tulip123

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Re: HRT or the pill or depo injection?
« Reply #6 on: October 21, 2023, 10:01:55 PM »

I'm in a similar situation. I'm 47 and have been on Evorel 50 & utrogestan for 13 months now.
I have been referred to gynae as I have irregular periods and horrible cramps (now they are every day).

Until last year I had no period issues as I was taking the combined pill for 30 yrs.

They gave me the minipill this week to add in more progesterone and I'm going back for more tests in 2 weeks.

Have you tried the minipill?
They also suggested the coil.

My mum stopped her periods at age 49. I hope I will be the same so I only have 2 yrs of this left!
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Cosmicgirl

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Re: HRT or the pill or depo injection?
« Reply #7 on: October 23, 2023, 09:48:55 PM »

I'm in a similar situation. I'm 47 and have been on Evorel 50 & utrogestan for 13 months now.
I have been referred to gynae as I have irregular periods and horrible cramps (now they are every day).

Until last year I had no period issues as I was taking the combined pill for 30 yrs.

They gave me the minipill this week to add in more progesterone and I'm going back for more tests in 2 weeks.

Have you tried the minipill?
They also suggested the coil.

My mum stopped her periods at age 49. I hope I will be the same so I only have 2 yrs of this left!

I have an appointment with the nurse practioner on Weds so I'm going to ask about the pill, the unpredictability of when my period will start (along with the heavy bleeding and pain) is a nightmare especially with work, and I honestly think it's one of the reasons I'm feeling so down.

My mum was mid 50s so I always assumed it was years off for me but looking back I'm pretty sure I've been peri for a few years already so praying I'll be nearing the end soon.
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Cosmicgirl

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Re: HRT or the pill or depo injection?
« Reply #8 on: October 25, 2023, 05:35:47 PM »

Just a quick update. Saw the nurse practioner (who was lovely) this afternoon and she's prescribed me the mini pill to hopefully get my periods lighter and under control. I'm to stop the HRT and just take the mini pill until things settle (she expects it to be less than 3 months) and then to add the HRT again along side it to tackle the other symptoms. Feeling positive  :)
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joziel

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Re: HRT or the pill or depo injection?
« Reply #9 on: October 25, 2023, 05:57:45 PM »

I'm not sure about that advice, frankly. There's no need to stop your HRT to add the mini pill in. You just start it alongside everything else. You are only going to get your low estrogen symptoms back again...
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pastie supper

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Re: HRT or the pill or depo injection?
« Reply #10 on: October 26, 2023, 07:59:38 AM »

I suppose the logic behind it is that progesterone is usually the first hormone to exit the stage as it were.
So if you have a peri woman suffering symptoms it might only be progesterone she's missing.
My periods were still frequent and heavy when I was 49 and 50, but they weren't in a regular cycle as they had been when I was 48.
My last natural period was just after I turned 51, not one since except induced by HRT.
I'm just saying that in case the time frame is similar for you, you could expect maybe a year or two of periods then I expect they'll stop.
If you get a mirena or a depo now, it will probably last until you are post menopausal and you might never have to have periods again, if you can tolerate the progesterone of course.
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pastie supper

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Re: HRT or the pill or depo injection?
« Reply #11 on: October 26, 2023, 08:15:05 AM »

One other thing cosmicgirl, Have you tried the Luna or Mooncup or other brand? There are loads.
I discovered the Luna when I was 45 and I wished I'd had it for many years, especially for travelling to countries where they don't consider female toilets something to provide for the public!
I always had very heavy periods, after getting the cup I measured a few and I was bleeding over 200ml each and every month.
It holds 16ml easily and 30ml if I don't move about, lol, it is a million times better than tampons which didn't work for me, always a line of blood down one side of a tampon and then running out to flood me while the rest of the tampon stays pure white.
What a waste of money when the cups existed all along!
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joziel

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Re: HRT or the pill or depo injection?
« Reply #12 on: October 28, 2023, 10:43:29 AM »

The mini-pill isn't progesterone.

Progesterone is a hormone made by our own bodies. The only reliable drug we have which is progesterone, is utrogestan. Utrogestan does not override your own cycle or body, because it isn't powerful enough to (unless you take a huge amount of it).

The mini-pill is a progestin. This is a manmade synthetic hormone which has made side effects (increased risk of breast cancer, affects lipids and cholesterol, and more). It overrides your own cycle, typically prevents ovulation, and actually reduces production of estrogen. Which is why it's used for women with endo - because it suppresses estrogen.

Last thing you'd want to do if you are having low estrogen symptoms, is to be on a progestin-only. It's just doctors with no clue what they are doing, mucking around because they don't need to be the ones suffering horrendous symptoms for weeks as a result.
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pastie supper

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Re: HRT or the pill or depo injection?
« Reply #13 on: October 31, 2023, 08:00:13 AM »

The mini-pill isn't progesterone.

Progesterone is a hormone made by our own bodies. The only reliable drug we have which is progesterone, is utrogestan. Utrogestan does not override your own cycle or body, because it isn't powerful enough to (unless you take a huge amount of it).

The mini-pill is a progestin. This is a manmade synthetic hormone which has made side effects (increased risk of breast cancer, affects lipids and cholesterol, and more). It overrides your own cycle, typically prevents ovulation, and actually reduces production of estrogen. Which is why it's used for women with endo - because it suppresses estrogen.

Last thing you'd want to do if you are having low estrogen symptoms, is to be on a progestin-only. It's just doctors with no clue what they are doing, mucking around because they don't need to be the ones suffering horrendous symptoms for weeks as a result.
That's interesting, I noticed I have to take utrogestan for longer than provera before I bleed but it has fewer side effects.

Provera makes me bleed a few days into taking it, that wasn't what the doctor said would happen.
In fact the gynae thought it was the best med they have for stopping bleeding occurring!

They aren't identical, but aren't they designed to be similar and do the same things? Why would they be interchangeable otherwise?

I thought Cyclogest was bioidentical progesterone as well and the progesterone in bijuve, but who knows.
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joziel

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Re: HRT or the pill or depo injection?
« Reply #14 on: November 02, 2023, 10:20:54 PM »

Cyclogest is the same thing as utrogestan, it's just designed to be a vaginal pessary instead of an oral capsule.

The progesterone in Bijuve is... utrogestan. All these are body identical utrogestan, they are just for different routes or combined with other things.

Progestins can sometimes make you bleed when you first start taking them but long-term/over time that stops. When I used to start the POP, I would bleed lightly for weeks if not months - then it would stop completely for as long as I took it.
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