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[Jessbob]

I’m 50 and definitely perimenopausal. But I have regular 28 day periods.

I tried gel and patches (low dose) and both times the oestrogen made me feel awful after a week. Terrible joints pains, jitters, poor sleep, anxiety, I just felt absolutely awful.

I’ve read around progesterone therapy only and it seems that there are some studies that women have been given P only for 14 days in the luteal phase or continuous alone. No Oestrogen.

I decided this month to give it a go. I decided to try continuous.
Day one of my cycle and I started 100mg Utrogestan daily.
I’ve slept beautifully, feel much calmer. I’ve had some aching joints and some gas / bloating but nothing to really write home about.

I thought this might be a success but today on day 20 of my cycle, over a week early, I’ve started painfully bleeding. Dark, brown blood and period pain.

I had read that taking P continuously whilst still having a cycle can cause irregular bleeding but I can’t understand why?

Stopping / dropping P triggers a bleed? Has my own P dropped in the background enough to trigger bleeding? Surely the oral P would keep it topped up and is enough to stop it?

Can someone explain why this has happened please? It’s no good if I will throw my cycle off.
I was planning on taking up until day 25 then taking a 3 day break to trigger a bleed then restart.

Any ideas please? Not sure what to do now going forward

[Hurdity]

Hi Jessbob

If you are having regular 28 periods then you are not strictly peri-menopausal, according to the medical definition (as I've just explained on another post). The NICE Guidelines define it as when period cycle length varies by around 7 days each month. However hormones do begin to go awry in the stage before that and in fact in many cases periods start getting closer together before cycles get longer. Unfortunately many women do start to get symptoms at this point and this can be difficult to treat because often the standard HRT treatments won't work (they're not really designed for this stage because ovulation is still occurring).

The reason you are bleeding is because the progesterone is not suppressing ovulation and your natural cycle is going on in the background. The added progesterone may well mess up your cycle, and once you start taking something you don't know what would have happened if you hadn't - if you see what I mean? ie your cycle will naturally start to change but you won't know whether it's due to what you're taking, or what your body would be doing anyway, without intervention.

Progesterone on its own can be taken in  the luteal phase, not for therapeutic reasons, but to regulate heavy bleeding that can occur around this time and especially once peri-menopause proper starts and there are cycles without ovulation, but the womb lining builds up. I can't see any reason to start to take it on its own continuously when you are still having regular periods.

What symptoms did you have that led you to want to take something?

Progesterone is a sedative - many of us hate this effect because it leads to foggy head and fatigue but if in your case it is being used purely as a sleeping aid, that may well be OK, for the time being.

Sometimes just taking P can trigger a bleed if the womb lining has built up - especially if it has got too thick. The P changes the endometrium from proliferative (growing) due to oestrogen, to secretory (changes structure) during the progesterone phase.This is ready for implantation from fertilised egg. If no egg then P drops and away it comes. Sometimes it comes away early if ready and especially if it is thicker? However if ovulation has occurred then your own P will drop and yes this will trigger a bleed if the lining has built up from your natural cycle.

So in answer - likely you ovulated....

25 days out of 28 likely won't work (in terms of 3 day stop to trigger a bleed) if you're having regular periods and your own cycle is strong. That only really works for later peri or post-meno.

Hope that's not too garbled (think Im feeling a bit garbled this eve) and makes a bit of sense!

All the best

Hurdity x

[Jessbob]

Hurdity thank you so much for your really helpful response.

I started HRT in the hope it would sort out my very poor sleep, cortisol surges which were waking me in the early hours. Lightheadedness, dizzy spells and terrible digestive issues that started around 5 years ago.

I’ve never suffered sweats, flushes, my skin is good, a little itchy at times maybe. I have lost some interest in sex but everything works fine and I’ve not had issues too much with dryness etc. I think my oestrogen levels are ok.

I did some reading and it sounded like low progesterone may be my issue rather thank low oestrogen. So I thought just taking 100mg P daily would perhaps help.

It’s definitely helped me feel calmer and I sleep so much better. It also slowed my bowels down a bit which has improved my loose stools.

It would be highly unusual that my own cycle would have started my period on day 20 though, I’ve never had such a short cycle before and it must be due to taking the P?

I’ll leave everything off for a full month or two and see how I go.

[CrispyChick]

Hey.

Although it's not worked for me - there is a big following for prog only therapy in other countries.

I took do not need E. It makes me feel poisioned, as does my own, which is always high on testing.

I've been through a bhrt clinic and they told me I needed only prog to help balance my higher estrogen.

If you feel better on it, it's a good thing to try. If u can cope with that one off bleed, I'd keep going and see what happens next month.

It's well known that in peri our progesterone drops first, whilst our estrogen can go higher than it's ever been before. Yes, some woman feel the estrogen dips, but I only feel the horrific spikes. I'll be glad when mine drops.

The NHS do not engage in this idea. No idea why. I felt horrific when I tried estrogen hrt.

Xx

[Jessbob]

How interesting, Ive had loads of 'telling's off' on other forums and on Facebook when I dare to suggest I dont feel I need Oestrogen.

I also feel poisoned. Its a good way to describe it. I feel anxious and shaky, wired yet exhausted. I feel sick, I get headaches and where I place the patch or gel I get terrible muscle and joint pain nearby. When I applied the gel to my arms I got TMJ in the ear / jaw. If I put the patch on my buttock my lower back is  agony after a few days. When I ovulated I was so bloated and in pain I thought my lower belly was going to pop with pressure.

I have small fibroids but my GP was quite dismissive. When I went for a scan to check my womb lining thickness the radiographer couldnt see my ovary on one side, it was almost tied up against and behind the womb. She asked whether Id ever been diagnosed with endometriosis. I havent but it may account for the terrible pains and IBS type issues iver had for years. 

Not sure whether to try P alone again next month. I dont want a period every 20 days - I hoped it would have stopped them altogether!.

[AngelaH]

I made through peri with Mirena coil only as progesterone source. In peri I started losing progesterone first  while estrogen remained at a fairly high level, making me feeling estrogen dominant. The Mirena sorted out all my peri symptoms and stopped completely my chaotic heavy periods too. I was lucky that time, my NHS GP was German and she even didn’t try to poison me with estrogen on top of my own. NHS approach to meno symptoms treatment is different from Europe and probably the rest of the World.

I have just discovered recently, because I am post meno now, my body hates estradiol, for more than a year I struggled to find the right for me form of estrogen. Now I am happily settled down on the low dose of estriol, which is very weak form of estrogen.

We all different, HRT which is available through NHS doesn’t work for everyone. The best way to find out your right treatment is to learn your own body, listen to your own body and try different sources which are available around.

[Jessbob]

Thanks, do you mind me asking what your symptoms of Oestrogen dominance were please?

[CrispyChick]

You really do sound like you are more in my position.

It took me trying hrt to realise that my own 'poison' was elevated by the estrogen in hrt.

It's unfortunate, as Angela says, the rest of the world treat peri differently. A lot of us have excess estrogen, or two little progesterone to balance it.

I think you were asking Angela, but fur what it's worth, my estrogen dominance is extreme poision feeling, nauseous, swimming spinny head with motion sickness. I lose my appetite. My lower back aches with it. Horrific.

Unfortunately I couldn't tolerate the progesterone. If it were me, I'd try another month on it. I don't think you would continue to get so many periods. As you've been on estrogen your lining will have built up. Progesterone helps secrete it.

Try the Estrogen dominance Facebook group.

[Jessbob]

Crispy Chick, sounds like exactly my experience on oestrogen.

I felt like I had motion sickness, I struggled walking the dog. I felt breathless, lightheaded, strange, Snappy and moody.

I HATE how I feel on Oestrogen. Its as though it takes time to build and starts the effects about 5-6 days in and gets worse and worse. I had one day of pure liquid diarrhea, i couldnt leave the house. I ripped that patch off and within 2 days my head cleared and I was back to normal.

Ive tried it about 3 or 4 times now, same effect each time.

 

[CrispyChick]

It's crazy that that's what the NHS give us in peri.

Unfortunately for me, my very short hrt trial just alerted me to estrogen dominance. My own estrogen gives me the poision. It's horrific.

I'm nearly 48 and no better. 😞

[AngelaH]

Thanks, do you mind me asking what your symptoms of Oestrogen dominance were please?

My progesterone level started declining when I was still in my 30s. The first symptom was itchy skin on my face, that time NHS failed to recognise the problem. In the age of 39 I experienced my first night sweats and I started feeling constantly warm, in my 40s my muscles and joints became painful. By the age of 46 I had insomnia and developed fatigue. When I was 48 anxiety and depression added to my symptoms, panic attacks, dizziness and I felt like I was dying. Heavy non stop bleedings for months. At that point I was fitted with the Mirena. All changed overnight, the next day I woke up in the morning and all the symptoms were gone, I got my life back eventually and I enjoyed it for the next 2 years or so. After that my estrogen level started declining and I started experiencing low estrogen symptoms.

Since I was teenager I had my periods longer and heavier than average women, I thought I just was different, but now I think my body actually never produced sufficient amount of progesterone. Apart from long and heavy periods I did not have any other symptoms of estrogen dominance until the age of 30+, when my skin started becoming itchy.

[Jessbob]

Thank to you all for your replies.

When my period started 3 days ago I stopped taking the one Utrogestan tablet with the intention of having a 3 day break then restarting.

I’ve woken up half the night feeling warm and jittery, also my muscles are aching badly.

So what does this mean? Do I need to start the progesterone again and it will pass, do I actually need oestrogen?


I’m confused because symptoms of low oestrogen are the same as high. Should I start the P alone again tonight and give it another month?


I’m loathe to try a patch again (even the 25mg Everol made me feel awful). Perhaps my own progesterone at this part of my cycle is rock bottom?


I’m surprised at how heavy my period has been, I was hoping the regular P would have helped make it lighter, is this something that takes a while?

[CrispyChick]

Unfortunately we're all different and most woman on this forum seems to require additional estrogen.

There are a few, and plenty on other groups that, in peri, suffer more with too much E relative to P. This is 100% my case. I've also had it confirmed by a private clinic.

If I could tolerate progesterone, I'd be in a decent dose in a heartbeat to try and balance my estrogen.

From what you have said, it sounds like you are the same - at this stage. I have read that progesterone makes any lining builder up shed - so that's possibly what happened this month.

So, if it were me, I'd do another month on the prog. You're day 3 of a new cycle - estrogen will be rising. For me, those would be estrogen symptoms, unbalanced.

If the progesterone doesn't help, you could try cutting your patch and trying a lower dose of estrogen on top?

If I'd have had advice about high estrogen/low prog in peri much earlier on, I think I could've had a different experience. 

But I'm still stuck in torture. Just praying for the day my estrogen goes south!

[AngelaH]

When my period started 3 days ago I stopped taking the one Utrogestan tablet with the intention of having a 3 day break then restarting.

I’ve woken up half the night feeling warm and jittery, also my muscles are aching badly.

So what does this mean? Do I need to start the progesterone again and it will pass, do I actually need oestrogen?


I’m confused because symptoms of low oestrogen are the same as high. Should I start the P alone again tonight and give it another month?


I’m loathe to try a patch again (even the 25mg Everol made me feel awful). Perhaps my own progesterone at this part of my cycle is rock bottom?


I’m surprised at how heavy my period has been, I was hoping the regular P would have helped make it lighter, is this something that takes a while?

If you really have heavy periods your estrogen level is not low. You are in peri and your body still has more control, plus you have regular periods, it means nothing wrong with estrogen. But this is from my point of view.

Utrogestan is not the best choice of progesterone to control the symptoms. I think it’s very controversial form of progesterone. NHS love it, a lot of women hate it. The best way to control bleedings is the Mirena, but it is possible it will stop your periods at all.

From my own experience: symptoms of  high estrogen and low estrogen are not completely the same, although some of them like insomnia and itchy skin can be very similar. I also would not mix up symptoms of high estrogen, which occur in the body naturally (when progesterone goes down or the body produces too much estrogen) with symptoms, which we are experiencing when taking HRT. There are different indeed. For me even taking 3 different forms of estrogen: patches, gel and spray, gives me absolutely different symptoms, but the same poisoning feeling. There are nothing to do with the symptoms, which I had in peri naturally and which were treated with progesterone only.

I am sorry I can’t really help you with advice, it took me many years to go through all stages of menopause to learn my body and how I react on different hormonal fluctuations, learn which hormone causes the problems and how to treat it. Unfortunately when it comes to sex hormones we are all different.

[AngelaH]

If I'd have had advice about high estrogen/low prog in peri much earlier on, I think I could've had a different experience. 

Now 20 years later I say to myself the same things everyday. I went to GP in my 30s with my itchy face and GP failed to find the reason, I went undiagnosed for another 10+ years! I was prescribed low dose steroid cream to use on the face, of course it helped me with itchy problems, but it didn’t stop my progesterone from falling down further in my life and consequences were horrific. Of course if NHS don’t recognise “estrogen dominance”, this is what is happening. Absolutely unnecessary suffering for ladies.

Actually as I remember gynaecologist in hospital who fitted me with the Mirena told me if I had the Mirena before as a contraception I would go through peri without even noticing it. He was English, very pleasant man in his 40s. So some English doctors know about progesterone, but NHS as organisation creates its own rules and doctors have to follow them.