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[Turkish delight]

Hi Gals!

Just asking if anyone takes 2 Utrogestan vaginally for the 2nd part of the cycle? Or is it pointless?
I ask because I've just upped my Oestrogel by 1 pump from 6 to 7 pumps.
I haven't ever had any breakthrough bleeding before at all while taking the previous 6 pumps and 1 utrogestan vaginally for 15 days,
but wondering if I need to increase now as taking an extra pump?

Also, is anyone putting Testogel on their wrists?

Thanks
TD

[sheila99]

Yes. 2x100 is the standard dose according to Besins and the BMS. it's only Newson who thinks youvcan use half the dose (and I think she may have changed this recently?). I only tried one cycle on 1x100 but I didn't bleed though it's possible I wouldn't have done on the standard dose either. I use my instep for tostran, everywhere else seems to get more hairy.

[Hollyboll]

I wouldn’t use wrists. Famous meno ‘specialist’ pvt Gp suggested non-hairy parts of arms, and that a) made them hairy b) contaminated blood tests.

Im on conti not cyclical but higher doses oestr need higher prog. Route is irrelevant to needing more, according to leading meno consultant Im lucky to see.

Xx

[Turkish delight]

Wow, thank you both!

Great advice, I really appreciate your help.

X

[RebJT]

Hello

I've just switched from 7 pumps of Oestrogel (after all the issues women are having with it lately) to a patch, as my E numbers have plummted despite increasing doses.  I don't think it's doing a fat lot.  There's a big thread going on here if you want to have a read.

Just to say it's not just Louise Newsom who thinks lower doses of utro vaginally are OK (I'm not a big fan of Newsom, my gynae calls her 'that woman'), consultant gynaes will also approve this with regular scans in certain circs, they will also approve lower dose coils for the same reason, or Lutigest or Cyclogest - all of this is off licence.  Prof Studd was one, my gynae is another, Nick Pannay is another.  Some women are very prog sensitive and simply cannot tolerate 200mg per day, and I'm one of them.  I can sometimes tolerate the odd day of 200 (or 100 oral, 100 vag), and as Nick Pannay says, tolerance can be built (this is also my experience) but we're all individuals it's not hard and fast.  (No doubt the menopause rainman will be along to dominate this thread with a load of data in a minute.  I've read the data, including the latest BMS reports, women are not data).  Nick Pannay talking about it here: https://youtu.be/TonsBFCf5hg?si=SIkqokG7F3TH1Gam

Good gynaes have years of clinical practice to back up their decisions, they see it in their work, that's good enough for me.  There's a lack of data in this area, simply because the studies are not being done.

And yes I put T on my wrist, no issues, I use a pea sized blob of Tostran daily, have done since 2019, no hairs.

Come and have a look at the oestrogel thread, as many of us were on increasing doses to no benefit after being stable for years.  My levels fell from 1,500 to about 150 pmol over the course of a few months, from the moment they changed the bottles, and I was increasing the doses by a pump every month or so, it did absolutely sod all.

Reb

[Hollyboll]

Well said: women are not data!

Agree experienced consultants are very helpful, including for individual needs. Great you’ve got a good one (as have I, very luckily). Not all gynaes are great at meno. I really worry about the people calling themselves meno ‘specialists ‘ when they are actually GPs (or nurses) who are simply less ignorant than most GPs- not a high bar.


Fwiw I think even some of those leading specialists have strengthened their messaging that utro vag needs same dose as oral, probably partly in response to newson shouting everywhere pro v high oestr and lower / less / a 3-month trial without prog.

But as you say it’s all about individuals and lots of individual factors, which is why it needs advice from specialist and not anecdotal from what works for someone else on board.

I’m off to hide from rain man/ newson acolytes (of whom I was one; I learned the hard way) / hurled rotting tomatoes ….

[RebJT]

Thanks

One thing I admire Newsom for is she's a good business woman, she now has dozens of GPs and nurses working for her in posh locations around the country charging consultant gynae (Harley St) prices for ten minutes with a GP or nurse, hats off to her for making a shed load of money.  Beyond that, if I'm paying consultant gynae prices I want to see a consultant gynae.  I think she's cavalier and a one trick pony, but she's done some good with education and empowering women to demand better care, that's about it.  I have histamine intolerance and my gynae specialises in this area, Newsom send their f**k ups to her, one lady with serious mast cell over activation on SIXTEEN PUMPS of oestrogel from Newsom, histamine jitters wrongly interpreted as formication by a Newsom GP!  My sis in law sees Nick Pannay in person, she had a hysterectomy young, dreadful treatment NHS.  Pannay has her on 2 x 100 estradot plus extra gel to keep her blood levels at 700 pmol, he utterly transformed her life.  He insisted on regular tests and has expertly dealt with the GP.  She's a poor absorber.  We are not all alike!

Agree about messaging, and indeed the standard advice is 200mg, but a good gynae will listen to and work with a patient.  My gynae will sometimes say things like 'that's at the edges of safe, I'd prefer not to do that, let's think about X instead' or whatever, but providing I'm testing (190 pmol on 7 pumps of oestrogel, pretty safe to say I'm not suffering from an excess of unopposed oestrogen!) and having scans, and more to the point feeling good, not having excess bleeding etc, then she uses her medical knowledge, the research and ... drumroll ... clinical signs and symptoms to actually practice medicine!

The other thing I was told (I have other health issues, that I largely had to figure out myself) is that people on internet forums are not the 'norm' - people who are well and happy are off living their life, not posting on the internet, so already before we start, the experience is skewed.  I wouldn't be able to manage any of this without the help and supervision of a doctor I trust, who will be my partner and work with me to figure things out.  I haven't ever seen my GP on meno, I only deal with a specialist.

Reb
x

[Hollyboll]

Yep - newson is great at business, social media and pr. she’s done a lot to raise awareness and normalise hrt.

Unfortunately that also means even GPs assume it’s universal / simple panacea. For some women that works for many it doesn’t and is dangerous.

My Gp totally useless, and calls himself meno ‘specialist’.

And yes - this like any forum is highly self-selected/skewed. Those who have no issues, whether without or on hrt, aren’t here.

Xx

[Turkish delight]

Thanks gals

This is all so interesting and educational. I am aware of the 14-page Ogel thread, and have added to it myself a few times and lately too.

We are all different as you say, we are not robots that all need the same work through to fix us.

As I've often said, this HRT business is like the Wild West. I am having to work through this by myself as GP is great but lets be
real, I know more about HRT than him at this point, well and from the jump actually when it was 1st prescribed.
I could get on an NHS waiting list for a specialist but that's years wait, and I'm not confident that they will even be that up on it tbh.

I couldn't agree more about meno specialists just being GPs with a "special interest" in meno..end of, and it's like you took the words right out of my mouth re L.Newson, she certainly found the pot of gold at the end of that rainbow and seems to be winging it and trying to catch up with the info before she's busted.

Hollydoll hi, Wondering what did you mean about T application on wrist contaminated blood test?

TD