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[buffy26]

Hi, has anyone done this, would you say its an issue to do so?
I am pondering on the idea of experimenting myself with oestrogel dosage, I have been on 4 pumps of gel for 9 months now and was tested a couple of times to assess the absorption the first two were 330 or in the region of. The most recent test I have dropped down to 261. I know times of day etc is relevent but on 4 pumps this really should be higher. My symptoms are not under control either so I clearly need more.
I know some ladies on here have shared they are on much higher dosages as directed by private doctors but before I go down that road I was considering increasing my dose myself. I am only still on 1 x Utrogestan as I am assuming the need to increase that is dependant if bleeding starts.
I am just wondering if its safe to do the increase of the gel only and not up the utrogestan accordingly?

As I have a history of endometriosis and my mum had a DVT at 60yrs old, tablets are not advised which is a shame. Patches were an issue too as they fell off a lot and I did not absorb that either. I clearly have the dry skin problem where the skin barrier is not good for absorbing into the bloodstream. Has anyone heard good results about the Lenzetto spray where it just has to go into one localised area?

Thank you ladies

[CLKD]

MayB put the product name/s into the search box and read any threads about your regime?

Would the softer inner part of the arm B more likely to hasten absorption? 

[jillydoll]

Hi
My meno doctor told me 100mg utrogestion tablet covers about 6 pumps of estrogel.

[buffy26]

MayB put the product name/s into the search box and read any threads about your regime?

Would the softer inner part of the arm B more likely to hasten absorption?

Thats worth considering, but I wonder even though it has absorbed it is a bit risky with the inner arm touching the breast area during the night, like sweating it out? I will contact the manufacturer for their suggestions, although I suspect they will advocate contacting a health professional

[Dotty]

Hi new guidance from BMS advises that 4 pumps of Oestrogel needs 200mg of Utrogestan.

https://thebms.org.uk/wp-content/uploads/2024/05/01-BMS-GUIDELINE-Management-of-unscheduled-bleeding-HRT-MAY2024-G.pdf     Page 16

[CLKD]

Hadn't thought of the breast being affected 

Let us know how you get on.

[buffy26]

Hi new guidance from BMS advises that 4 pumps of Oestrogel needs 200mg of Utrogestan.

https://thebms.org.uk/wp-content/uploads/2024/05/01-BMS-GUIDELINE-Management-of-unscheduled-bleeding-HRT-MAY2024-G.pdf     Page 16

Thank you Dotty, this is really helpful. I was only advised to take 200 mgs if I started to bleed so that was incorrect! I am concerned now, as I have been 9 months on the official maximum dose without adequate protection. I am jittery about everything as I have has a lot of night sweats that have occured only in the last year. I am 61 and these sweats were not a big issue for me before then, not thinking the lack of progesterone is causing the sweats but wonder if something else could be happening
I am beginning to think I should be re-scanned, as I had a thickened lining two years ago of 7mm and at the hysteroscopy they said I was atrophic and all was fine. It mentioned the ovaries were not visible too, and that has played on the back of my mind. I dont trust things nowadays, people are understaffed and stressed. Mistakes are made!

[Dotty]

Hi it used to be the advice that you took 200mg if you bleed, but the new advice says it should be 200mg if you use 4 pumps. I think some specialists don’t agree with it .

[Suziemc]

I'm currently on 3.5 pumps of gel, having increased from 2 to 3 several months ago and then to 3.5 a few weeks ago (4 was too much). On both occasions I've let my GP know after the event so that she can increase my prescription to cover the extra.

When I saw her last week and asked her to increase it she specifically told me that if I increase to more than 4 at any point I need to go and see her to get progesterone increased. I currently have a Mirena Coil but she said I'd need to add utrogestan to this to ensure I'm adequately protected.

I'd definitely experiment yourself and find the level that addresses your symptoms, giving it time between increases to take effect, and then go and see your gp once you're happy that you're on the right dose for you.

What I didn't ask at my GP time, and I will if I increase gel again, is whether the extra progesterone is needed when my oestrogen levels are so low (clearly either not absorbing properly or being affected by the alleged/suspected change in Oestrogel). I can understand needing more progesterone if oestrogen levels are increasing but if I need more to achieve the same level then I can't see why progesterone needs increasing too   

And you're right, don't apply to inner arms as too close to breast tissue . Instructions  specify outer arms or mid/outer thighs.

[buffy26]

Hi it used to be the advice that you took 200mg if you bleed, but the new advice says it should be 200mg if you use 4 pumps. I think some specialists don’t agree with it .

The fact 'some' specialists dont agree with it fills me with no confidence. I think I need to go back to the specialist afterall, with all my concerns
she is on the research panel for the British Menopause Society. I just feel those who are in the higher risk groups should be monitored closely. When I said I would like to be monitored to my GP she laughed and said you wont get that!! . Im not laughing!!

[buffy26]

I'm currently on 3.5 pumps of gel, having increased from 2 to 3 several months ago and then to 3.5 a few weeks ago (4 was too much). On both occasions I've let my GP know after the event so that she can increase my prescription to cover the extra.

When I saw her last week and asked her to increase it she specifically told me that if I increase to more than 4 at any point I need to go and see her to get progesterone increased. I currently have a Mirena Coil but she said I'd need to add utrogestan to this to ensure I'm adequately protected.

I'd definitely experiment yourself and find the level that addresses your symptoms, giving it time between increases to take effect, and then go and see your gp once you're happy that you're on the right dose for you.

What I didn't ask at my GP time, and I will if I increase gel again, is whether the extra progesterone is needed when my oestrogen levels are so low (clearly either not absorbing properly or being affected by the alleged/suspected change in Oestrogel). I can understand needing more progesterone if oestrogen levels are increasing but if I need more to achieve the same level then I can't see why progesterone needs increasing too   

And you're right, don't apply to inner arms as too close to breast tissue . Instructions  specify outer arms or mid/outer thighs.

Sorry Suziemc, I missed your post as I was in a panic with all these new guidelines. I am not aufait with Mirena,  meaning the levels of progesterone in there so wouldnt wish to say or advise on that. But thank you for sharing what your GP has said as well.

[buffy26]

Hi
My meno doctor told me 100mg utrogestion tablet covers about 6 pumps of estrogel.

Hi Jillydoll, thank you for responding. Is your doctor a private one? Its all so confusing, the new guidelines now advise x 2 for 4 pumps.

[CLKD]

Specialists are more often likely to prescribe what is known as 'off licence' because their experiences tell them that some women need to dabble a bit with dose to find what suits.  So don't worry too much, also I don't believe that if oestrogen is increased that, especially with a Mirena in situ, that progesterone needs to be increased too.  It's often the latter which causes the most problems in a regime!

MayB experiement and keep a diary.  That way U have knowledge of what *your* body requires ;-) to discuss with your GP.  If she/he isn't keen on that, then she/he should be referring U to a dedicated clnininc.  Especially as there are waiting lists.

[buffy26]

Thank you CLKD but the experimentation is a concern for me now that these guidelines have been released as I have history that places me as a risk due to family history and the previous endometriosis. If I were to push the dosage now I will definately take 2x progesterone and see what this does. My GP felt when the results were mid 300's that was a good enough level to stick at, despite my symptoms being a problem still, she felt I was getting the sufficient amount of estrogen to protect my bones and heart so that in the eyes of NHS is a job done I guess.

[CLKD]

Yep.  Also the body doesn't get where it is suddenly so increasing/decreasing should be done on a gradual basis.