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[monster85]

I’ve been having issues with what I assumed was PMDD for a couple o my years now. I’m 39 and actually inclined to believe it is perimenopause despite being regular still. I’m on HRT (2 pumps oestrogel/100mg utrogestan vaginally for 12 days before period). First two months were actual bliss! This month I’m on day 5 of utrogestan and am ABSOLUTELY FLOORED with exhaustion. I’ve had to go to sleep at 8.30 the past two nights and all day I’m just hoping for bed. I get tired walking up the road. Would upping to a 3rd pump of gel help? My GP has been utterly useless these last two years and smirked at me when I asked for HRT so I’m really reluctant to ask them for any help.

[CLKD]

Don't know about increasing the dose, but do ask for a referral to a dedicated menopause clinic.  There are waiting lists for both NHS and private.  There's another member with PMDD so you may like to read her recent thread.

Hopefully some1 will be along with proper advice.   

[sheila99]

Utro has a similar effect on me. I tried increasing gel but it didn't help me. The only thing that made a difference was when I didn't produce any progesterone of my own.

[Hurdity]

Hi monster85

 

Sorry to hear about your exhaustion...

I am interested to know what led you to starting HRT at such a young age? Were your periods completely regular before you started (and not taking the CCP or anything similar?)? Is the additional oestrogen to try to cushion the oestrogen crashes in the 2nd part of the cycle, which could have been leading to your suffering PMDD?

It sounds a bit like the Studd regime, though since his death, we don't seem to hear on here about this regime much any more and not sure if his clinic still runs, and if so according along these lines?

An additional 100 mg Utrogestan shouldn't cause utter exhaustion but you may be extra sensitive, though combining it with your own progesterone may tip you over the top.

The Studd approach was to give very high doses of oestrogen to suppress the cycle and avoid the fluctuations that can be so troublesome sometimes prior to and during peri-menopause.

The other alternative for someone as young as you are is the combined pill - one of the stronger but more modern ones - that give a high dose of oestrogen - but I guess you've thought of this and decided against it?

Hurdity x



Hurdity x

[bombsh3ll]

I don't understand why anyone would recommend cyclical HRT in the form you describe to someone with a cyclical condition like PMDD.

Cyclical HRT is a pharmacological model of premenstrual symptoms.

Typically women with PMDD or other conditions aggravated by their cycle are better off with menstrual suppression, ie shutting down the endogenous cycle and adding back a stable consistent daily dose of hormones.

I am on Zoely which is a combined oral contraceptive pill that I take continuously without any breaks and it is great, it keeps me bleed free and hormonally stable.

If you don't want or can't take the pill there are other ways of doing this which would require specialist oversight - I would suggest a referral to a menstrual disorders clinic.