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[Booblet]

Hi,
Had my Oestrogen blood test.
Results: 153 pm/ol
I'm taking 0 5 Sandrina Gel.

 However, I know that my main problem (I think?) is the level and "type" of Progesterone:
Which is: Natural Progesterone cream - supposedly the ratio of this cream is the amount I take.

I have an appointment nxt week with the Menopause Nurse (NHS).

I want to carry on with the Sandrina gel ( I think because it's bio- identical)
The problem is the Progesterone: I can't tolerate Ustrogestron at all.
Therefore I may have to go on a combined HRT?

I am very sensitive: My Allergen levels are extremely high - hence, favouring bio-identical hrt.

Regards to you all 

[bombsh3ll]

Is a mirena IUS an option for you?

That is such a low dose of estrogen and low plasma level however that SOME private specialists would sanction using that unopposed, provided you had regular scans to monitor your uterine lining.

Essentially you are doing that now as progesterone is not significantly absorbed through the skin.

The NHS would not generally support this.

[Booblet]

Hi,
Thankyou for your reply.
I'm 64 and had the Mirena Coil fitted approximately 20 yrs ago. Do you think I have inserted again?

Your right  - the NHS Do not sanction (my) Progesterone/Oestrogen application - that's why I have app with Menopause Nurse.

I've never heard that Progesterone gel/cream cannot be absorbed though the skin  -  but it does make sense with my results.

Kind regards

[bombsh3ll]

Yes you could absolutely get another mirena IUS.

If it's suited you in the past it could be your best option now.

It also provides strong enough endometrial protection that you could increase your estrogen if you need to.

[AngelaH]

I've never heard that Progesterone gel/cream cannot be absorbed though the skin 

Absorption rate is 20%. Plus skin cells are able to keep some amount of progesterone until the body decides to use it.

[Penguin]

If progesterone isn't absorbed through the skin, then how is utrogestan absorbed when used vaginally, i mean in effect it it is going through vaginal skin, isn’t it? And while it isn't licensed for use in this way in UK, it is in other countries. Is it because it is in oil or something different compared to topical cream? I always used utrogestan vaginally and would say that I had the opposite problem of too much absorption.

[bombsh3ll]

Vaginal mucosa is very different to the hard keratinised skin on the outside of your body.

It's more like the inside of your mouth.

It is warmer, more moist and much more vascular.

No reliable carrier has been developed to get meaningful doses of micronised progesterone through the skin.

Some women do feel they get benefits from applying progesterone cream to their skin, but this should never be relied on to provide endometrial protection if taking systemic estrogen.

There is or at least was a gel called crinone designed for vaginal use which did show endometrial protection in clinical studies, however it never became popular due to cost and mess.

[Mary G]

Compounded hormone clinics have developed progesterone creams that protect the womb, backed up with scans of course.  My progesterone gel should not provide womb protection in theory but it absorbs into the blood stream well and also provides womb protection as long as the oestrogen dose is low ie one pump of Oestrogel.

Buccal progesterone lozenges are also a highly successful way to provide endometrial protection.  These products need to be developed further and produced by pharmaceutical companies.

[Cassie]

For many years one has been able to purchase Progesterone Cream from compounding pharmacies which appear to protect the endometrial lining if the oestrogen dose is low enough, as Mary has stated. I would imagine they would be different to ones that one can buy over the counter, these creams are developed in a way which enhances transdermal absorption, I would imagine much the same as the oestrogel but am no expert.