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[Hormona]

Hello All

So glad to have found this forum & site.

I’m a week into HRT - am 18 mths post last period & on Evorel 50 & Utrogestan 100 (at my request) continuously. 

I’m feeling less anxiety, palpitations, doom/adrenal surges & less like I’m losing my mind. I’ve had a terrible peri but for various health reasons been unable to start HRT - so this initial relief is so so welcomed. Long may it last!

I’m very sensitive to meds & withdrawal in general (have ME/CFS & long standing anxiety & depression & recent ADHD DX) so am wary of progesterone intolerance.

& can well see how higher doses could negate the positive effects of oestrogen.

Any fatigue & low mood from the Utrogestan tends to be passing atm & feels worth it for the increased feelings of calm & reduced anxiety that I’m currently getting on this combination. Obviously it’s very early days still & this may change…

I plan to review in 12 wks & while desperate to get as much estrogen as my body may need am very wary of exchanging what I have now for potentially more side FX & instability - that any higher progesterone may cause.

I’m not able to seek private support unfortunately & my GP I don’t think will support any off label prescribing.

My question is how on the NHS is endometrial protection monitored once a starting HRT?
Are you offered routine scans after x amount of time on HRT or do these only happen if you get symptoms or any unusual bleeding?

Or can your GP request one to check everything is ok at a current dosage?

My thinking is if I can remain on a fairly low dose of progesterone - will it be enough?

A recent gynaecology appt (for post pelvic radiotherapy not menopause) suggested my GP increase my Utrogestan to 200 - for no real reason & I did not report any bleeding or anything.

I don’t feel I need/will get necessarily get on with twice as much Utrogestan while remaining on 50 evorel.

I’m ignoring this & hope my GP will allow me to remain on the 100 (orally daily) but wonder if the general tendency in the NHS is to err on the side of endometrial caution & keep progesterone quite high relative to estrogen (because routine scans are not generally offered on the NHS)?

From the combined preparation doses I’ve looked at (which my GP wanted to prescribe before I requested separate ones) the estrogen to progesterone ratio seems to be 1:3.

From reading on here, my dosage of evorel 50 utrogestan 100 seems very common - but is this in itself typical of an off label prescription or quite accepted in the NHS?

I’ll have to wait to see how much my GP will work me & what changes I feel I may need to make - as I progress along this journey.

But any thoughts or comments on the topic would be appreciated.

Ok many thanks 🙏 & well wishes

Hormona

[CLKD]

Morning.     sorry that I am unable to offer advice.  Hopefully some1 will be along today.

[sheila99]

The prescribing guidelines have changed recently, it used to be 100mg utro for up up to 100mcg oestrogen but now it's changed to 200mg, presumably because they've found 100mg wasn't enough for everyone. The NHS don't offer scans unless you have bleeding but if you take less than the recommended dose it might be wise to arrange your own scan periodically, I think it costs around £100.

[Hormona]

Thanks for the welcome CLKD & your reply sheila99 - that’s really helpful re prescribing guidelines. And if a scan is only £100 or so I may be able to afford to get input periodically.

I don’t want to take less than the recommended amount but am just fearful of being intolerant when I suffer with my mood & anxiety already.

Good to know scans are not routinely offered on the NHS - so many thanks it’s much appreciated 🙏

[Kathleen]

Hello Hormona and welcome to the forum.


Due to post meno bleeding I was referred for a scan on the NHS but I arranged to have one done privately which worked very well. I think it was about £125 but the company emailed the results and images to me and I was able to forward these to my Nurse Practitioner. As it turned out, the NHS appointment came through soon after so perhaps the waiting times are shorter in some areas.

Have you been offered any medication for ADHD? There may be other ladies on the forum who have similar experiences and they can advise.

Take care.

K.

[Hormona]

Hi Kathleen

Thanks that’s really helpful - good your Nurse Practitioner accepted your private scan as well - I may be able to try that with my GP as well.

How often are scans recommended generally (if no bleeding) or how frequently do you tend to have them to keep a check on things?

Re ADHD no not medicated yet but would like to be. I was advised not to start it until recent treatment for cancer was over. So hoping to re-visit it as will be a year post treatment soon. However the medication is known to impact sleep & this is already severely & chronically disrupted as is so….it’s a bit of a minefield.

And why I’ve been most desperate to get on HRT - when perimeno really ramped up my MH symptoms - esp the emotional dysregulation of ADHD too.

I think a lot of women get diagnosed with ADHD during menopause when it can become impossible to keep masking any longer. 
I’ve had such a positive & quick reaction to HRT - which has been so validating as antidepressants tend to lose their efficacy for me so having the hormonal side of things boosted has been so encouraging.

And why I’m so wary of it being disrupted which I realise is unrealistic to expect when going on this journey into the hormonal unknown!!

Thank god for the collective wisdom, voices & support that is this forum!

How has your route been on HRT Kathleen if you don’t mind me asking? Have you found a combination that suits you & did it take you long?

Appreciate the support x