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Author Topic: Feeling pretty bad on 1st night (+day) after stopping Utrogestan on cyclical  (Read 8402 times)

rferdi

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This is my first time on cyclical HRT, after having started on continuous a couple of months prior and not feeling much benefit.

Switched to cyclical this month of August and the first week was difficult, but then it gradually improved to the point my worst symptoms had improved significantly, I'd say both the frequency and intensity were reduced to about half of what they used to be before cyclical, so that was great.

I took Utrogestan 200mg for 13 days (I wanted to take it for 12 but got it wrong somehow) from 14 to 26 inclusive. So yesterday night it was the first night of not taking it and I had a pretty rough night, with almost all of my worst symptoms coming back, although not quite as extreme as they used to be before HRT.

I just couldn't sleep (progesterone was amazing for making me sleep soundly through the night and I DO miss that), so I took a CBD supplement which helped me relax slightly. But I had the pounding throbbing heart throughout my whole body, pins and needles in feet and hands (though at least they didn't go numb), heart skipping beats several times before being able to fall asleep. I've slept very few hours and with interruptions, and since I got up I've been having almost all those same symptoms plus quite a bit of dizziness, and just feeling unwell overall.

This looks like a bit of a setback to me, seems like not taking progesterone last night has affected me quite negatively. Which surprises me as I thought the lack of estradiol was the main reason for my symptoms. Please could someone give me some enlightenment here, to try to understand what may be happening? Thank you  :)

 
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joziel

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rferdi, I can't talk about progesterone but my own experience with identical symptoms was low/fluctuating estrogen.

I've tried taking no P, 100, 200, 300 and 400mg of P. None of it made any difference to my symptoms. I mean, not consistently. Sometimes things seemed to get a bit better or worse but it's just because the symptoms fluctuate a bit anyway.

The only thing that helped was getting my E up.
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rferdi

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thanks again joziel, yes i know I probably need more E, I know you've had almost the same symptoms as me and that's what's helped you, and it'll most likely be the case for me.  I just wanted to wait a bit more to give this current new regime at least a whole month if not 2 before making any changes. But we'll see how it goes I guess, I may try it sooner if things don't settle.

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Hurdity

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Hi rferdi

Sorry to hear about your issues

What you may be experiencing is classic progesterone withdrawal - it's a bit like coming off a drug. There are physiological changes that occur in the body when you take progesterone (and when it produced by the body) and these are reversed when you stop taking it, or when it declines. Once the progesterone leaves your system after a few days you should feel better again, even notwithstanding your oestrogen levels though I agree these should be optimal. You haven't said what dose you are taking though? Also whether you are peri or post-meno as this will make a difference too? The sleep inducing qualities of progesterone are a different issue - it seems some women like this! At the right dose though oestrogen should not interfere with sleep and should help due to decreased flishes and sweats and general improvement in well-being.  The downside of prog is the daytime sleepiness and head fog some of us experience so it's like being dulled mentally.

Hurdity x
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rferdi

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Hi Hurdity,

Thank you for your reply, I'm in peri, and I'm taking the equivalent to 2 pumps of Oestrogel (I'm using 2.5g of Oestraclin gel, which has 0.6mg estradiol per g.) and 200mg Utrogestan for the 12 days a month.

Yes progesterone really seems to suit me, so far I've not had any downsides, just a great overall feeling of relaxation and wellbeing and great sleep, while I'm on it. I didn't know about progesterone withdrawal, but I can see that's what must've happened. The worst day was the first one, and it's been improving gradually, now that's been 4 days without it I'm feeling better but still a lot worse than while I was taking it. Not just because I don't sleep nearly as well, but also because all my usual symptoms have intensified since I stopped.

I just got started on HRT really, and I know I still have to find my right estradiol dose. The previous couple of months before this I'd been on a continuous regime, using 1 spray of Lenzetto instead of Oestrogel, and it didn't help me much with my symptoms. Things began to improve quite a lot since I switched to cyclical in August, but I also changed from Lenzetto to Oestrogel so I'm not sure if the improvement is from the product change or from the cyclical regime, or from both. I guess I'll find out as I go.



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rferdi

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Hi joziel,  I'd like to know what your regime is, I hope you don't mind me asking how much estradiol and progesterone you're taking and how many days of P every month.  I know we're all different but just out of curiosity since your symptoms seem so similar to mine. You're also in peri as well, I think?
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joziel

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I am 46yo and in peri. Started HRT at age 42yo. Have spent the last 3 years trying to resolve these symptoms which only began when I started taking it. (But stopping it didn't stop the symptoms!) I have none of my pre-HRT low estrogen symptoms, just this situation at night - which is bollocks.

I need to take utrogestan continuously because I have a history of endo. Not very severe or widespread but it doesn't take much for it to cause a lot of pain for some women. I had a lap for it in 2013, so I know I definitely have it as the surgeon saw it and lasered it out. (Not very reliable way to remove it.)

I have tried taking utrogestan sequentially, at the standard dose of 200mg and then also sequentially at a higher dose of 300mg, but I got the old familiar endo pains back in the old familiar places. So I moved to taking it continuously. I have zero endo pains if I take it continuously. This also made sense because I am taking higher levels of estrogen, so everyone seems happier if I take more utrogestan. It also can make me slightly sedated and woozy at night which, given my sleeping problems, was a good thing. (That effect seems to have stopped now, sadly.) I was taking 200mg continuously, but this became 200mg for the first half of the month and increased to 300mg the second half.

So it goes days 1-5 - no utrogestan (bleed)
Days 6-14 - 200mg
Days 14-26 - 300mg

I sometimes start to bleed around day 23, and will just stop there and go to day 1 if that happens. (In my 30s, I used to cycle every 35 days but in peri now, it's getting shorter at the moment.)

I take it all orally because I have no probs with progesterone.

Do I really need 300mg? I don't know. What usually happens is I start out at 200mg, planning to get to day 14 like that. And then I struggle with sleep at some point, and I think "oh, if I just take one extra utrogestan early, it might help with the sleep", so I then increase to 300mg. Then I think "I can't drop back down to 200mg or I might bleed early now" - so I just stay on 300mg for the rest of the cycle. ;D ;D Anyway, my doctors are all happy with that.

With estrogen, the goal is to get me between 450-650pmol and see how I feel at that level. So this is a work in progress because I don't absorb it well. Although it really wasn't clear for a long time that that was the problem, because I've never had rock bottom estrogen levels.

The lowest was around 198pmol on a 50mcg patch a few months after starting HRT. My highest ever was 450pmol - on a 37.5mcg patch(!), again shortly after starting. This is why blood tests are so useless. More recently, I always try to test during my period because my own estrogen will be lowest then (hopefully) so I can better see what I'm getting from HRT. On 6 pumps of gel I was around 325pmol. On 12 pumps of gel, I was 330pmol.....(!) - so I wasn't absorbing any of the extra 6 pumps there.

So now we've added in patches with the hope that a combo of gel and patch can get me high enough. My Newson doctor said she has many women on 300-400mcg of patches. I'm currently on 100mcg patch (will increase tomorrow to 125) and 12 pumps of gel. Well, it's supposed to be 12 pumps of gel except I had all this Sandrena left over and decided to use it up  ;D  I just can't throw estrogen out.

So I'm actually on a daily dose of 8 pumps of gel + 2 sachets of Sandrena + 100mcg patch (125mcg tomorrow). I split the gels AM and PM, so I do 4 pumps of gel and a sachet of Sandrena AM and the same PM.

But the general plan is to gradually increase the patches up to at least 200mcg if I still have any symptoms. And I think to decrease the gel to at least 6 pumps, seeing I was able to absorb more from 6 pumps than from 4. At that point I will re-test and see if I need to go higher on the patches. I would like to get as much onto patches as possible as they are much easier to deal with, but I do like having some gel as well (I use the leftover gel in each pump on my face  ;D ;D )

Does that help?





« Last Edit: August 29, 2024, 05:06:18 PM by joziel »
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AnonoMiss

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This is my first time on cyclical HRT, after having started on continuous a couple of months prior and not feeling much benefit.

Switched to cyclical this month of August and the first week was difficult, but then it gradually improved to the point my worst symptoms had improved significantly, I'd say both the frequency and intensity were reduced to about half of what they used to be before cyclical, so that was great.

I took Utrogestan 200mg for 13 days (I wanted to take it for 12 but got it wrong somehow) from 14 to 26 inclusive. So yesterday night it was the first night of not taking it and I had a pretty rough night, with almost all of my worst symptoms coming back, although not quite as extreme as they used to be before HRT.

I just couldn't sleep (progesterone was amazing for making me sleep soundly through the night and I DO miss that), so I took a CBD supplement which helped me relax slightly. But I had the pounding throbbing heart throughout my whole body, pins and needles in feet and hands (though at least they didn't go numb), heart skipping beats several times before being able to fall asleep. I've slept very few hours and with interruptions, and since I got up I've been having almost all those same symptoms plus quite a bit of dizziness, and just feeling unwell overall.

This looks like a bit of a setback to me, seems like not taking progesterone last night has affected me quite negatively. Which surprises me as I thought the lack of estradiol was the main reason for my symptoms. Please could someone give me some enlightenment here, to try to understand what may be happening? Thank you  :)

Gosh this happened to me! You might want to join the Progesterone Withdrawal/Negative reaction support group on FB there is lots of posts on thee to help explain what may be happening!
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rferdi

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joziel that was very helpful, and thanks for such a detailed post. I wonder what were the peri symptoms you had when you started HRT, which I understand disappeared with it.

And then hasn't any doctor been able to tell you why would this other different set of symptoms appear (the ones that you described in another post that coincide so well with mine)? I don't understand, these are supposed to be due to low estrogen, but before you began taking HRT you didn't have them (though you did have others, also due to low estrogen, that went away with the HRT)? Quite confusing.

I'm also kind of wondering if progesterone is something one can sort of get addicted to?... I know it sounds silly since it's bioidentical and P is something we naturally produce anyway throughout our lives till menopause comes along. But I've also noticed the effects seem to decrease over time, with the same dose. Do you also get sleeping problems (and maybe other symptoms, like me) once you stop the progesterone for those 3 days or so?

More recently, I always try to test during my period because my own estrogen will be lowest then (hopefully) so I can better see what I'm getting from HRT.
This is good to know because every time I've had blood tests done to see my levels they've come back either too low or too high, but no doctor's ever told me there was a specific day when it was best to do them, which is yet another thing that makes me distrust so many of the doctors I've consulted with, unfortunately.


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rferdi

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Gosh this happened to me! You might want to join the Progesterone Withdrawal/Negative reaction support group on FB there is lots of posts on thee to help explain what may be happening!
Thanks for the info, I'll check it out!
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joziel

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Before HRT, I had:

- Joint pain, especially on waking in the mornings or if I stayed in a position any length of time (knelt on the floor and then got up, for eg). I had pain in hips, knees, just felt stiff when I woke up. I had trigger finger in my little fingers when I woke (little finger would jerk up and down and wouldn't move smoothly) which is apparently a sign of arthritis. I had bloods done for arthritis which were all negative and I was referred to rheumtatology. They told me to see if HRT would help and come back if it didn't. GP was useless and said I was hypermobile and it must be because of that. (But I've been flexible all my life, that hasn't changed, so why would I suddenly get these symptoms?) I suggested it was peri-menopause but he said I was too young (at 42??). He did estrogen and FSH tests and told me they were fine so it couldn't be peri. I knew otherwise and just went to other doctors.

- Vaginal dryness. I actually thought this was thrush at first and treated twice for thrush, with no luck. Felt scratchy and burn-y and sore. I also had incredibly thick sticky/gluelike vaginal discharge a couple times which was like a mucous plug, it was gross. And at other times I would have a gush of runny watery stuff. Apparently this is all the cervix trying to lubricate itself, it goes either way. I had swabs done which were all normal and was given local estrogen, Vagifem and got Ovestin from Newson Health so I could have both and a ton of local moisturisers. I don't need any of that anymore, now my systemic estrogen is up. Which is good because it was a faff applying it all multiple times a day and my vag was taking over my life.

- Brain fog. I couldn't read and retain info. I would read and re-read the same sentence over and over again because I'd forget the start of it and the point of it by the time I got to the end. I'm pretty academic and a big reader so this was a problem. I couldn't think properly, my brain felt like it wasn't working.

- Constipation and gas/flatulence. Like humongous massive old people farts....

- Not wanting to do anything. Just wanting to sit around and wait, I had no idea what for. I wasn't depressed, just couldn't feel there was anything I 'wanted' or got excited about.

- Zero libido.

- Dry eye. I'd actually had this for years, my optician had told me about it - but I hadn't realised it was a low estrogen symptom until I started estrogen and it went away. It was associated with a watery/tearing eye as well, which would ruin any eye make-up and was really embarrassing. (I guess like the cervix, it goes both ways with all mucous-y things!)

- Migraines. I do still get these at times when I have a big sudden surge in estrogen, or if I drive and stare at the road for ages or am extra-tired. But the hormonal triggers are much reduced now.

I had no sleep problems, before though. I was always a very good sleeper my entire life. Head would hit the pillow and I'd be out for 8 hours or more. Self-employed so wouldn't need to set the alarm clock, just got up when I woke up. If I tried to stay awake lying on the sofa and watching a film, I was incapable of staying awake past 11pm. Just couldn't, no matter how much I tried. I would 'just rest' my eyes - and I'd be gone.

As for - has any doctor been able to tell me why this other set of symptoms appeared... There are thoughts and theories but not anything definitive. One is that they are due to the brain wanting extra estrogen (neurological symptoms) because the communication between brain and ovaries is going haywire.

One is that they are more due to a time of great fluctuations, hormonally, rather than simply high or low - when I started HRT, I also stopped the desogestrel POP which I'd been on for about 10 years. That suppresses your ovaries and keeps your estrogen quite low (and progesterone non-existent and testosterone low as well). So I went from a state of very low hormones, to adding all 3 hormones at once. My ovaries woke up because I'd stopped the desogestrel and started firing sharp shocks across my abdomen for a few months - they were doing weird things and probably increasing the fluctuations of hormones. (Stupid doctor question 'but how do you know it's your ovaries?' me: 'I can feel them.'. Doctor 'you can feel your ovaries?'.  ???  ::)

And another theory is that there was no pattern to the rise and fall of hormones going on either. Our bodies are used to different hormone levels but across a cycle, which is predictable and has a pattern. They are not used to wild highs and lows lasting a few hours which have nothing to do with what time of the month it is. And that this causes the neurological stuff. So beforehand, the desogestrel was keeping everything low but constant - but it was too low. When I stopped it, I unleashed all the fluctuations.

With progesterone, I don't think 'addicted' is the right word. But there are people who say you need to take a break from it to reset the receptors, so that they can work again. But I do take a 5 day break and haven't noticed it working well again when I restart so not sure about that one! Maybe if I took it sequentially, I would really notice it when I started it - but I can't do that due to endo. I do find that if I take it with a little food, I absorb it even more and it hits me better (makes me sleepier). You could try that. It has to be a small amount of food and the same thing every night. (I usually have a coconut nibble healthy thing, I think the fat helps it absorb.)

Anyway, hope that helps! Really there is only experimentation. Keep trying things, dosages, products, keep experimenting until you find what works best for you. Because we are soooooooo far behind with women's health, that's the best we can do.
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bombsh3ll

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I'm also kind of wondering if progesterone is something one can sort of get addicted to?...


I know someone who is currently pregnant for the 9th time and another who has 13 children so maybe  ;)

However the definition of addiction includes a persistent and irresistible urge to do/use the substance or activity to the point that this is causing or threatening to cause harm - this doesn't occur with therapeutic progesterone.

Tolerance is another feature where a person starts to require more and more of a substance to achieve the same effect. Again there is no evidence of women increasing and increasing their progesterone doses and demanding more than they are prescribed.

If anything the issue with progesterone is many women dislike it and take less than the dose they need for endometrial protection.
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Seasidegirl

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@joziel thanks for sharing your experiences,  it's really helpful to me as a newbie to HRT, it's much appreciated.
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rferdi

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I  also had the joint pain, vaginal dryness, brain fog, gas, dry eyes etc etc years before the horrible unbearable symptoms began, but I didn't even know what peri was then. I was completely ignorant about menopause, I never heard any woman in my family talk about this, or any other woman for that matter anywhere, ever. 

Thanks again for all the valuable info provided joziel, HRT really is something that requires experimentation and patience. And women's menopause health is so ignored by the vast majority of doctors. I spent almost 3 years going to specialist after specialist, including gynaecologists, who NEVER even suggested the possibility of my symptoms being perimenopause.

For me progesterone actually works best when taken on an empty stomach, I did try taking it with food sometimes and every time I'd feel the good effects were very diminished (the great sleep etc).

I'll continue trying for sure,  even though it can be rather discouraging sometimes. For example I was feeling fairly good just a week ago and today it's been quite bad... Anyway let's keep going :valkyrie:

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rferdi

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I know someone who is currently pregnant for the 9th time and another who has 13 children so maybe  ;)
  :lol:
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