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[dancinghrt]

I have been on Oestrogen patches and vaginal Utrogestran for years, first for awful PMS and then Perimenopause.  I was on 100mg Oestrogen and 200mg utrogestran on days 12-26, not symptom free but a whole lot better than being off HRT.  I am in week 3 of trying a continuous regime to try and help with migraines and hormone surges:  100mg oestrogen patches plus 100mg Utrogestran daily.  I have always hated progesterone but thought I would give it a try.  My mood has been low, anxiety high, occasional really on the edge and I feel sluggish and woozy at night.  How long do I give it?    I'm on a long wait list back into the menopause clinic and my GP in the know is away.  I don't absorb oestrogen well.  My GP will prescribe me testosterone but wants to try one thing at a time.  I'm almost tempted to stop as usual at day 26 as if I do go back to continuous, I don't want to be out of sync with my natural cycle (which I believe is still at play).  If I go back to cyclical, are there any other options progesterone wise that may help?  I also really don't want to have to increase from 200mg to 300mg which I have been told is the new guidelines (stupid when I am a low oestrogen absorber)
Thanks

[bombsh3ll]

There are multiple other options -

IUS
Desogestrel 150mg (off licence but supported by the BMS)
Dydrogesterone - only available in an oral combo but well tolerated and may suit better if you don't absorb well through the skin.
Norethisterone - available in pill form and as combi patch.
Slynd
Tibolone
Provera - metabolically less favourable but tolerated by some where micronised progesterone has failed.

Also anecdotally testosterone helps some people tolerate the progestogen better so withholding this isn't necessarily a good idea.

[dancinghrt]

thanks.  I know I am slightly limited to my sticky blood and cannot tolerate the coil.  Any idea how long best to try continuous/takes body to get used to?

[bombsh3ll]

A general rule of thumb is to try to give any changes in treatment at least 3 months to settle in.

However if is clear that something is affecting you negatively then I would speak to your provider sooner rather than just plough on.

We are all individual and some people have milder side effects that continue beyond 3 months but may still improve or abate after this time.

[sheila99]

Personally I wouldn't bother trying, if it's always had a bad effect on you there's no reason to believe you'll miraculously feel good now. For me 100mg isn't much different to 200mg so I have stayed on a sequi regime. There is a slightly higher risk or endometrial cancer this way but for me it beats being having very little sleep but being sedated all day. Evorel patches didn't give me side effects so you might find you're OK with a different progestogen.

[FakeID]

I tried the same this summer on the advice of a Newson doc. I’m 55 and likely post meno.
Couldn’t take it after a couple of month. Just like you- low mood, lethargy, irritability. The thing is, my sleep was GREAT.
Anyway, couldn’t live with the mood issues, went back to cyclical a month ago and my sleep is absolutely destroyed. So bad I’m on sleeping tablets. I presume it’ll reset to its bearable/often good levels eventually but this is gruelling and hard to work.
My mood is much better though.

[Nici_j]

I tried continuous for 9 months and had no end of problems with breakthrough bleeding, exhaustion, dryness and itching below and generally feeling rubbish. I had to take 200mg utrogestan to stop breakthrough bleeding but I still kept having bleeds but they were random and I never new when they were coming which was wearing and also I started to get very low iron. I also looked exhausted.  I realised that I had felt great on sequential so went back to it 2 months ago and I feel completely normal and back to my old energetic self again. Have just added a small amount of testosterone into the mix and that also seems very beneficial in terms of general wellbeing.

[Hurdity]

Hi dancinghrt

 

I agree with the others

No need to suffer. I have years of experience of progesterone!! Hateful stuff!!! I'm 71 and have been on cyclical HRT since 2007 more or less all the time. Yes there are slightly increased risks of endometrial cancer but this is relatively easily detected and the absolute risk is small.

I would return to the cycle that suited you and also think of trying the testosterone  - if your libido is rock bottom and the associated response during intimacy has disappeared.

You haven;t said how old you are?

Hurdity x