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Menopause Matters magazine ISSUE 81 out now. (Autumn issue, September 2025)

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Author Topic: Lowest doses of hrt  (Read 1952 times)

sooper_cooper

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Lowest doses of hrt
« on: September 11, 2024, 06:15:02 PM »

Hi, I may or may not have had side effects from HRT this year… specially reoccurring nausea. I stopped taking HRT 12 weeks ago and now have hot flushes and really bad bouts of anxiety. I am thinking about trying HRt again and am wondering what the lowest dose is? I know there is a 0.5 mg oestrogen gel. Is the progesterone in the progesterone only birth pill enough to take with it ?
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sheila99

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Re: Lowest doses of hrt
« Reply #1 on: September 12, 2024, 08:09:07 AM »

I think you need 2xPOP but if you're using a bcp and only need a low dose of oestrogen a combined pill such as zoelly might suit you.
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bombsh3ll

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Re: Lowest doses of hrt
« Reply #2 on: September 12, 2024, 04:26:19 PM »

Officially, guidelines would recommend either 2*desogestrel pills every day (i.e. 150mg) or taking micronised progesterone 100mg in addition to a single dose of POP.

However this ignores the fact that 0.5mg gel is a very low dose, and a knowledgeable specialist may be happy for you to just take the single dose POP provided you did not increase the dose of gel further without reviewing this.

Other options as Sheila mentioned are a combined pill - I am on Zoely which I take continuously and love it! Zoely keeps me bleed free, hormonally stable, estrogen replete, and so convenient to use as it's just one pill.

If desogestrel suits you well and you prefer not to change progestins there is also a low strength combined pill called Mercilon which has 150mcg desogestrel plus 20mcg ethinylestradiol.

I should just say that if you are 50+ you are unlikely to get a combined pill prescribed on the NHS however privately they can be used in low risk patients up to 55 who have an ongoing medical need for them such as bleed control or endometriosis, typically individuals who have already been on them long term when they reach 50.
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Caro1965

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Re: Lowest doses of hrt
« Reply #3 on: September 17, 2024, 08:10:00 AM »

Hi, sorry you're feeling so awful. I'll just share my experience, in case it's any help - I have been on ultra low dose Femoston Conti (.5 oestrogen/2.5 dydrogesterone, oral) for three years now, and I love it. Yes, .5mg oestrogen is very, very low, but it seems to be just enough to nudge me back into feeling more or less normal. If I try to up the dose (they do a 1mg/5mg version) I find that the increased prog makes me very grumpy and PMS-y. This might pass if I persisted with it, but as I feel OK on the ultra low version, I'm sticking with that. Might be worth a try?
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sooper_cooper

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Re: Lowest doses of hrt
« Reply #4 on: October 09, 2024, 01:15:12 PM »

Thanks. I’ve discussed it with my dr and decided not to try hrt again to avoid any destabilisation. I’m going to persevere with herbal remedies.
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sheila99

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Re: Lowest doses of hrt
« Reply #5 on: October 09, 2024, 03:42:43 PM »

Good luck  :foryou:
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