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[TheMidnightSkulker]

Given the dose of drospirenone in Yasmin (which has 30mcg ethinylestradiol), and a historic HRT preparation called Angeliq, I am pretty sure you could cut the Slynd pill in half and take 2mg daily with 2 pumps of estrogen.

Shame there isn't a conversion table for this kind of thing, but of course it doesn't work like that.

Obviously this is not standardized but your doctor might agree to this if you were willing to get a scan now and then to monitor your endometrium.

I will remember that when the time comes to have that conversation.

[TheMidnightSkulker]

Do you keep the remaining half dose somehow? Or just write it off?

I just slightly pressed the pump so less came out, none wasted 

I will try that! Thanks!

[TheMidnightSkulker]

Quick update for the curious:

SUCCESS! (for one day):
Four days ago (Friday), I tried the 2.5 pumps of oestrogel + 1 Slynd.

On Saturday (the second day), there was finally some major progress on the undereye bags, and my eyes were looking like they're supposed to.

POSSIBLE CONFOUNDER: Short night Fri/Sat. Puffiness is a function of how long I spend lying down. And I was a bit puffy (better, but a bit puffy) on Sunday. So, I don't know.

POSSIBLE CONFOUNDER: Realized on either Friday or Saturday that I'd had the dehumidifier running since Monday. I don't know how much that was contributing to the dehydration. Normally it would take more than 24 hours to become uncomfortable, but normally I'm not taking Slynd.

The dehydration was making my teeth feel squeaky and crumbly. If I hadn't been to the dentist within the last month I would be worried. Certainly a dry mouth can give you tooth decay, so, that's not good. Since turning off the dehumidifier I feel OK again.

====

This morning I tried 2 x oestrogel + 0.5 x Slynd. I still feel OK and not dehydrated, and my eyelids look pretty much like they did yesterday.

I'll give this three days, then possibly try the 2.5 x oestrogel + 1 x Slynd again, in case the dehumidifier was screwing me up.

===

You know... I TOLD them my upper eyelids are supposed to be concave. My MUM's upper eyelids are concave. My MUM's. And she is NINETY EFFING FIVE. Pardon me for wanting to look younger than 96, I guess?

[TheMidnightSkulker]

In today's exciting episode: my eighth day of trying 0.5 x Slynd + 2 pumps Oestrogel at 5am daily.

Definitions:
baseline regime: 2 pumps Oestrogel daily, plus 200mg Utrogestan cyclical. This is what I was on, for about 18 months, before I saw the specialist.

specialist regime: 3 pumps Oestrogel daily, plus 100mg Utrogestan continuous.

current experiment: 0.5 Slynd + 2 pumps Oestrogel daily, for the last eight days.

next experiment: 1 Slynd + 2 pumps Oestrogel daily. I will start this tomorrow.

post-Slynd regime: My experiments with Slynd before the current one. 1 Slynd + 2, 2.5, or 3 pumps Oestrogel daily.

Overall:

- upper eyelids seem (subjectively, it is harder to photograph) to be heavier each day on waking. But they don't ever seem to look particularly good on waking.

By now, having been up for over five hours, I'm in "A++, can't complain" territory; they are totally holding up by themselves. They were never this good on the baseline regime, not even once.

Evening photos (taken just before getting ready for bed, around 11pm on average) show a much clearer progression over the seven days of the current experiment. Upper eyelids are good in seven photos out of seven, but have gone from "really hollow" to "less hollow".

- structural bags (puffy volume under the eyes) This is hard to photograph, and hard to measure objectively in any other way. I can tell an extremely terrible photo apart from others, but "meh" photos are harder to tell apart. The very worst photo I can point to is six days into the specialist regime: very voluminous, very low-hanging undereye puffiness, outlined with vascular redness, which I don't normally suffer from. Almost anything looks better than that photo.

Subjectively I think the structural bags are less voluminous after the current experiment than on the baseline regime, but I have no way to actually prove this.

My entire face is less puffy, which contributes to the subjectively better impression.

- scale weight: this tells me something about overall water levels. Was not surprised to see it go down by 3lbs on Slynd, despite eating at least 10% more than usual. During this week on 0.5 Slynd, scale weight has gone back up by 1lb, despite no change to calorie intake from previous weeks.

tl;dr my scale weight is further evidence of water loss from the Slynd.

side rant: every article I've ever read about hormonal water retention has condescendingly focussed on scale weight. I do not care about the effect of water on scale weight for its own sake. I do care about it as evidence that the water retention is being treated by the Slynd.

- dehydration: I don't feel generally dehydrated, so that's good. Mouth is not dry, eyes are no drier than usual.

- oiliness: I feel like I have no oil production at all, which is a weird sensation. I have stopped washing my face in the morning; and am only using Differin, not benzoyl peroxide, as a topical treatment. Despite this I have had no acne on my face or body.

I have been washing my hair less frequently because it does not feel like it needs it. Apparently it does, because on the third day of not washing my hair, I find I have some breakouts on my scalp.

I haven't been pathologically greasy since stopping Yasmin. I have only been greasy a normal amount. But even that normal amount of greasiness has stopped since my first Slynd. It's a bit weird, I'm not sure I like it.

- mood: mostly boredom. But that could just be because my daily routine is, in fact, boring and there's not much I can do about that. (To be clear, I'm not complaining. Many people around the world, and many past and possibly future versions of me, would love to be bored in this fashion.)

- sleep: I still hate getting up, but at least the oversleeping is within predictable limits, unlike with Utrogestan. I remain optimistic that my self-discipline has a window of opportunity here.

- libido: could be worse. But I kind of miss the early days of the baseline regime. Wouldn't mind getting that part of it back.

[TheMidnightSkulker]

In today's exciting episode: results of seven days of trying 1 x Slynd + 2 pumps Oestrogel at 5am daily.

For definitions, see previous post.

next experiment: 1 Slynd + 2.5 pumps Oestrogel daily. I started this yesterday and will report in five days' time.

Overall:

- upper eyelids: same as previous post, only better.

- structural bags (puffy volume under the eyes): peaked on the fourth day, then seemed to get worse. I had this same experience with the previous experiment. I am wondering if this is because the relative levels of each hormone balance in the middle of the week and then tip one way or the other; or if it actually has something to do with weekend habits (sleeping later, eating more crisps etc.)

- scale weight: down another pound over this week. Similar conditions.

- dehydration: I don't have the alarming dehydration I experienced the last time I tried one whole Slynd. That must have been because of the dehumidifier, not the Slynd.

Notably, on the first couple of days I felt recognizably headachy because of the dehydration; I had to keep drinking water to keep the headache at bay. On the next day I was chugging lots of water - not excessive amounts, but at least 2 litres in the span of one day. Over the last three days I wasn't as thirsty. This could be why the puffiness seemed to get worse again: maybe I just wasn't drinking enough water.

- oiliness: Started getting minor breakouts, so I've gone back to my previous regime *except* that I no longer apply benzoyl peroxide. Skin doesn't feel oily, but it doesn't feel eerily dry either.

I've gone back to washing my hair the same amount as before, and the acne breakouts have cleared up.

- mood: started out possibly more agitated than usual, tapered off to being agitated a normal amount.

- sleep: same as previous.

- libido: same as previous.

tl;dr I think the main difference between a half a Slynd and a whole Slynd is that my upper eyelids are better. They seem to get worse on both towards the end of the respective weeks, and I can't tell if that's because of the hormonal balance, or because of some weekend habit e.g. sleeping later. My habits are depressingly similar on weekends as weekdays, though. More likely it's because I wasn't drinking enough water over the last three days out of seven.

[TheMidnightSkulker]

Okay, final round, and the results are in.

I tried one last titration: 1 x Slynd with 2.5 x Oestrogel. Puffiness got worse. 1 x Slynd with 2 x Oestrogel is the best balance I'm likely to get, for now.

=====

An explanation of why eyes get puffy post-menopause: this all gets blamed on oestrogen withdrawal. Upper eyelid droop happens because the skin of the upper lids becomes lax. With the lower lid, which is basically padded with fat - the orbicularis muscle AND the skin, which previously were holding that fat in, both become lax such that the lower eyelid pooches out into a bag.

I'm pretty sure the specialist I saw thought that this phenomenon was the main cause of my problems. This is probably why she prescribed an increase in oestrogen, while dismissing my questions about progestins entirely. However, it's perfectly clear by now that increasing oestrogen increases my oedema. Three pumps are enough to give me joint pain and headaches after a week.

=====

I've compared pictures of the same eye, taken under similar lighting conditions after performing the same series of actions, in the mornings. The morning is the worst possible time of day for puffiness, so morning photos are the acid test for visible improvement.

- [1] Old regime: 2 x Oestrogel + 2 x Utrogestan, photo taken on morning of 12th day of Utrogestan cycle. This is where I came in.
 
Rating: not great, not terrible. Upper eyelid droopy, lower eyelid a bit puffy.

- [2] Specialist prescribed regime: 3 x Oestrogel + 1 x Utrogestan, not cyclical. Photo taken on morning of 5th day.

Rating: terrible. Upper lid is drooping in a heavy curtain about as low as it can go; lower lid is the most swollen it's ever been, with a deeply grooved, reddish outline.

- [3] Slynd regime, take 1: 2 x Oestrogel + 1 x Slynd. Photo taken on 5th day.

Rating: obviously better than [2], but looks almost the same as [1]. However, there are creases in the upper lid, which look bad cosmetically, but are actually a sign of progress, because it means the skin is shrinking as it recovers from the swelling.

- [4] Slynd regime, take 2: 2 x Oestrogel + 0.5 x Slynd. Photo taken on day 4 of 8.

Rating: Worse than [3].

- [5] Slynd regime, take 3: 2 x Oestrogel + 1 x Slynd. Photo taken on day 4 of 7.

Rating: Better than [1] and the first time I have seen an improvement from baseline. The upper eyelid is holding up on its own, still with some morning puffiness but NO DROOPING. The lower eyelid is no worse than [1] and maybe better.

- [6] Slynd regime, take 4: 2.5 x Oestrogel + 1 x Slynd. Photo taken on day 4 of 7.

Rating: Not as good as [5], and it got much worse over the next three days.

It looks like [5] is about as good as it gets. Time to stick to [5] until further notice.

So yeah, the upper lids are holding up on their own now, which makes a huge difference. It's the lower lid I'm having the most trouble with. They look either fine or rather visibly baggy, depending on lighting conditions. But at least they aren't visibly baggy in every light. What this means is that I've progressed point of fretting about fairly minor flaws, so that's great. Oestrogel + Slynd for the win!

One would also think that, if part of the problem is oestrogen loss to the skin, that wiping the excess oestrogel off on my face would help. So that's what I've been doing; it's only a faint residue, and it doesn't seem to be doing any harm.

Also, if part of the problem is laxity of the orbicularis, one wonders why exercising those muscles *wouldn't* help. Unfortunately there's no evidence in favour of facial exercises, but they also aren't known not to work. I suppose I could try exercising just one eye and see if it gets beefier over the span of say 3 months, compared to the other eye.

But anyway, to stay on topic: as far as HRT is concerned, it's pretty clear that 2 x oestrogel plus 1 x Slynd [5] is the best combination for overall water balance for me, and also that the Slynd makes a visible difference to my eye puffiness, which is exactly what I expected/hoped it would do.

I still have trouble getting up in the morning, but I'm gradually improving. I'm now able to wake at 6am reliably, even though I can't get up. It helps that I'm not being sedated by Utrogestan. I wouldn't go back to Utrogestan unless I had to.

[TheMidnightSkulker]

Update after finishing second pack: everything was fine until a week or two ago.

However, I was getting acne breakouts that were getting worse, with new and more severe breakouts every day. Then the cystic acne kicked in.

ME: I WANT TO SPEAK TO THE MANAGER OF EXOGENOUS HORMONES. I DEMAND THAT YOU PUT EVERYTHING BACK THE WAY IT WAS BEFORE

HRT FAIRY: OK, here you go.

ME: Great!

ME: ...NO, NOT LIKE THAT

The worst case would be if this were somehow caused by the Slynd. I don't see how, but anything's possible.

It's also possible this was caused by smearing the oestrogel on my face.

However, I scaled back my topical treatments far more than usual since starting Slynd. For a short time I was not even washing my face in the mornings so I was cutting back on salicylic acid.

And I stopped using benzoyl peroxide, which previously I had used once a day. The only treatment I was using daily was adapalene. I have not been so lax with topical treatments in living memory.

So the first thing I did was stop putting oestrogel on my face. No Vitamin C serum either, no anything that could theoretically cause breakouts. And I started applying the benzoyl peroxide twice daily.

As of a few days ago I am not getting any new breakouts and the ones that I have are starting to heal.

I am also washing my hair every single day, and my scalp breakouts are calming down.

Once the existing acne has cleared up (probably in a couple of months) I will try smearing the leftover oestrogel onto my face again, and see what happens.

I do notice I have been a bit puffier than I'd like over the last couple of days. I wonder if stopping the oestrogel-on-face has something to do with that.

Or it could be because I ate only simple carbs (no protein) and a lot of salt over the last two days, and barely slept. In other words - the lifestyle things that are SUPPOSED to cause puffiness in normal people, are now causing puffiness in me, THE WAY THEY'RE SUPPOSED TO.

I also note that my calorie needs seem to be back the way they were before - about 10% higher than before I stopped Yasmin. I think, and there's no way to prove this, that my calorie needs have been this way throughout (OK maybe not post-menopause, but probably post-HRT) and the excess water has been masking my real weight, interfering with the calculations. Now that the excess water has drained, I know what I *actually* weigh and, therefore, what I need to consume in order to maintain that weight.

Everything else is fine. Mood is just that bit more even-keeled, and in general, everything else is back the way it was before. As nature intended. Or, I guess, as God intended, since nature seems to have never been quite on my side in these matters.

Next I need to get an appointment with my GP about this. I hope I'll be able to see the one that knows my history in all this. I'm nervous, I don't like having these conversations.

I also see that the pharmacy I ordered from has me on a 3-month subscription. Which means I'm going to run out before I receive the next one. Why is everything so stressful all the time.

[TheMidnightSkulker]

OK, I have almost come to the end of my third pack of Slynd (so just over 2.5 months).

I have been relentless in applying benzoyl peroxide twice daily, followed by adapalene after 30 minutes at night. I have not had any new breakouts in several days, and my existing breakouts are healing, though it will take some time. As I haven't had any breakouts on my back and chest, that relieves some of my worry that the Slynd was actually provoking the acne. Most likely it was because I stopped all topical acne treatments for more than 14 days, which is something I have not done in living memory, and will certainly never do again.

Once the acne is completely healed I'll cautiously try wiping off the excess oestrogel onto my face again. If I get any breakouts after that, I'll know it was the oestrogel that caused it.

=========

I have requested an appointment with my GP asking to change to Slynd from Utrogestan. I supplied a "before Slynd" photo taken on 9 September, and an "after Slynd" photo taken yesterday, both at almost the same time of day, under similar lighting conditions. The difference is very obvious to the naked eye.

I have an appointment on 18 December. Pray for me  Until then, I am living in fear that they might say no.

On Slynd, I don't have to be messed up by the sedative effects of Utrogestan.

On Slynd, my stress tolerance is above the line, whereas it was below the line on Utrogestan.

Everything globally feels just better.

=====

I can definitively say that my daily calorie requirements are 28% higher on Slynd than I thought they were on Utrogestan, and before starting HRT at all. I say "I thought", since there was no way to reliably measure it because of the constant and unpredictable interference of water weight every time I did anything at all - including cutting calories. (Memories of that one time I cut by 15% and gained two pounds, taking me to my highest ever recorded scale weight.) GOOD RIDDANCE, WATER.

[flo69]

Hi TMS
I got a couple of spots when I tried a little oestrogen cream on my face, it was biovea, one I bought while the GP was playing silly beggers with me in her blissful menopause ignorance which will end in about 15 years I'd say.

I'm on tibolone because I'm progesterone intolerant, always have been, so that is the first line HRT that the GP should have offered me, but she forced me through various treatments first that made me feel awful, so I do sympathise.

Why do you want oestrogel on your face? Can it make you appear more youthful? I've still half a bottle of oestrogel myself, from the failed, horror story treatments.

I couldn't tolerate utrogestan, I wasn't offered one like Slynd, so it makes me wonder, was there a progesterone out there I could have tolerated?

[TheMidnightSkulker]

Why do you want oestrogel on your face? Can it make you appear more youthful? I've still half a bottle of oestrogel myself, from the failed, horror story treatments.

Hi flo69, sorry to be so late replying, I only just saw this.

I was just curious because everyone says putting oestrogen on the face is rejuvenating.

As soon as my acne was completely cleared up, I tried the oestrogel on my face one more time. I got one small breakout straight away. The timing suggests it was coincidental. However I think it's not worth introducing another step into my already complex routine.

I think I get enough of a rejuvenating effect from the Differin (it's not exactly proven to have that effect, but I smear it on my hands last thing at night, and I don't know what else would explain why my hands aren't aged worse). It also helps that my face is no longer baggy from unnecessary water retention 

I couldn't tolerate utrogestan, I wasn't offered one like Slynd, so it makes me wonder, was there a progesterone out there I could have tolerated?

Maybe? People have to try various different BCP before they find the one that suits them. Logically the same must be true of HRT.

[TheMidnightSkulker]

A small update on the statistics:

Right through to the end of December, it seemed like my calorie needs were about 24% higher on Slynd.

It now looks like that might have settled down to only about 12% higher.

Not sure if this was caused by:
- continuing to lose water weight, just more slowly, until it was finally drained?
- inconsistent exercise? I have kept to a consistent daily minimum in January, but was all over the place at the end of 2024
- just a temporary startup effect of the Slynd on my metabolism?

Anyway, who knows. I had a ravenous appetite after starting Slynd, but it seems to have levelled off now. I'm still hungrier than I was before Slynd, but not so hungry that I could eat western Europe and be looking around for a second helping.

[CLKD]

When did U last have a thyroid function blood test?

[TheMidnightSkulker]

Maybe around 2021.

I don't think there is anything going on with my thyroid.

[CLKD]

Intense hunger is a sign of thyroid function issues.  As are bulging eyes and some1 being hyperactive.

[TheMidnightSkulker]

Well, if it were a thyroid problem, you would expect my puffy eyes to have gotten worse as I got hungrier. Instead, they got better.

Also, I understand that with thyroid problems, it's traditionally the eyes themselves that bulge out of their sockets. Not the eyelids that swell and droop over and around the eye.

I'm going to proceed on the assumption that the water retention is caused by what I think it is - hormones - and that the improvement that followed hormone treatment is a result of that hormone treatment.