Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[K45]

Hi ladies, I've managed to get an appointment with my GP as the withdrawal from cycling utrogestan makes me feel suicidal every month. I am going to ask if continous is an option despite being only 46 and on cyclical hrt for past 9 months. Is anyone aware of any studies/research/experts who recommend this as I don't want to get dismissed. Thanks x

[Dandelion]

Hi ladies, I've managed to get an appointment with my GP as the withdrawal from cycling utrogestan makes me feel suicidal every month. I am going to ask if continous is an option despite being only 46 and on cyclical hrt for past 9 months. Is anyone aware of any studies/research/experts who recommend this as I don't want to get dismissed. Thanks x

Hello, and sorry you are going through this agony.
I'm just realising how behind-the-times and misinformed the medical community is on HRT, peri and meno. I include myself in this, as I thought I knew it all about meno.
It's not their fault, they were not taught, they mean well, most of them.
The thing is, we are missing data, that only a few, as far as I can see, menopause experts are aware of.
For the last 15 years, since I started peri, at 42, unknowingly, blaming cessation of other medication, I have never felt right.
At 47 I started HRT, oestrogen and progesterone, had a few tweaks, bleeds, hospital treatment, GP appointments, but still, I resigned myself to the fact that I'd now "got through" meno, and went on continuous at 52, and this was my lot.
I'm now 58 and have just been humbled as I learnt more meno stuff and realised my so called full menopause knowledge was limited and narrow.
There's now courses for prescribers, done by GP's who want to prevent future menopause related health conditions as hormones affect every cell in the body.
There's loads of free podcasts and videos which are delivered in a way that even I, with my meno-induced limited attention span can absorb and learn from hungrily.
Peri is an up and down time, however, if our culture had of been more up-to-date (this knowledge has been proved by science in the 1940s but forgotten) I could have had my hormones balanced while I was in peri, and kept an eye on them.
It's worth considering all three hormones and their action on the body and incorporating them into your regime.
It might be, that you may be able to stay on cyclical, and not feel suicidal each month, as it might be you need another hormone added in to balance them all for the whole of the month.
I learnt E and P come from testosterone, one Dr calls it the mother hormone and another said it helps the others work optimally.
We are all very individual in HRT, peri, and meno, and we all need an individualised programme.
The very best of luck.

[K45]

Hi Dandelion, thank you for sharing your experiences. I think you've hit the nail on the head when you say we are all very individual in HRT, Peri and meno. Everyone seems to react slightly or sometimes even wildly different to hormones and treatment. I have listened to quite a few podcasts and tried to read a lot on the subject. My only option where I live is a GP so unfortunately testosterone is not available. It's either hrt or antidepressants - with the latter I tried 6 different meds most of which made my GS symptoms worse and did not help at all. My GP suggested the Mirena but I can't deal with smear tests after bad experiences with a police surgeon and then a rather bullish practice nurse who refused to stop despite me crying in pain. I think I will likely need to look into alternatives to manage symptoms as the options are pretty limited.

 

[bombsh3ll]

Of course using a continuous regimen is entirely reasonable - bleeding pattern should never be prioritised above patient wellbeing and quality of life.

Only the most inexperienced prescriber sticking rigidly to flowchart based guidelines would insist on cyclical hormone therapy where this is exacerbating cyclical symptoms, rather than using their clinical judgement and providing individualised care.

Professor Studd's clinic, Professor John Stevenson and Dr Louise Newson are all proponents of this approach.

There is no medical reason for insisting someone take intermittent progesterone rather than continuous - this is not done to treat or prevent any disease, but merely from the point of view of producing regular bleeding, which doesn't even happen all the time anyway.

I am sure that your local NHS menopause clinic would be happy to provide email advice to your GP regarding this matter, and you would not have to wait for a face to face appointment.

However, as the recommended dose of continuous progesterone is generally half as much as the dose for cyclical, the overall number of capsules taken per 28 day cycle works out exactly the same, so it is probably already in your gift to take it this way if you wish, with the prescription you have.

There is absolutely no harm in this provided you take the same overall amount of progesterone per cycle. As you know this may result in a more irregular bleeding pattern, but I am sure you know your way around a pack of sanitary towels by now.

Another really good option in peri, and my own personal favourite, is a combined birth control pill taken continuously - no bleeding or hormonal fluctuations whatsoever.

[K45]

Thanks so much Bombsh3ll 

I feel a lot more confident about seeing my GP now on Monday. Unfortunately I don't live in the UK so no NHS menopause clinics. My thinking is try continuous for a month or 2 to see if it helps improve mood/headaches/sleep. My back up plan is now as you have suggested to try knocking the cycle on it's head so no bleeding/hormonal fluctuations. 

Thanks again for the reassurance & helpful response.