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[Hippolyta]

I was on HRT for 18months which I had started due to migraines. I was on one pump of oestrogel + 100mg Utrogestan daily and although still having periods was on a continuous dose. The HRT seemed to 'diffuse' my migraines in that the pain was less intense but they were more frequent - though I don't know if this was the HRT or just my own hormonal changes.

I stopped the HRT 3 months ago, mainly just to see where I stood in my cycle and whether the migraines would be any different. Since then I've had joint pain - strong in my hips - and hot flushes which I can cope with generally but they are both really disturbing my sleep.

 I used to sleep well on the Utrogestan which I took vaginally at night so I'm wondering whether to go back to the HRT but to try progesterone only to solve this. I was just wondering if anyone has tried this or has any thoughts?

Thanks.

[discogirl]

Hi Flowerpot

I'm post menopause and I recently had another very heavy bleed, I had a hysteroscopy and biopsy and all was ok. I stopped the oestrogel but remained for a while on the utrogestan as it also helped my sleep. I asked my gynae if it was ok to take just the utrogestan but she said that was "insufficient evidence" on taking it on its own.'' So I ended up stopping the utrogestan as well.

There is another thread about this subject and it was Hurdity I think, who said that taking it on its own may lead to over-ulceration of the womb. I think that's what she said.

Take care x

[sheila99]

As above, it can cause over thinning if you take prog without oestrogen. Is there a reason to stop the oestrogen? As it's oestrogen that's controlling the flushes and hip pain. Insomnia is a common symptom of oestrogen deficiency so it might be helping with your sleep too. It's possible your gp won't prescribe prog on it's own as usually (not always) the NHS prescribes it only for womb protection.

[bombsh3ll]

Plenty of people take progesterone alone, for various reasons, and it is not harmful at all (unless potentially in the setting of hormonally sensitive cancers - some breast cancers express P receptors).

I have no idea what "ulceration of the womb" is but my best guess is someone may have had a complication relating to a mirena IUS.

Nothing like that could plausibly result from typically used doses of micronised progesterone.

Whilst I personally wouldn't want to just use progesterone and miss out on the benefits of estrogen, there are people that this suits, and clinicians who are happy to support this.

Particularly if the problem is insomnia, it is far better to take micronised progesterone if this is effective, than either going untreated or taking sleeping pills, which comes with its own problems.

[Hippolyta]

Thanks for your advice ladies - wise and well-informed as always

[discogirl]

Plenty of people take progesterone alone, for various reasons, and it is not harmful at all (unless potentially in the setting of hormonally sensitive cancers - some breast cancers express P receptors).

I have no idea what "ulceration of the womb" is but my best guess is someone may have had a complication relating to a mirena IUS.

Nothing like that could plausibly result from typically used doses of micronised progesterone.

Whilst I personally wouldn't want to just use progesterone and miss out on the benefits of estrogen, there are people that this suits, and clinicians who are happy to support this.

Particularly if the problem is insomnia, it is far better to take micronised progesterone if this is effective, than either going untreated or taking sleeping pills, which comes with its own problems.

Hi bombsh3ll

I'm really interested in what you've said, as I had continued to take the utrogestan long after I'd stopped the oestrogel.

So do you think that taking the utrogestan on its own won't cause any problems like bleeding or anything?

[bombsh3ll]

So do you think that taking the utrogestan on its own won't cause any problems like bleeding or anything?

It shouldn't do, because the endometrium is not being stimulated, and it is perfectly safe to take as monotherapy.

In fact there are a number of clinicians who really advocate for progesterone alone - this practice became quite common in the wake of the WHI when estrogen was maligned and everyone was afraid to prescribe or take it but women were still desperate for relief from miserable symptoms. There is some evidence that hot flushes are also reduced at higher doses of progesterone. 

Whilst I don't believe this is the best option for the majority as most of the gains in quality of life and long term health come from estrogen, it is a valid option for those who either don't want or perhaps haven't tolerated estrogen.

However as there is currently no evidence to support any long term health benefits with progesterone alone, I personally believe it should only be used if it is providing symptomatic benefit in some way, such as improved sleep, and not taken primarily in the hope of improving future outcomes e.g. osteoporosis prevention or cardiometabolic health. This is not to say it definitely doesn't help in these areas, but as we just don't know this is not a current indication.

[CrispyChick]

There are plenty of clinicians support this route, as bombshell says.

There's even a Facebook group about estrogen dominance and the use of prog only.

The bottom line is progesterone leaves our bodies much earlier in peri than estrogen does. So it can help to balance during those years of annovulation and estrogen spikes.

If it's working for you...but you won't find NHS or BMS support for this. It's certainly big in other countries. 

[tinkywinkyshandbag]

I asked my GO about this today as estrogel gives me incredibly sore and massive boobs but the progesterone helps me sleep. She said progesterone only increases risk of Breast cancer and is not recommended. Not sure what to think now…

[CrispyChick]

It's so so unfair that us ladies are being fed either inaccurate information -  certainly not scientific truths.

One dic will tell you prog alone is unsafe, another that it's totally safe. I mean, which is it?

It's like we all need to get medical degrees to find out way round this torrid time in our lives.

It's time this conflicting information ended. How, in this day and age, can we have one country (canada for example) advocating for prog only use in early peri (as prog declines first) and the UK saying that's not a thing. Either it does decline first or if doesn't. Fact. Makes me mad!!!

 

[bombsh3ll]

Whilst progesterone added to estrogen does unfortunately increase the risk of breast cancer, there's no evidence that taking progesterone alone does so.

It simply hasn't been studied so nobody can say conclusively that it does or doesn't.

However it makes no sense that someone willing to prescribe both estrogen and progesterone together, thinks progesterone on it's own is more of a risk.

If it were me I would just go back to getting the dual prescription. What you do with the estrogen is up to you.