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Author Topic: Migraine and continuous hrt  (Read 1504 times)

Jimpywimpy

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Migraine and continuous hrt
« on: April 18, 2025, 08:54:18 AM »

Hello everyone!

I've looked for posts but can't find information on this - apologies if it has already been posted!

I'm 47 and  perimenopause and recently started hrt, mainly to deal with chronic anxiety symptoms. I was originally put on patches but the fluctuating hormones brought on migraines. I was then given a coil to stabilise progesterone but it gave me pain. The last Doctor put me on Urtogestan cyclically. The Urtogestan has worked amazingly for me - sleeping better and anxiety has reduced. But if I stop it after day 26 I get horrific migraines. My body can't handle the sudden drop in progesterone.

Has anyone here  in peri been put on continuous HRT? I would like to continue with Urtogestan and Estrogen gel continuously. Normally it is post menopause ladies who take 100mg continuously - not peri.  I went to the Doctor but he was clueless and has written to the Menopause Clinic.

I'm so grateful for any advice!
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bombsh3ll

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Re: Migraine and continuous hrt
« Reply #1 on: April 18, 2025, 11:58:32 AM »

The only reason progesterone is typically prescribed cyclically in perimenopause is in an attempt to create a regular bleeding pattern.

It achieves this only a minority of the time anyway in my experience.

If you don't mind the possibility of a less regular bleed pattern, there is no medical reason why you can't take the progesterone continuously.

This is usually recommended from the start for those with cyclical symptoms such as migraine or endometriosis etc.

However practitioners who lack knowledge and confidence will often stick rigidly to the flow chart which signposts cyclical for peri, continuous for post.

The dose for continuous is half the dose for cyclical eg 100mg nightly vs 200mg nightly.

This means taking the same number of capsules over a 4 week period regardless, so with your existing prescription it will already be in your gift to take it continuously if you prefer.
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