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[thankyou]

Hi ladies This is my first post. Hope I'm not asking too many questions.

I started HRT 1 x pump estrodiol gel and 100mg utrogestan tablet daily - been on for about 5 months.

I stopped having periods about 8 years ago.

Hot flushes went away quickly with the HRT. But still have the anxiety, panic and depression.

I think I have progesterone intolerance. Taking the tablets before bed knocks me out all night and leaves me feeling groggy/ fatigued/ nauseous next day and hair is shedding.

Have tried various ways to take the the utrogestan - but not getting anywhere with them and feel utterly miserable. Basically at the end of my tether with it all.

I'm looking at completely stopping. What is the best way to do it, taper off or just stop? Or do I try another form of HRT

Sorry for all the questions and thanks so much for any help, it's really difficult to get a doctors appointment.

And I'm worried that if I go private they will just milk me with blood tests and try this and that and I'll still be the same at the end of it all.

[DottyD68]

Hi there,

1 pump of gel is a pretty low dose. 2 pumps is the standard starting dose I believe. Maybe an increase in dose would alleviate your symptoms?

If there is a problem with the utrogestan you could try other forms of progesterone. Combined patch or Mirena coil for starters.

As you are on a low dose at the moment you could just stop without reducing down. But if you still have the symptoms you had prior to starting HRT maybe an increase or change would be worth trying in the first instance.

I discovered, as have lots of other ladies, HRT isn't the simple, fix-all solution to menopause as it is marketed as. Good luck wth whatever you try.

[Furyan]

Your symptoms sound progesterone related. I only just made that same connection after 4 years of taking HRT. You maybe could do with a little more oestrogen to balance out those symptoms - perhaps increase by 1 pump and see. The gel is versatile in how you use it and if you take the progesterone as a suppository you can be rest assured your womb lining is protected with that dose of oestrogen. Good luck…   

[Kathleen]

Hello and welcome the forum.


I am also post meno and utterly frustrated with HRT.

I use one sachet of Sandrena gel and 100mg of Utrogestan daily however I also continue to have some symptoms including the psychological ones.

A few years ago I weaned myself off HRT over a period of a few months and about one month into being without any oestrogen several symptoms came back, these included hot flushes, night sweats intense vaginal dryness and crying spells. After a while I resumed HRT but I have never really got the balance right.

 I am now considering tapering off my current dose over the next few weeks to see where I am naturally. I am hoping that I will be able to manage any returning symptoms and hopefully feel better when everything settles down. I live in hope!

Wishing you well and take care.

K.

[DottyD68]

I think it is also a useful exercise to write a list of the benefits you feel on HRT, and also the side effects whilst you are on it.

When you stop HRT to is quite easy to remember the benefits you had from it when symptoms return (for me aching legs) which may make me consider restarting. But I then try and remember all the negative side effects that HRT cause (for me,  acid reflux, post-nasal drip, sore boobs, weight gain, anxiety, palpitations, hair loss, increased allergies, health anxiry for the above). So that focuses the mind. Noone ever explains exactly what is in it (in plain English) and how each of the hormones can affect our bodies. We are just told you need more estrogen.

I would love it if there was a little menu option (a bit like room service breakfast) where you could just tick the things you want to improve without any unwanted extras. One can dream.

[bombsh3ll]

Firstly I would like to say that there are multiple options other than micronised progesterone, and it is a real tragedy when someone gives up on all the benefits of estrogen, both short and long term, having only tried one progestogen option.

I would start by making sure you are well informed about all available options including tibolone.

This is particularly important if you don't have a menopause literate GP, which is probably the case given you were initially prescribed antidepressants.

There is almost certainly an option that will suit you, but you may need the help of a menopause specialist to provide that level of individualised care.

However to answer the question you posed regarding stopping hormones, there's no compelling evidence that weaning down gradually is superior to just stopping. I personally think it is kinder to maybe taper the estrogen down over a few weeks, using progressively lower amounts.

If the progesterone is upsetting you and you are coming off the estrogen permanently, then the progesterone can just be stopped.

The low residual dose of estrogen over a very short period would pose negligible endometrial risk - this becomes an issue if someone takes unopposed estrogen for months to years, not a few weeks.

[Mary G]

I would say it could be too much progesterone and not enough oestrogen.  Hot flushes are the first thing to go when you start HRT and one pump of Oestrogel will be enough to do that for most women but if you have insomnia, anxiety and depression for example, you will need a higher dose.

I would stick with the Utrogestan for now and increase to two pumps of gel and be prepared to go to three pumps if necessary.

If the Utrogestan is still a problem, I would switch to a different progesterone and consider one of the synthetics.

I would think very carefully about giving up on HRT altogether because you would lose all the long term benefits and it won't address your immediate problems either.  Antidepressants can help a lot of women alongside HRT but it's no substitute.

[Furyan]

As some of these comments capture, I’m somewhere on the fence about continuing with HRT myself, having never got the balance right. Regarding progesterone, I’m only just realising that I can only tolerate around 60mg daily let alone the 200mg I now have to take on a 100 patch, which surprised me as I thought my issue was with the oestrogen!
But as MaryG and Bombsh3ll have just mentioned, I’m now considering another progesterone component as I cannot live with this level of fatigue and metabolic issues caused at this dose. I’m going to try mirena as one of my final options. Really helpful that I’ve read some advice on here about how to deal with the initial issues that can happen with mirena though. 

[sheila99]

I didn't get on with utro either, I now have a mirena which suits me well. I agree you need more oestrogen. You could also try a sequi regime instead of conti (200mg x 12 days, days 15-26) so you can see how much the utro is affecting you. The nhs don't like it much, they say there's a slight increased risk of endometrial cancer but they agreed to it for me because of the side effects of utro.