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[joziel]

I just wanted to make people aware that a new product is on the market: Dydrogesterone (one of the kinder/better synthetic progestins) is now available as a stand-alone progestin to be used with estrogen in HRT.

It used to be called Duphaston. It is now called Nalvee. Here is some info: https://pharmaphorum.com/news/gedeon-richter-brings-hrt-option-back-uk-market

[Clovie]

Thank you Joziel - this is great news!
I don't rate my chances of getting it in Scotland for a while, going by my previous experiences

Do you know if you can have it prescribed by private specialist? I'd love to try it.
I am usually highly intolerant of synthetic progesterone and am having a mare with continuous  estrogel and Utrogestan (100mg) not stopping my own cycle. I am late menopause as well (age 61 and still bleeding predictably regularly with PMT before it) so it's always a drama, it's causing me major anxiety...

[bombsh3ll]

Also something I am very interested in for when I graduate from OCP to MHT.

I don't care for my own progesterone and want the minimum progestogen exposure possible whilst maintaining endometrial health on a therapeutic dose of estradiol, so this retroisomer that selectively increases potency at a fraction of the dose is on my shortlist.

Clovie, I do not believe dydrogesterone at the doses typically used provides suppression of ovulation from my knowledge of its use in fertility (sorry) however it is still absolutely worth trying.

[Konijntje]

Clovie, you could try Slynd (drospirenone) as your progestin, as it can be used as the progestin part of hrt and it’s also a progesterone only birth controll, so it will suppress your cycle. In my experience so far (I’m trialing Drovelis, which is estetrol/drospirenone), it’s pretty different from other progestins, I’m progesterone + progestin intolerant. I do have some annoying side effects from the diuretic properties and some other side effects, that feel more like the passing kind, but mood wise it seems a lot better for me (I do have some mood issues, but much less than on previous trials).

I’m in the Netherlands and for me dydrogesterone has been available, but wasn’t great. It does have a very good safety profile and I’m glad it is an option in the UK again. So frustrating when things just aren’t available, I really wanted (still do actually) to try Duavive and that has been discontinued here in June and my appointment at the clinic (GP didn’t want to prescribe) was in July.

[Mary G]

Duphaston is also available in Ireland but you would have to get a prescription - they do accept UK prescriptions.

I haven't been able to buy dydrogesterone in Spain or Gibraltar but I'm going to try Portugal. 

I tried it in the form of Femoston but I'm afraid I was plagued with migraine auras. Obviously I don't know if it was the oestrogen component or the dydrogesterone but it was a nightmare.  So I'm stuck with six months worth of in date Femoston conti 0.5/2.5mg that I can't use which is unfortunate because I had to go to some effort to buy it from a pharmacy in Gibraltar.

Konijntje, I've got a Dutch neighbour aged 58 who is having terrible menopause problems according to her husband.  Unlike my partner he doesn't know much about the menopause and HRT so I've offered to help but he implied that HRT is not widely discussed or used in the Netherlands.  Is that still true?  They have been over here for 5 years now so things might have moved on in that time.

[Konijntje]

Yes, Dutch mentality is really just struggle through menopause. However, there are really clear guidelines for GP’s to follow. And I do think mentality is changing a bit luckily. I’ve been referred to a clinic, since my GP wasn’t willing to prescribe off license, but she had no problem with referring me (wait times are ok, mine was 2-3 months).

[Dotty]

https://www.menopausematters.co.uk/forum/index.php/topic,73052.0.html

Hi this is a link to a previous post about Nalvee.

[Mary G]

Konijntje, thanks for replying.  I'm glad things are improving in Holland but I think my neighbour is going to be hard to persuade re HRT.  It's a pity because she is really suffering and has now given up driving which is a real problem here. Her quality of life has been badly affected but the anti HRT culture seems to run really deep which is strange because people don't feel the need to struggle on with other medical conditions.

There still seems to be some kind of embarrassment and stigma attached to the menopause despite efforts to increase awareness.  I'm always happy to talk about the menopause and HRT with men too which often seems to embarrass people.  I wonder if it's worse for people who are particularly age sensitive and can't face getting older. 

[Konijntje]

Yes, it is definitely a strange thing, there is a similar anti pain medication during child birth going on here. I do think that also is slowly changing with more women choosing to go to the hospital for child birth (home birth is still very popular, and with our densely populated country, there is always a hospital nearby, so it is relatively safe).
I’m pretty open too about using hrt and my struggles to find a good fit. I also need to keep functioning, because I have 2 children with disabilities, so can’t just curl up and do nothing. It seems to make trying off license things more acceptable somehow, my GP wrote it in the referral letter, that not sleeping because of low estrogen was not an option because of my family (you’d think not sleeping is always a reason to get treatment ;-)), I don’t think she actually thinks that way, but I did mention I was having trouble taking care of my children and having to drive a car with my lack of sleep, so that is probably why she mentioned it. I guess the Dutch culture of “what doesn’t kill you makes you stronger” is still inside me too, like I need to have an excuse to take hrt.

So, I also don’t think you’ll have an easy time with persuading your neighbour. Even pro-hrt me that is open with friends, feels the need to have excuses to even use hrt and I find myself thinking “why would you start hrt in early peri, if you hardly have symptoms” when I read other stories and then realize it’s that ingrained Dutch mentality seeping through.

[Wrensong]

Just a quickie to say I was on Duphaston on UK private script (imported from Germany I think) for 18 months in 2021-23.  I'm highly progesterone intolerant & having tried everything else, this was the one progestogen that enabled me to stay on HRT pending hysterectomy.  On MM we had long lamented its discontinuation in the UK, so the news it's making a comeback is very welcome.  Well worth trying for anyone who struggles with other forms.

[Mary G]

I was able to buy Duphaston in Portugal yesterday.  It cost €9.85 for a box of 42 tablets so not expensive.  I was expecting the pharmacist to say it wasn't available or it would need to be ordered so I was surprised when she came back with it in her hand.

I will give it a try soon but not @10mg because I think it's too high a dose with 2 pumps of Oestrogel so I will cut the tablets in half and take 5mg. 

[Clovie]

I was able to buy Duphaston in Portugal yesterday.  It cost €9.85 for a box of 42 tablets so not expensive.  I was expecting the pharmacist to say it wasn't available or it would need to be ordered so I was surprised when she came back with it in her hand.

I will give it a try soon but not @10mg because I think it's too high a dose with 2 pumps of Oestrogel so I will cut the tablets in half and take 5mg.

Hi Mary

Hi Mary
We are moving to Spain next year, retiring early. Currently buying a house out there. Exciting (in amongst all my period drama  Annoyed that it is spoiling our excitement)

Hoping to be able to buy this stuff when we get out there.  Good to know.

[Mary G]

clovie, dydrogesterone is not currently available in Spain but depending on where you are relocating, it's worth taking a trip to Portugal for vital meds.  I'm currently in Villa Real (VRS) which is just a few kilometres drive over the bridge from Ayamonte in Spain so you can go between pharmacies, make comparisons and pick up all the stuff you need.  It's swings and roundabouts, Spain is better for some things, Portugal is better for others.  Gibraltar only has UK medication but they often seem to have supply problems so a lot of people go over the border to Spain buy it in La Linea.

Good luck with your move!

[Clovie]

clovie, dydrogesterone is not currently available in Spain but depending on where you are relocating, it's worth taking a trip to Portugal for vital meds.  I'm currently in Villa Real (VRS) which is just a few kilometres drive over the bridge from Ayamonte in Spain so you can go between pharmacies, make comparisons and pick up all the stuff you need.  It's swings and roundabouts, Spain is better for some things, Portugal is better for others.  Gibraltar only has UK medication but they often seem to have supply problems so a lot of people go over the border to Spain buy it in La Linea.

Good luck with your move!

Oh you're very well placed there! 

Thank you for the good wishes!      We are going to be East of Malaga, in Axarquia. Stressful but exciting!

[Mary G]

clovie, I don't actually live in the Ayamonte area but I can get there fairly easily.

I have good news for you if you are moving to Spain and taking out private health insurance.  It's brilliant and you don't need referrals to see a specialist, you just book it yourself.  Uterine scans are included of course, they are very easy to book and better still, the gynaecologist carries out the scan personally (no sonographers) so the results are instant.  Ditto the breast ultrasound that is conducted immediately after a mammogram and again, instant results because the breast specialist does the breast ultrasound personally. This should help your health anxiety no end.

I don't envy you battling the post Brexit residency requirements (assuming you are British) but at least you have the benefit of the private healthcare system!