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[elle]

Hello, I'm experimenting with different HRT to see if it helps with my chronic pain due to ligament laxity and subluxations. I'm post menopausal currently on  sequential HRT, 4 pumps estrogel and 300 Utrogestan. I'm due to start the Utrogestan in a few days and worried that taking 300mg all at the same time might be too much if it's the progesterone causing laxity. Does anyone know if I can take this dose over the day rather than at the one time for it to be effective, ie prevent hyperplasia? Guidelines suggest not unless discussed with GP. I'm wondering if anyone else has split their dose and if they had any issues doing this. I previously took 200mg on continuous. Been down investigation route and given all clear.Thanks, elle x

[Konijntje]

I remember my utrogestan insert actually saying to split the dose when taking 300 mg or more, so it will be fine, it’s more about taking enough through the month than when you take it.
I also get very bad lower back pain from progesterone (and most progestins), sequential was slightly better than continously for me. (I’m also intolerant and get depressed from it, so I’m trialing drospirenone (in Drovelis) now, but I have lower back pain now too. I’m just not sure yet if it is a temporary side effect or if the drospirenone is also causing laxity. The lower back pain feels more crampy than the pain I get from progesterone, so I still have a bit of hope it’s temporary).

Are you taking the utrogestan orally or vaginally? Vaginally was worse for laxity for me, my bladder responded very badly to that route, so I’ve only tried that a few times (I was hoping that wouldn’t give me as many mood issues, but turned out to not be an option for me).

[elle]

Thanks for the response and sorry to hear you're having to trial so many options to try to avoid pain. I'm taking progesterone orally. I have a connective tissue disorder, waiting for a genetic referral to investigate possible EDS. Chronic pain came on quickly during perimenopause due to hormone changes which affect the musculoskeletal system and my ribs subluxated. Despite 3 years researching I'm still no further forward to knowing what hormones increase my pain, hence the experimenting! That's useful to know you were told you could split the dose.Yes, like you, I always got higher crampy pains during my cycle and relaxin was another hormone that had a really strong effect during pregnancy too. Movement and exercise has really helped me, though I'm limited in what I can do. As for bladder issues, I had uterine fibroids removed as part of gyne invstigations and that seems to have helped a little (I also started wearing period pants which made me feel more secure, not sure why I waited so long to do this!) The depression is horrible, I'm so sorry you experience this. I had huge mood swings with some opiates I was on for pain. I hope you can find the right balance and help soon x

[Konijntje]

I’m sorry about your connective tissue disorder, chronic pain is awful.

I don’t think I have a connective tissue disorder myself, but my daughter does, not EDS, but she has fragile X syndrome + (+, because she has more genes affected, since she has a deletion instead of mutation). I’m very worried she will have the same strong response to hormones as me, she is 10 and has just started puberty. She already has hypermobility issues (and spasticity) without hormonal infuence. Well, I worry about a lot of things with her obviously, but hormones is a big one.

[bombsh3ll]

It is absolutely fine to split your progesterone dose.

However progesterone exacerbates joint laxity over days/weeks/months not hours so I don't necessarily see splitting the dose being beneficial for this purpose.

The reason progesterone is recommended to be taken all at night is if swallowed it can form sedating metabolites. Vaginal use negates this.

However given your concern is joint laxity I would recommend an androgenic progestin in its place and to make sure you have testosterone on board.

[elle]

I’m sorry about your connective tissue disorder, chronic pain is awful.

I don’t think I have a connective tissue disorder myself, but my daughter does, not EDS, but she has fragile X syndrome + (+, because she has more genes affected, since she has a deletion instead of mutation). I’m very worried she will have the same strong response to hormones as me, she is 10 and has just started puberty. She already has hypermobility issues (and spasticity) without hormonal infuence. Well, I worry about a lot of things with her obviously, but hormones is a big one.

Thank you, I completely understand the worry with your daughter (my son has EDS). I really hope that treatment, support, research etc improves and she manages to avoid any major hormonal impacts. Have you joined any facebook groups for her condition? Sometimes, like this forum, they can be really valuable x

[elle]

It is absolutely fine to split your progesterone dose.

However progesterone exacerbates joint laxity over days/weeks/months not hours so I don't necessarily see splitting the dose being beneficial for this purpose.

The reason progesterone is recommended to be taken all at night is if swallowed it can form sedating metabolites. Vaginal use negates this.

However given your concern is joint laxity I would recommend an androgenic progestin in its place and to make sure you have testosterone on board.

That's good to know thanks. I'm working up to soeaking to GP about testosterone and you've kindly helped me in previous posts re this.
I'm actually fine having an increase in pain because I can alter my dosage to reduce again but I don't want to risk rib subluxations which are a totally different ballgame! I'm keeping a diary but I feel it will be a long road experimenting.
Yes, the progesterone are great for getting a good nights sleep, from that point of view I'd be very happy taking them all at once!

[bombsh3ll]

Just remember you will have to say the testosterone is for low libido if you are trying to get it on the NHS.

Whilst we have androgen receptors throughout our body, the NHS will only fund testosterone to make us sleep with men, not for our own quality of life.

[Konijntje]

Thank you, I completely understand the worry with your daughter (my son has EDS). I really hope that treatment, support, research etc improves and she manages to avoid any major hormonal impacts. Have you joined any facebook groups for her condition? Sometimes, like this forum, they can be really valuable x

Her deletion is unique and some of her issues aren’t explained by fragile x syndrome, so it’s difficult to find others with similar problems. Also with a syndrome on a X chromosome boys and girls can’t be really compared and girls can have major issues or almost none (my daughter has major issues). There is a university hospital in Rotterdam (which is a bit of a drive) with a fragile x expertise center, so I might contact the hospital to see if they can offer more than her current doctors (she has quite a few). I’ll wait until she’s had her next (brain) mri, because if anything has changed there, there is other things to worry about more. (her brain abnormalities can’t be explained by fragile x syndrome at all)

I didn’t mean to talk this much about my daughter in your topic, let’s get back to your sequential progesterone trial. My lower back pain started after about 3 days when I tried sequential and just kept building up the longer I took it, so I agree that it probably doesn’t matter if you take the dose at once. For me, it took more than a week for the back pain to subside again, so with sequential I still had only 1 week where the pain was less. Hopefully, you will repond better than me (depression from intolerance + pain is not a good combination).

[elle]

Just remember you will have to say the testosterone is for low libido if you are trying to get it on the NHS.

Whilst we have androgen receptors throughout our body, the NHS will only fund testosterone to make us sleep with men, not for our own quality of life.

Yes, had heard this and unsurprisingly I'm not surprised.......