Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Becr]

Hi all. I am post meno 5 years but started HRT 3 months ago. 100mg Utrogestan vaginally at night, 2 pumps oestrogen gel morning.

The first two months of HRT I had bleeds, this last month however no bleed. What I have found this month is I am having the most awful insomnia, where I wake every night 3.30 on the dot. In this last month I have also had frequent (every few days) what I call pre-syncope, the feeling of going to faint with dizziness, tinnitus and darkening vision. These events pass quickly.

I feel this is down to the progesterone building up. I am progesterone intolerant and this is why I stopped HRT last time. I have found the utro vaginally a game changer. Mood better, joint pain gone....LOVELY HAIR lol. I want to continue on this regime but I wonder if I am better off taking a break from the utro every month. I don't care about bleeding. I can cope with that. I just have this strong feeling that I will do better cycling. Even if I cycle for a week. I am seeing my GP next week but would value comments from ladies here. I am always interested in other peoples experience even though I appreciate we are all different.

[sheila99]

I don't now as I have a mirena but on utro I did long cycle (6 week) sequi because it wiped me out. The nhs don't like it though so you may have trouble getting your gp to agree to it.

[Becr]

Thanks @shelia99, yes I wondered if my GP might be unwilling to agree. That said they were great about switching to vaginal progesterone.

[bombsh3ll]

I am not yet menopausal but when I am I don't plan to take a continuous progestogen.

I will do long cycle like Sheila, 2 weeks every 6-8 weeks. For me this may be with a progestin, which are more effective in terms of endometrial protection than micronised progesterone.

Long cycle sequential gets you as close as possible to the health benefits and quality of life enjoyed by those on estrogen only, which obviously you cannot do unless hysterectomised.

However the NHS doesn't support this. It is something you would have to take ownership of yourself, and I would strongly recommend paying for a scan every year or 2 years to ensure endometrial control, which is what I will be doing.

Also because I have banked decades of endometrial protection on the combined pill, my personal risk of endometrial cancer is lower than average.

Regarding the presyncope, which is something I truly empathise with and is horrible, as I live with severe dysautonomia, are you aware of the hypotensive and salt wasting effects of micronised progesterone?

A non-diuretic progestin can be much better in this regard. I am on the combined pill to prevent me releasing my own progesterone.

Oral estrogen also helps support your blood pressure, whereas transdermal does not, and testosterone also helps with this (although you would have to tell the NHS it's for libido - they care far more about you putting out than passing out).

[Becr]

I had no idea about progesterone and its diuretic effect. Yes, the pre-syncopes are awful, there is no pattern to them, I even have them laid in bed. Sometimes they can really frighten me.

Helpful about the scans. I will do that. I find the vaginal progesterone has made a big difference in terms of mood so I am keen to stay on it but less days over the month. Previously when I tried synthetic progesterones I had terrible depression. Thanks for your response.

[Lucoley]

Hi Becr
Im the same. Progesterone gives me shocking insomnia and Im currently waiting for an appointment at NHS meno clinic. I suggested cycling to my GP and she reacted like I'd suggested murder. I think the plan is to try me on vaginal Progesterone. Ive only been on HRT 3 months, same regime as you. Ive actually started bleeding this week and think I'd benefit from increasing Progesterone but I darent. Ive also experienced increased anxiety. All a bit of a mess!

[bombsh3ll]

Just to clarify if the progesterone is being taken half the time, it is twice the dose.

There are multiple other progestin options, nobody is stuck with micronised progesterone.

You don't need your GPs permission to use it vaginally. This is how it is routinely used in Europe and they think swallowing it is odd.

Tibolone is another good option often overlooked by those with progestogen intolerance.

[Becr]

I am thinking seriously of going to a private menopause clinic near my home in the south west. If the clinician there agrees to let me cycle how does it work with the NHS. Can I still get my prescription via the NHS?

I am happy to pay for a scan. It would be worth it to try cycling again. The insomnia has been around for 5 years (since post meno) but not as pronounced as this. The progesterone vaginally works great, I am so much less grumpy etc than oral prog. I can fall asleep as usual but I wake 3.30 and I am WIDE awake. If I am on a day off I can then have a cup of tea, something to eat and then an hour later will usually sleep again, which gives me around 7 hours. If I am working and I can't do this then the most I get is 4-5 hours. Not bad.....but after several nights like this I feel so shattered.

Thanks again for the input ladies.

[bombsh3ll]

You don't need anyone to "let" you cycle.

If you are happy with micronised progesterone it is already within your gift to do so with the prescriptions you have.

I wouldn't say anything to the NHS or you risk being labelled "non-compliant" and losing your prescription or being forced onto a combination product which may not meet your needs.

[Becr]

Very helpful! Appreciate your input. Thank you.

[juliaC]

Becr most of the things you are experiencing I am getting the same.  I was thinking oestrogen was out of balance but in the last few months it's all adding up, every symptom I have seems to link back to progesterone.

I'm not against being on it and know I have to be, but my own natural progesterone didn't bring about all these symptoms, or it did but they were much milder.  And I think I might still be having cycles of my own here and there and so maybe too much progesterone I don't know. 

When I first used the combined patch I was euphoric, went hiking, energy returned, etc.  But that was 5 years ago now.  2 years into it I started getting all the symptoms you've described.

I have been contemplating cycling this time around, need to give it some thought and I would like to be under the guidance of a menopause doctor.  My nhs doctors nearby seem very rigid and unhelpful and overly reliant on theory and textbook and don't want to hear my experience of what's happening to me.

[Becr]

I started a break from the prog yesterday and last night I had 2.5 hours of deep sleep, according to my watch, which is fantastic. I had the drowsy sleep I would get before periods (when I had cycles). I think like you Julia, I will see a private meno doc for guidance but I just have a strong feeling I will be better cycling the prog. We are all different and I respect that. It’s finding the right balance for our unique chemistry. For me continuous progesterone feels like it’s building up and down regulating the oestrogen. I also find my vagina is so dry with using the prog vaginally every day. I start to wince at the thought of inserting it and have to use my ovestin cream most days.

[Hurdity]

Hi becr - have only skimmed this thread but just to let you know that I have almost never taken progesterone on a continuous basis and I've been on HRT for 17 years I think now. Fortunately my GP is happy for me to take it cyclically but as bombshell says - you don't need to tell them, and you should have the right amount if they prescribe sufficient for daily use ( and as said, you need to take double ie 200 mg for 12-14 days per cycle if used cyclically, as opposed to minimum 100 mg daily for continuous use).

I've been on long cycle HRT since probably 2011 or 2012 - can't remember exactly. Around 5-6 weeks. The length of the cycle will be determined by your oestrogen dose - so that if you take a higher dose and absorb well - then you will need more prog so may not be able to go 8 weeks in between cycles. If you do go for that length then probably best to take Utrogestan for the full 14 days and yes you will need to have regular scans until you get to know how your uterus lining behaves on the cycle.

Also to mention that when you do stop the Utrogestan each cycle you may well get progesterone withdrawal symptoms - which can be a bit delayed if taking the Utro vaginally because it hangs around for a bit - so don't be alarmed if you feel worse before you feel better! Once the prog has cleared the system then you should feel wonderful!

All the best

Hurdity x

[juliaC]

I started a break from the prog yesterday and last night I had 2.5 hours of deep sleep, according to my watch, which is fantastic. I had the drowsy sleep I would get before periods (when I had cycles). I think like you Julia, I will see a private meno doc for guidance but I just have a strong feeling I will be better cycling the prog. We are all different and I respect that. It’s finding the right balance for our unique chemistry. For me continuous progesterone feels like it’s building up and down regulating the oestrogen. I also find my vagina is so dry with using the prog vaginally every day. I start to wince at the thought of inserting it and have to use my ovestin cream most days.

I was supposed to change back to my combined patch tonight but by mistake I put on another estradiol only.  Now I'm thinking of leaving it for a day or two just to see if I start to feel any better.  The other part of me is thinking I'll just mess up my cycle as my body will be expecting progesterone now.

Either way I'm off Monday afternoon and I'm going to make a decision where to see someone privately.

[Lucoley]

I have a private appt today to discuss progesterone but just wanted to let you know since you are questioning your dosage.

By last week 14 weeks after starting daily progesterone I had to stop work. I had crushing anxiety, insomnia, body fatigue as in could not move from the couch till 3pm. I couldn't go out or make plans. I decided to stop my progesterone ahead of my appt today to see.

When I tell you EVERYTHING has lifted! It was a slow improvement over the week but the last 2 nights Ive slept. Yesterday I got up and went out with my daughter. Today Im going to my hair appt that I had to cancel last week as I was too panicky. I cannot quite believe progesterone did thst to me. But it did.

So YES stop the progesterone for a week or 2 to see how you feel. It won't do any harm for a short period of time.