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[Vicky81]

So, yesterday I decided to use my pill cutter to cut down my slynd from 4mg to 3mg - says on the net yes yiu can reduce the dose.
Remember im very sensitive to medications even vitamins because of my withdrawal from my antidepressant. 
I had some advice e from 2 ladies private messaged to say give it a go.
All day yesterday I had physical anxiety in my body, even in bed last night. Then when I woke at 5am I was clinging to the bed sheet with terrible anxiety..i read this is fluctuations so the 3mg didnt do me. Any good right?  The 4mg took away my horrid angdr on the 4th day but gave me fatigue....so do you think i shoukd try again on the 4mg or oush through with the 3mg all il say js i felt terribke this morning ..... ive not had the bed clinging from anxiety si ce my first post on here I think 2022? The anxiety was horrid.i got up took lorazepam........then immediately started heavy crying i was even retching in the bathroom but didn't vomit ....think it was extra anxiety .
The reason I cut it down was on the 4th day of 4mg.....it seemed to knock me out with fatigue .....now I get fatigue anyway so I didn't want a tablet giving me more.
Was also thinking about work in my mind d.
So what do I do here ? Woukd you ladies carry on with cutting down ( maybe stupid question) and try to push through ? Or go back to 4mg normal dose?
Plus any ideas on progesterone only tablets thst sippress ovaries thst dont make you tired? Or at lesst lower than this one ?.i dont like cerazete made my eyes funny. So any oyhers where i dont have to double up in order to suppress woukd be goid to hear. Im still sat on bed wjth physic anxiety.....i did read thags fluctuations sory to repeat.....so.Please help me as I get bad peri as u know I dont know what to do for the best?... please be kind and i hope you ladies reply s im crying so much dont know what to choose or do with this slynd. Xxxx love to all

[bombsh3ll]

It really depends what you are using the slynd for and how small you are cutting it.

If you are relying on it for birth control then it should not be cut.

If you want reliable ovarian suppression, it should also (probably) not be cut.

However if you are using it purely for endometrial protection with estradiol then 2mg of drospirenone has been established as safe with 1-2mg of oral estradiol (approximately 100mcg patch but equivalents can vary depending on absorption).

This would be half a slynd tablet.

If you are doing anything off piste like this however I would recommend endometrial monitoring just to be sure.

[Konijntje]

I’m responding here too again Vicky, because I do want to repeat myself that I got bad fatigue too when I started with that progestin (and now that I’ve started dienogest too), but it is an initial side effect for me and it got much better after the first 2 weeks.
It sounds that we both respond very strongly to starting anything new, so let’s just pretend/hope this will be the same for you and your fatigue will be better next week.
Since you write your anxiety seemed less on the 4 mg, I would just stick with that and try to accept the fatigue. Maybe call in sick at work if you really can’t function? (I feel I can sort of function, but I’m feeling hungover and like I could sleep all week (but I can’t, because I’m very tired, but not sleepy)).

[Minusminnie]

It has been suggested to you Vicky to write things down each day to be able to follow progress and note what you are doing.

If you cannot do this could your partner make notes for you and give it some oversight.

Use of Lorazepam may be a source of your fatigue and how often you take it needs monitoring. It is not for long term either.

[Vicky81]

It really depends what you are using the slynd for and how small you are cutting it.

If you are relying on it for birth control then it should not be cut.

If you want reliable ovarian suppression, it should also (probably) not be cut.

However if you are using it purely for endometrial protection with estradiol then 2mg of drospirenone has been established as safe with 1-2mg of oral estradiol (approximately 100mcg patch but equivalents can vary depending on absorption).

This would be half a slynd tablet.

If you are doing anything off piste like this however I would recommend endometrial monitoring just to be sure.

So bomb just so i know i did hhe wrong thing.....as its suppression i want and need desperately.  On day 4 of skynd all my anger stopped and it was very hostile aggressive anger.....but same day got fatigue more so that's why I thought hmm I wonder....but what yiure saying us anything lower on slynd woukd not suppress.....just so I can tell my partner too. So stay on 4mg is yiur advice? Xxxx love ya xxxx

[Vicky81]

I’m responding here too again Vicky, because I do want to repeat myself that I got bad fatigue too when I started with that progestin (and now that I’ve started dienogest too), but it is an initial side effect for me and it got much better after the first 2 weeks.
It sounds that we both respond very strongly to starting anything new, so let’s just pretend/hope this will be the same for you and your fatigue will be better next week.
Since you write your anxiety seemed less on the 4 mg, I would just stick with that and try to accept the fatigue. Maybe call in sick at work if you really can’t function? (I feel I can sort of function, but I’m feeling hungover and like I could sleep all week (but I can’t, because I’m very tired, but not sleepy)).

Thanks hun so much .....yes I can't stop crying way more anxiety ....so stick to 4mg?

[Vicky81]

It has been suggested to you Vicky to write things down each day to be able to follow progress and note what you are doing.

If you cannot do this could your partner make notes for you and give it some oversight.

Use of Lorazepam may be a source of your fatigue and how often you take it needs monitoring. It is not for long term either.

Thanks hun so much yes i have a diary everyday xxxx

[Vicky81]

It really depends what you are using the slynd for and how small you are cutting it.

If you are relying on it for birth control then it should not be cut.

If you want reliable ovarian suppression, it should also (probably) not be cut.

However if you are using it purely for endometrial protection with estradiol then 2mg of drospirenone has been established as safe with 1-2mg of oral estradiol (approximately 100mcg patch but equivalents can vary depending on absorption).

This would be half a slynd tablet.

If you are doing anything off piste like this however I would recommend endometrial monitoring just to be sure.

So it's deffo not used to cut up for suppressing? Jhst so we know here in .y house hold xxx

[Mary G]

There is no way I would ever take 4mg Slynd.  I previously used Angeliq which contains 2mg Slynd and I had to top that up with additional oestrogen because that progesterone was wiping out the benefits of the oestrogen.  If you overload with progesterone it overrides the benefits of oestrogen.  Progesterone raises core body temperature too so it stands to reason that it will interfere with thermoregulation if you take too high a dose and that is the last thing you need in menopause treatment.  Interestingly the US brand of Angeliq contains 0.5mg Slynd with the same 1mg oestrogen dose which is a huge difference.

Overall it would seem you need more Slynd than Cerazette to stop ovulation and I think Cerazette is probably more effective hence the lower dose needed. 

I would be cutting the pill in half.  I had complete suppression with 2mg.

[Vicky81]

Ahh I can't use a combined pill mary....and yesterday I cut up the pill yo make 3mgs this morning i crie so hard and woke up clinging to the bed sheet with anxiety....I agree it's too high but now im s are to try again to cut it abd cerazette didn't suit me ..im in a withdrawal and I know more or less straight away if a med or vitamin is ging to be an issue cos the withdrawal doesn't take well to everything. I don't know what to do now ?? Out thing i could do ......abd after advice here is try the 3mg again cut down from 4mg in say 2 days time see if i get the hard crying and terrtibke frightening morning anxiety again? What do people think and you Mary any thoughts? Xxxx

[Vicky81]

Update so I've just looked at the box for my 100 patch .....it says 6.4.mg of estradiol.  So that woukd make it higher than my progesterone pill at 4mg wouldn't it?. Or is it me being dense? Xxx

[bombsh3ll]

Less than 4mg of slynd has not been shown to provide ovarian suppression.

That's not to say that some individuals wouldn't be suppressed with less but the available evidence that has been demonstrated in studies is 4mg.

The combined pill with 3mg of drospirenone plus ethinylestradiol can also achieve this however some of the effectiveness is down to the estrogen.

I personally couldn't and wouldn't take drospirenone at all as it is a diuretic.

However it is also very difficult to tell which way is up in terms of side effects when treatment is changed so rapidly.

I know I've probably said it before but I can highly recommend Zoely which I take, because that's a much kinder progestin, guaranteed ovarian suppression plus body identical estradiol so you aren't having to juggle and fund two separate products.

[Vicky81]

So bomb you think i shouldn't cut up the slynd? I've already got 100mg patch on too.
Aby thoughts ...what woukd you do if u were me? X

Ahh I can't take zoely it doesn't suppress me i tried it years ago abd I forgot that I had....but sadly no xx I think my peri and fluctuations have always been cruel to me ....very bad symptoms ....severe anger and I mean smashing up the flats we have lived in....hard crying....then angry.....very cruel words to my ex .partner and in 2022 when it first started I was hurting myself ....digging my nails into my skin , scratch marks on my arms terrible for someone who is normally level headed and works in broadmoor xxxx

[bombsh3ll]

Personally no, I wouldn't cut up the slynd.

If you aren't tolerating it then I would find another alternative rather than having potentially inadequate treatment AND feeling rubbish!

[Vicky81]

Were gunna try tomorrow taking it still 5 ot 6pm as recommended by a lady on here as she was getting fatigue but s different pill she saud it was skit better day after but bear in mind there still was a little fstigue still there . But yes bomb yiure right but I dont know alot about the other progesterones ...
Cerazette and zoeky no goid 4 me.
Im not gunna the 5 x norgeston lol
So unsure what else woukd suppress but is lower and maybe kinder out the lot??? Xxxanyone help me here please? Xxxx