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[Rafiroo]

Hello,

I’m feeling very lost and would really, really value some advice and opinions.

47, wasn’t particularly struggling with peri, would get reasonably regular periods, night sweats for a week prior to getting the period.

Mood not the greatest, irritable, but I’ve always been a bit grumpy/quick to temper if I’m honest!

Started trying HRT earlier in the year. Patches (evorel 50) gave me anxiety the first few days, didn’t like them. Ustrogestan for 14 days - slept well but didn’t like the aching/low mood it gave me.

To be honest I didn’t stick at them for very long.

Then a few months ago the hot flashes at night (no HRT at this point) started really keeping me awake. Urgh. Mood was low. Irritability/rage was bad - snapping at my son all the time and feeling terrible about it.

Saw a specialist who put me on ustrogestan 100 daily - they did bloods a couple of times in a couple of weeks and each time my estrogen level was super high.

Test 1. 1434 estrogen 12 progesterone  no HRT.

Test 2. 2040 estrogen, 6.8 progesterone
On ustrogestan 100 daily for 2 x weeks by this test.

Specialist had prescribed estrogen gel but said don’t use it, estrogen is already super high. Said it can spike/fluctuate in peri.

So, it’s been 3 x months now of ustrogestan 100 daily. I’m permanently bloated. Normally super fit (gym 5 x a week) but just feel heavy, unmotivated and bloated. Put weight on round my stomach only. Irritation still feels pretty high. The muscle aches for the first week were almost unbearable! And I feel my hip pain has gotten worse.

I got a period a few days ago. I figured technically my estrogen should be low at that point, so tried half a pump. Did this for the last 5 days. Initially, fine - my aching hip actually felt better, think I felt slightly clearer mentally.

Now though, 5 days in, I’m waking up with hot flashes again. Insomnia. 😭

I have no idea what to do.

They’ve said I can go up to 200 ustrogestan daily. Or try it vaginally.

I know it’s trial and error, a guessing game etc….but honestly, there must be a better way?!?! Do I really have to spend 3 x months on something before deciding whether it’s helping? 3 x months for every change I implement?

I really, really hate the bloating ustrogestan gives me. I look 6 months pregnant half the time. It’s so uncomfortable.

I don’t even know what questions I’m asking you ladies to help me with really - there’s so many - do I increase to 200? Scared it’ll give me awful low mood and even WORSE bloating etc. Does the vaginal method eliminate bloating? Why is my estrogen crazy high?! Why does half a pump give me insomnia but help my hip? Arrrgggghhh I’ve no idea what to do.

Sorry for such a long and rambling post. I really hope some people will reply, I just feel lost and at this point wonder whether I should come off everything. Ready to give up.

[Mary G]

Sorry to hear you are suffering but I would put money on it being the dreaded Utrogestan.  We have more women on here posting about problems with Utrogestan than any other products. 

My personal view is the stuff is dreadful and far more trouble than it's worth for most women.  People dread taking it, they try to keep the dose to a minimum, have a long cycle and still they have problems and terrible side effects with it.  It's given the hard sell on the basis of being natural, body identical progesterone but I'm afraid the reality is completely different and most people have far worse side effects with Utrogestan than they do with the more tolerable brands of synthetic progesterone.  You can use Utrogestan vaginally but frankly, it's still not much better in most cases. 

Utrogestan is destabilising and it gave me endless migraine auras whereas Cyclogest and compounded progesterone which are also body identical didn't.  So it's something that is uniquely a problem with Utrogestan and women like me with no history of progesterone intolerance or sensitivity have numerous problems and side effects with it.  It's not fantastic at controlling bleeding either. 

My advice is ditch the Utrogestan immediately and find something else.  I would stop taking it and have a long run of oestrogen only and then start taking a different form of progesterone.  I recommend Cerazette because you can buy it over the counter in the UK without a prescription.  If that doesn't work out there are plenty of other options that are better than Utrogestan.  If your hormones are spiking you might be to suppress ovulation (FSH and LH) to create a more stable hormone environment so Utrogestan is the last thing you need.  From my own experience, Oestrogel is an excellent product that provides a good dose of oestrogen and it shouldn't destabilise your hormones if you split the dose by 12 hours.

The contraceptive pill is another option at your age so worth reading up.

I hope that helps.

[CLKD]

   if a medication makes a patient ill it is failing to do the work that it's designed to do!  Stop as suggested. 

Which symptom would you like to ease 1st?  Some find that keeping a mood/food/symptom diary of use.

Don't be fobbed off with medics who try to insist on a strict regime, as our hormones are individual.

Let us know how you get on!

[bombsh3ll]

At your age you could still be on a combined oral contraceptive pill continuously like me - I take Zoely - and have no periods and nice stable hormone levels every day instead of messing around with hormone therapy which will neither suppress your own hormonal fluctuations nor get rid of your periods.

It's a no brainer if you ask me!

[sheila99]

I would take the utro vaginally which should avoid digestives issues and bloating. Flushes and insomnia are low oestrogen symptoms so I'd suggest increasing the gel. Normally 2 pumps are prescribed in peri, half a pump is next to nothing. I wouldn't increase utro.

[Rafiroo]

Sorry apologies - I’m still figuring out how to reply specifically to people! 🙈

I appreciate the responses!!

Thing is, the flushes and insomnia only started when I started the estrogel a few days ago. So I’m assuming it’s that.

I’ve tried the pill a few times (contraceptive) but always had very low mood/constantly hungry…plus I don’t really want the synthetic hormones?

I hear what you’re saying re the ustrogestan - so many people say the same thing - but I’ve heard others say a higher dose actually was way better.

They’ve asked me to try it - I’m unsure.

Is 3 months enough to establish that it’s not benefitting me? Everyone always says you need to give it 3 months for side effects to settle. The bloating definitely hasn’t improved.

Sorry I’ve answered various questions from different people on this one reply! I appreciate it all though, thank you.

[sheila99]

Unless you had a blood test you don't know what your own production of oestrogen is. My guess it was much lower than when you tested before. Insomnia can have other causes but you don't get flushes when you're 25 and producing gallons of you own oestrogen.

[Rafiroo]

But weirdly it’s only happening (hot flashes/insomnia) the last 5 days - which is exactly when I started using a half pump of estrogel.

Yesterday I didn’t use it. No hot flashes in the night. But my hip aches were back this morning…

[common-lime]

I could be wrong, but want to float the idea that half a pump of oestrogel might be worst of all worlds. It's such a tiny amount, it might be that your body is absorbing it in such a way that it's creating fluctuations in your estrogen levels, so you're getting rebound symptoms overnight when it drops suddenly. I was just thinking this because hot flashes are normally a symptom of low or dropping estrogen rather than high. You might have a totally different experience on one or two pumps, or on the patch, which some (not all!) people find gives more consistent levels.

[Konijntje]

Since some of your symptoms and issues with hrt sound very similar to mine, I’m going to share my story so far. Your issues might turn out to be totally different or you might see some helpful things.

So, for me, the insomnia in the week before my period, started in my early 40’s and this went from only the week before my period (when estrogen is low) to all the time at about 48. I had some hot flushes during the day too, but those were pretty mild (during the night too, but very very disruptive to my sleep) and then there came dizzyness. I’ve been trying to get my hrt right for almost 2 years now, but I soon realized estrogen was the answer for me. Progesterone (utrogestan) was the devil (I’m intolerant, I’ve tried continuous, sequential, vaginal, everything), but I now have good hopes I’ve found a progestin I’m tolerating.

The estrogen part is however tricky for me too. I find that with oral estrogen I get way too many fluctuations, I seem to metabolize oral estradiol really fast, giving me spikes (and nausea and a jittery feeling) a few hours later and drops (and hotflashes) after about 8-10 hours. Patches gave me a rash, but also were very uneven for me, I was nauseous and jittery for the first day, then I had 1 goid day and then low estrogen symptoms again. I’ve been on lenzetto and split my dose to around 7 am and 7 pm and that felt very even, but was a bit low towards the end. I’m now on oestrogel (for 2 weeks) and also split my dosage and it also feels very even. Hot flushes are gone, I’m still slightly dizzy and not sleeping the best, so maybe going higher with my estrogen will turn out to be better, but I’ll wait until my next appointment with that (I went one pump higher than my prescription already).

Another piece of the puzzle for me was suppressing my cycle btw, progesterone doesn’t do that and not all progestins do either. My cycle was getting worse each month lately and now that it’s suppressed, I feel way more balanced (even though I have annoying side effects right now from starting a new progestin).