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[Emjay]

I have tried so many different ways with Utrogestan now and I seem to still be struggling with it (have been on hrt 2 years this feb)
I am currently on 100mcg estrogen patch as recommended by gyni (for pmdd plus perimenopause)and I have been taking Utrogestan cyclically but as I am on a higher dose of estrogen am wondering whether I should try Utrogestan daily or completely switch to slynd.
Has anyone here felt better on continuous slynd with higher estrogen patch?
I am on the waiting list for hysterectomy plus oorprectomy due to severe pmdd but it is a year long waiting list.
I am struggling with the constant fluctuations of hormones, I never know where I am at.
I do feel a lot worse once I start taking Utrogestan and have to take an ssri towards the end of the Utrogestan cycle which does help a bit.
But now because I am on a higher dose of estrogen via the patch, I feel like the estrogen is too high when I am not on the Utrogestan.
Like the balance is totally out.
Trouble is Utrogestan makes me feel so horrible I'm not sure i can take it every day of the month.
I asked the gyni if I could just take 100mg Utrogestan daily as I know the guidelines have changed recently and the daily amount should be 200mg but he said it is fine for me to stick to just 100mg daily.
I also have mild endometriosis aswell so I'm concerned that the lower amount isn't enough to prevent the endo getting worse but any more Utrogestan and I am a complete wreck mentally.
Have read that slynd can be helpful with women that are intolerant of the Utrogestan.
Looking for women that have been through the same and found relief with slynd.
I'm always worried to just switch as I know it can take a while to balance out, if I know there is light at the end of the tunnel then I could stick it out.
Not sure which way to go with the progesterone or progestins at the mo.
Hope this makes sense

[Konijntje]

I’m progesterone intolerant too and haven’t tried Slynd, but have tried Drovelis (which has the same progestin). However, the diuretic effect was bothering me (eczema flare up), so I switched. Mood wise, it was much better, it will also suppress your ovaries very well (first month was quite difficult for me), so you might not need the hysterectomy if you get on with it.

I switched to dienogest (also 4th generation progestin) + oestrogel, which seems to work well for me and might be even better for you if you have endometriosis. I’d say I’m still getting used to it, I’m now 7 weeks on it I think. I’d say my mood is slightly below baseline, but progesterone was horendous for me, so I’ll take slightly below baseline (it might get back to baseline, because I’ve read it takes 4 months to really get used to it. Even if it doesn’t, I’m happy I’m doing this well after 2 years of struggling). I think dienogest is also suppressing my cycle now, first month I could feel my ovaries waking up and I had some difficult weeks, but now everything starts to feel more level and side effects are getting much better (besides the acid reflux, but I’ve started on a PPI again).

However, since Slynd is in your guidelines (I’m in the Netherlands myself), I think it will be easiest to get prescribed and I recommend trying that first. Most people don’t have many problems with the diuretic effect, I was a bit unlucky I guess.

[Emjay]

Thanks for your reply, that is really helpful.
I think it is worth a shot, it can't be worse then Utrogestan and I am getting fed up of continuously trying, every month I hope my body is getting used to it and it will feel fine but it never does.
I hope I am one of the lucky ones aswell where Slynd works better.
I think I need more consistency then like a roller coaster with starting and stopping.
I have read that you need to drink a lot more fluids whilst using slynd, I'm guessing then because it is also a diuretic
I will make sure to do that, I know I need to focus more of drinking water even now so I will really need to up my game with that.
I hope your hormones even out soon and what you are taking now really works well for you.
I wish it was all so much more straightforward

[lizzy76]

Hi there,

I haven't tried Slynd but I use Nalvee (Dydrogesterone) which I have found to have no mood side effects. It is newly available on GP prescription. I also had problems with very low mood on Utrogestan.

[bombsh3ll]

There are multiple oral progestins, women struggle on for far too long with micronised progesterone, which is never going to shut down your own cycle and is a pharmacological model of PMDD.

I have never and would never take drospirenone (slynd) as for me personally anything diuretic is contraindicated.

However many women tolerate it perfectly well in the combined pill Yasmin.

If there is a particular birth control pill you have been OK on in the past, I would go for that progestin.

I don't know if you have access to testosterone but anecdotally it can also make progestogens easier to tolerate.

[Emjay]

Thanks all, I appreciate your comments.
I have just taken my 1st slynd this morning so will see how it goes.
I haven't really had much experience in the past with contraceptives as I tried to avoid them to be honest.
I had probably only had a contraceptive twice and only for a few months as I always felt my mood deteriorate but that was about 20 years ago now and I can't remember which ones they were.
I am currently using testosterone aswell so hopefully that will help in combination.
I definitely don't drink enough water so I will be upping that if slynd is a known diuretic.
I really hope I find the right combination soon, it's so complicated all of this and anything I change I am just worried to feel worse as life feels very difficult as it is with how I am.
I have 2 young children to take care of and be the best mum for them.
I do feel tired of it all and if this doesn't help them I will be leaning towards having the hysterectomy and oorprectomy.
When I am bad I have this weird feeling of I just want everything out, like it is a monster in me that needs to leave.
I do wonder sometimes if that feeling is my own intuition telling me that is what I need to do.
But I do understand that even on the other side of having the opporation I would need hormones still and finding the right balance could still  be tricky.
Although I have thought maybe tibolone could be something that may suit me better in that situation.
Such a mind field isn't it

[CrispyChick]

Have they not tried you on GNrh analogues? Chemical menopause?

To shut you down completely in the background. It wouldn't solve the prog issue but I thought if was tried as a precursor to hysterectomy.

Plus, if completely shut down, you can use tibolone.

[Emjay]

I'm on the waiting list for the operation, they have said I will have to have the zoladex injection to shut everything down then add back hormones. Will have that for 6 months.
But he recommended 1st that I upped my estrogen patch to 100mcg again, even 150mcg if I wanted to try that and see how I get on.
I said I will try that 1st but go on the waiting list anyway as it is a 12 month wait so I didn't have to go right back to that start again if I decided to go with the op.
My g.p has prescribed me slynd to try as the progesterone alternative for now along side the higher estrogen to see if I tolerate that better.
I suppose I will have to give it a few months and if no better or if I am even worse then I will book in with gyni to start the zoladex.

[CrispyChick]

Ah right, ok.

So they are possibly trying to supress you instead with high dose estrogen?

I guess if you have trialled all the progestins before zoladex then it's a good reason to ask for tibolone instead.