Menopause Matters Forum
General Discussion => New Members => Topic started by: VerityDreamer on August 30, 2016, 05:16:49 PM
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Hello,
I have been reading here recently - I am 45 and recently had the Mirena Coil removed after 5 years. - I did not have any bleeding at all in those 5 years on the coil and now, 2 1/2 months after removal I still haven't had any bleeding but I'm having terrible peri-meno syptoms.
I had tried progresterone cream which I bought online and that helped but it caused me to have hot flushes and other side effects so I stopped it. I bought some estriol cream and tried it starting Sunday but can't see any change.
I'm having lots of hot flushes, mood swings, and sweating. I am going to see a consultant here in the UK privately but I wonder if it is worth the money? I have an appt with my GP also in the works but I think she will just put me on Eostrogen therapy and in the past, even small doses of estrogen (from BCPs) caused me weight gain and anxiety.
I felt so much better at first without the coil and with the progesterone cream - it really helped my anxiety and sleep but then I started getting the hot flushes and other symptoms.
Anyone know of anything that I should try on my own or that I could specifically ask my GP to prescribe me?
Thanks for any advice.
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Hi VerityDreamer
:welcomemm:
I am not familiar with how long it might take for periods to come back after removal of Mirena if you are peri-menopausal - or even if you are not! However if you are getting hot flushes and without a period for two months and at your age this does indicate that you are peri-menopausal. If this is the case then your oestrogen levels are beginning to decline and HRT should help your symptoms.
The oestrogen from the BCPs is totally different from HRT - the former is strong and synthetic and the BCP's also contain high doses of synthetic progestogen. If the Mirena suited you, then why not ask for another one to be fitted - then it would also deal with contraception as well as providing the progestogen part of HRT? You can then add in oestrogen starting with small doses until you felt well. I would suggest transdermal oestrogen (through the skin) because that gets into the system quicker, doesn't have to be digested nor go through the liver. You can use patches or gel according to preference - I have just mentioned these to another new member. Oestrogen gel is applied once or twice a day, and patches applied twice a week.
Progesterone cream cannot help symptoms caused by reduced oestrogen, and nor can it protect the womb from over-thickening due to added oestrogen!
Personally I don't see the need to go privately - given that the above is all available on NHS and is your right if you want it and have no medical reason why not. However you would need to make sure you know what you want and why, that your GP (or another in your practice) is sympathetic to women in menopause and understands/will prescribe HRT - as there have been too many cases of women being fobbed off!
Hope this helps - do ask if you need any more info! :)
Hurdity x
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Hi - it took 5 months for my periods to come back after stopping hormonal BC. They used to come back straight away before peri-menopause. Then I had loads. ::)
If that happens, it is definitely worth considering another Mirena and oestrogen to stop any meno symptoms. I didn't because I was scared of them - sort of regret that now :-\
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Hi Dahliagirl and welcome.
As other ladies have mentioned, if you get on with Mirena then it's an easy and convenient way to deal with progesterone part of HRT. I don't get on with coils but if I did I'd have one. I've tried both oestrogel and oestrogen patches and have settled on patches.
I eventually went to a private gynae but as Hurdity says, there's no need to if you know what you want. I didn't, but do now. Transdermal oestrogen is probably the safest route for that part of HRT and if you don't agree with Mirena anymore, most consultant gynaes recommend utrogestan as a progesterone as its identical to our own progesterone.
Dig around on this sight and you'll find lots of experiences from women similar to you. Get all your ducks in a row and go to your GP. It'll save you a lot of money if you can get what you need from GP. The only 'extra' I got from private was a bone scan. You can have your bloods done at GP.
Hope this helps and good luck.
Dxx
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Hi,
Thank you so much for the replies! So helpful. I have read a lot here and see that most say that researching for yourself is the best thing to do so I set out to research for myself and ended up very confused but now have these recommendations here so thank you for that. I will ask for those from my GP in the first instance.
The Mirena did not suit me in many ways - I had a lot of problems with it - it caused me terrible bladder leak problems, bowel problems (sorry!) and weight gain, I am not keen to have it again at all however the GP was very very keen to replace my Mirena with another one.
Maybe my bleeding will return if I wait longer.
These hot flushes were terrible yesterday - I must have had 10 of them during the day and am now sweating which is awful when it happens during the day time.
I am seeing Mr. Dooley - I have read here that some consultants use a standard protocol for all patients - does anyone know if he does? I can't see a point in going if a consultant uses a standard protocol but maybe that is me misunderstanding the therapy.
I am also in the area for referral for Panay on the NHS but doubt very seriously that my GP would refer me until they have tried me on their regular protocol. I don't have a GP anymore that will work with me re the prescriptions but I guess I could try going in and asking for the gel as you've recommended and hope that she is amenable.
That's good news re the eostrogen in the BCP vs HRT being different - that may mean that I can tolerate it - very good news.
I'm confused though - re the blood tests - I didn't think they were very useful and that treatment is symptom based? Why would I request a blood test?
Also, please tell me that this mood swings/low mood are part of it? I haven't been so tearful/weepy and low mood (for no reason so at least I can rationalise that it is hormonal as I am actually in a good time in my life right now).
Thank you so much for the help. I am sweating profusely as I type. So lovely. :(
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Sorry Dahliagirl - used your name instead of postees! New to this, apologies.
Dx
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Hi and welcome to MM VerityDreamer
You have had some good advice so far but I would like to add my thoughts.
As Hurdity has already pointed out, BCPs are different to HRT so you mustn't look for problems when you try HRT. Most HRTs have bio identical oestrogen so works with your body far better that anything in a BCP.
It does sound as though you are peri meno and this is not unusual for mid 40s and this phase can last some years with the hormone levels fluctuating, periods coming and going in an erratic way and causing low mood, flushes etc. - it is staggering how these fluctuations can play havoc with our emotions.
You will read very mixed experiences and advice on this site and many are well informed but you must never assume that what works for one person will work for you. The menopause is a confusing and worrying time for many - nobody warns you about what can happen - but we are here to help. Do read up all the info on this site to get really clued up.
Blood tests can be useful as the FHS level can be a good indicator of whether you are entering menopause - although oestrogen and even FHS can fluctuate during peri meno.
You shouldn't need to go privately as your GP should be your first port of call. Try to find out which doctor at your practise specialises or has some knowledge of treatment for the meno first - make an appointment and go prepared. Write down your symptoms and questions, be clear about why you want to try HRT (if you do) and the type do HRT you would like to try.
If you look under TREATMENTS above under Perimenopause, you will see your HRT options - do take a print out with you when you see the GP. I have tried almost every HRT under the sun as I had a premature menopause and needed HRt for over 20 years. It does take some trial and error before finding the one that suits you but I would suggest you try Femoston 1/10 first as this is tolerated very well by many women. GPs usually prescribe Elleste Duet as it is the cheapest but Elleste has a progesterone that sometimes gives more PMT type symptoms.
I do think private gyneas can vary in the way they treat menopause but if you go armed with the right information and questions then you can usually get the better outcome. However I would let your GP try you on an HRT first before seeking advice privately - you may get a GP who is sympathetic and is prepared to find you something that works.
Keep us posted DG xxx
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Hi again
Just to add re blood tests that your doc should just go on your age and symptoms - according to the new NICE Guidelines - because as Dancinggirl says FSH is an unreliable indicator, although some docs like to test for it. It's a good idea to have general blood tests though when first going to docs with symptoms - to rule out other conditions eg thyroid problems which can cause overlapping symptoms eg sweats - so if you haven't had any bloods done recently I would hope your doc would do them for this reason - but not just to diagnose menopause.
If your GP or another in the practice will not consider the HRT that you decide you would like to try then I would insist on a referral (that might make them prescribe!) - and great that Nick Panay is in your area as he practises on NHS and is one of the top gynaes. I have also heard good reports of Mr Dooley as I know someone (on another forum) who has been to him for years. However as we have advised - do try your own GP practice first.
Hurdity x
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Ok, thank you so much for the replies. They are very helpful. I will see if it is too late to cancel my appointment and just try on the NHS.
Will also do as you've suggested re reading up on the information that you've given me.
Thank you so much, I can't thank you enough. :)
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Hi VerityDreamer
Apologies I didn't mean to confuse you re. Blood tests, just wanted to point out that other than bone scan, that was all I got at my private gynae. I have to say though that the bone scan was revealing and indicated that hrt was defo a good idea for me. The bloods, as others have pointed out, were for EVERYTHING - very thorough, not just peri/meno hormone levels and they did highlight that I had virtually no testosterone.
It's really up to you which way to go re. Nhs/private - do more research and make your own informed choice. Everyone's experience is different.
Good luck and keep us posted on your progress.
Dx
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Hello -
Thanks for the advice here - I ended up going to both GP and consultant privately. I've paid for bone scan and ultrasound just to make sure that nothing was wrong.
Blood tests also ordered to see if I do have reduced FHS levels.
My GP was not amenable to starting HT now - she ordered FSH levels to be tested now and in 6 weeks. Based on the results she will prescribe (or not prescribe) hormones. She wasn't interested in giving me a bone scan or a trans-vaginal ultrasound. And she didn't seem to care that I am having horrendous symptoms and that 6 weeks feels like an eternity without some relief.
I am working hard to change diet and exercise lots and get sleep, etc to the best state.
Will go back to the consultant on Thursday to get prescription - Oestrogel & progesterone. Does this sound like a good place to start?
I am wondering if anyone saw relief straight away?! My moods and irritability are now trumping the hot flushes and sweating and that's saying something! I am really struggling to control my anger and irritability and I have never been like this before.
I have read up and researched more but one thing I don't understand is where the mood swings come from - if oestrogen is declining, why the ups and downs and such terrible irritability - (I see from reading here that I am not alone.)
Thanks!
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Also - my GP will clearly not be amenable to working with me on what suits me re hormones - she insists that I need a new Mirena coil and some eostrogen tablets - when I asked about the gel she said that that was not what I would need but that we could talk about it later after bloods come back. :'(
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VerityDreamer, I would stick with the advice of your specialist and Oestrogel and progesterone sounds like a very good place to start. What type of progesterone did he prescribe? I found my symptoms disappeared very quickly on this regime.
From what you have said, you didn't do particularly well with the Mirena coil so I would advise caution. If you get on well with the Mirena coil then fine, it is a good option for the progesterone part of HRT but if you have suffered with any changes in mood, breast pain, headaches or migraines in the past while using it then it is probably better to look at other options. In theory, the progesterone in the Mirena is mostly confined to the womb but enough of it gets into your overall system to cause side effects.
I don't know what you GP meant by suggesting you don't need Oestrogel. From my own experience, the gel works far better than oral oestrogen and it is always better not to ingest the stuff and process it via your liver. This is the problem that so many women have, GPs are not HRT specialists and it is a bit hit and miss and to what you end up getting. They will often guide you towards a Mirena coil and/or oral HRT because it is easy (and cheaper) but it is not necessarily right for you.
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Thank you, Mary - I'm so glad to hear that your symptoms went away quickly with hormone therapy - you have made my weekend! I hope I feel better once I get the prescription.
He didn't say which type of progesterone - he is waiting for blood test results, etc to come back, he just said 'progesterone'.
The coil didn't suit me but I do worry that oral progesterone might not be great either but hopefully if it's balanced out with some oestrogen it will be better.
Thank you for replying.
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I'm glad you feel optimistic and you have every reason to, I found the gel to be the most effective form of oestrogen by far and it is also very flexible because you can adjust the dose to suit your needs.
Re the progesterone, he might prescribe Utrogestan which is better used vaginally because it hits the spot. It is better not to ingest progesterone if you don't have to and it works better at clearance/thinning when used in this way. It also has fewer side effects like breast pain.
Good luck and please let us know how you get on!
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Hello -
Thanks for the advice here - I ended up going to both GP and consultant privately. I've paid for bone scan and ultrasound just to make sure that nothing was wrong.
Blood tests also ordered to see if I do have reduced FHS levels.
My GP was not amenable to starting HT now - she ordered FSH levels to be tested now and in 6 weeks. Based on the results she will prescribe (or not prescribe) hormones. She wasn't interested in giving me a bone scan or a trans-vaginal ultrasound. And she didn't seem to care that I am having horrendous symptoms and that 6 weeks feels like an eternity without some relief.
I am working hard to change diet and exercise lots and get sleep, etc to the best state.
Will go back to the consultant on Thursday to get prescription - Oestrogel & progesterone. Does this sound like a good place to start?
I am wondering if anyone saw relief straight away?! My moods and irritability are now trumping the hot flushes and sweating and that's saying something! I am really struggling to control my anger and irritability and I have never been like this before.
I have read up and researched more but one thing I don't understand is where the mood swings come from - if oestrogen is declining, why the ups and downs and such terrible irritability - (I see from reading here that I am not alone.)
Thanks!
Just to reiterate what I said in my earlier post that your doctor is quite wrong not to agree to your starting HRT at your age based on your symptoms. Also she should let you have the HRT that you choose for the reasons that you give. I would recommend everyone to do their research before going to the doctor re HRT and especially the NICE Guidelines and the first two paragraphs on this site under Menopause diagnosis:
"The diagnosis of menopause and the menopausal transition should be made from a combination of factors with most emphasis being placed on the pattern of periods and presence of menopausal symptoms. Over the age of 45, the absence of periods or infrequent periods along with symptoms such as flushes and sweats can alone be used to diagnose the perimenopause or menopause. Blood or urine tests are unnecessary and are not recommended. [Ref 90]
Measurements of hormone levels are most useful when early or premature menopause is suspected, following hysterectomy with conservation of ovaries when there is no period pattern to observe, when unusual symptoms are present and when fertility appears to be reduced"
http://www.menopausematters.co.uk/diagnose.php
Your doctor is out of date here. Despite having been to a private consultant I would still go back to your GP and tell her what you want to do and your reasons (ie start HRT and which type). It is shocking that we have to educate our doctors (and great that we can educate ourselves), but I feel that those fortunate enough to have read about it, found this website and the information should if possible try to pass it on - for the benefit of other women after us. It's all going to take time so anything we can do to help ourselves and others - can only be of benefit! Even if you have got your prescription privately you will want to continue with the same prescription thereafter from your GP so you will want to have this discussion anyway.
I would still agree to general blood tests to test for everything as I mentioned before - as a baseline - and any good doctor should order these. No need to wait to start HRT though. Get the blood tests (and make sure your doc has ordered the whole range), get a prescription for HRT and then begin :)
You should begin to notice relief of flushes and sweats within a few days of using transdermal HRT - I certainly did using patches.
Oral progesterone isn't balanced by oestrogen - but can lead to side effects in some women. Like Mary G I have only ever used Utrogestan vaginally as I'm a nil-by-mouth gal when it comes to HRT!
Do keep us posted.
Hurdity x
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Thank you - have only just seen this reply - not sure why I didn't get an email notice about it.
I agree re educating the GP - I had planned to do that when I went in but I could see that there was absolutely no point - she is an aggressive Mirena pusher and has very clear views on what to do from here.
When I go back, I will see my usual GP who is more amenable to working with me. The GP that I saw is the practice's "hormone specialist" so I assumed that seeing her would be best but it clearly isn't.
My plan is to get settled on hormone therapy via the consultant and then go to my GP to get the regular prescription after a few months. I think my regular GP will be better - I have a child with complex medical needs so am somewhat exhausted with medical management and 'advocacy' - I just want things to be easy for once and paying just made it easier.
I have just had my first result back from the blood test that the GP ordered (I can see that the NICE guidelines are that she can diagnose menopause based on 2 low FSH tests 4 to 6 weeks apart) - My first Serum FSH level was 72iu/L. There are no laboratory specific ranges on the test results (I see them online so probably the GP has the ranges on their information). This is postmenopausal levels as far as I can tell.
However, I am worried that I have been using the Progesterone cream when I had the bloods taken and I see now that the guidelines are no hormone therapy when establishing FSH levels - does anyone know if the Progesterone cream would skew the results?
I will ask the consultant tomorrow as I go back to see him then but I just want to make sure that I haven't messed things up.
Also, Hurdity - can you explain what you mean by "Oral progesterone isn't balanced by oestrogen"?
I understand the need for progesterone is to protect the womb but not sure what this means?
I am seeing the consultant tomorrow and I will ask for transdermal in both progeserone and oestrogen as I have had recent elevated liver markers and am worried about straining my liver further.
I can't wait to start the therapy - I am so moody and hot and sweaty.
Thanks so much for your replies - it's been an absolute lifeline for me.
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Hi VerityDreamer
Hurdity is definitely the one to answer most of your questions. However, you are right that progesterone is there to protect the womb lining from building up but the amount of progesterone used needs to be balanced against the oestrogen being used - so in the pill or patch form of combined HRT this will have been formulated correctly.
When using progesterone and oestrogen separately the balance needs to be taken into account so the right amounts of both are used - the lining can become thickened and problematic bleeding is often the result if the balance isn't right. I wouldn't rule out having the Mirena as this can be a ‘no hassle' way to protect the womb and allows as little or as much oestrogen to be used alongside - it will shrink fibroids and polyps (if they are present) and often results in no bleeding at all which can be a big plus.
Here on MM we tend to advocate using HRT in a sequential regime to start off with so you can gage whether a particularly type of progesterone suits you. Whilst many on MM are very keen on Oestrogel or oestrogen patches with Utrogestan (micronised progesterone), your consultant may suggest you try a normal combined HRT patch first and these can be very good. Finding an HRT that suits you is trial and error and we are all different - so what works for one women may not suit another. I had a premature meno so have used HRT on and off for the last 25 years - I've tried just about everything and some HRT combos were successful and some were not - Utrogestan was the most problematic for me.
I doubt very much that the progesterone cream would have influenced the FSH test as it is very low dose - it might have influenced a test for progesterone if that had been tested. Your reading for FSH was high, so clearly indicating menopause.
I would follow the consultants advice, see how it goes and enjoy getting your life back on track. DG x
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Thank you, Dancinggirl - that is very helpful information and reassuring about the progesterone cream - especially as I am paying for one set of tests, I didn't want to skew them in any way and have to repeat them.
I wish the Mirena suited me in all ways but I saw a noticeable improvement in a few things when I had it removed but I wonder if the improvement was because I was having progesterone (through the Mirena) with NO oestrogen - as I hadn't realised that I was menopausal. I am worried that I may have been menopausal for 5 years and not known it - especially in regard to bone thinning. I will get the bone density results tomorrow.
I also just checked my Oestradiol levels on my blood tests - it is 18 pmol/L! That is really really low as far as I can tell - right?
I hope there is not too much trial and error for me in getting the hormones correct, as I am practically homicidal when I get "hormonally" angry and I've never been this way - am trying to take it out on the treadmill rather than the people around me.
Thanks for your support.
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VerityDreamer - I am certainly no expert but your readings do sound very low so you are probably post meno.
I don't think you have told us your age? Have you had any periods since having the Mirena removed?
If you had the Mirena while you were peri meno, without any oestrogen, then it may well have given you some side effects. The Mirena with oestrogen may well be a good option for you if you don't want to have the bother of monthly bleeds. If progesterone gives you PMT type symptoms or low mood, then taking any progesterone, either orally or transdermally, on a continuous basis can make these symptoms worse - this is why we always suggest you try a sequi HRt regime first. The Mirena gives you transdermal and more local absorption of progesterone but in much lower doses than any other form of HRT progesterone, usually results in no bleed at all after the first few weeks and allows you to use as little or as much oestrogen as you need.
I am not suggesting you should go for a Mirena at this stage - I actually think you need to try a combined sequi combined patch or possibly Oestrogel/oestrogen patch with separate progesterone in a sequi regime first to see how you get on. It is about finding the right progesterone that protects you womb lining whilst giving the least side effects.
Just keep an open mind and see how it goes. DG x
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Thanks, Dancinggirl - I haven't had a period since having the coil removed.
The consultant started me on Estraderm MX 50 patches 2 x a week. I started today. I also have days 1 to 10 to take Utrogestan 2 x 100mgs per day. So I will be taking that for 10 days out of the month starting 1 October. I am really hoping that I don't have a bleed! I haven't had one in 5 years and it's been the only positive of all this!
I am 45. I haven't had a bleed since I had the coil put in over 5 years ago. My bloods from both the GP and the Consultant show that I am menopausal. I clearly went through peri-menopause without knowing it due to the coil.
The coil did not suit me at all, I had terrible bladder problems that I'd attributed to "getting old" and when I had the coil removed the bladder problems stopped. Maybe it was because I had no oestrogen though.
I am having daily migraines and hot flushes, profuse sweating (yay) and very irritable, the worst in my life. I really hope that this regime helps with something. I am so desperate as I can see that many here are too.
Ok, now to go lay down in a dark room so I don't commit homicide due to the ragey hormone / migraine combo.
HOpe you are well.
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Hi VerityDreamer
Just to say you are likely to get a bleed when you use utrogestan in this way (first 10 days of the month) - as it is necessary to shed the womb lining. If you are post-menopausal then you can take progesterone all the time but best to start cyclically so that you can see how you get on with the oestrogen on its own. If you are happy on both parts of the HRT ( ie oestrogen alone and when you add progesterone) then you could try taking it all the time. However many of us continue with a cycle even into our 60's because we don't like taking prog all the time due to side effects. I'm sure many women are fine though.
It is probably a good idea also to use vaginal oestrogen to prevent further bladder problems and vaginal atrophy - such as Vagifem or estriol cream.
I hope you see an improvement soon - especially in your headaches. I presume you've had these checked out separately to rule out other causes?
Hurdity x
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Hello,
Thanks, Hurdity for the reply - yes, the migraines are primarily hormonal as I've had them off and on my whole life depending on what type of hormone/birth control I've been on - I can and do have other known triggers but usually hormones.
I'm now 5 days into wearing the patch - it's a nightmare to keep on! It stuck on my abdomen for about 2 hours so I put a Tegaderm patch over it to keep it on (fortunately had some at home that I use for my son) - then the next one I tried on my upper thigh and it fell off immediately too so I have had to buy Tegaderm to stick over it.
The consultant said it would take time to build up oestrogen levels - I am already feeling relief from the hot flushes, (still having small tolerable flushes) massive sweats (I didn't realise how little I sweat until it stopped - I was like a water spout sweating so much!) and the homicidal rage that I have never ever had in my life has passed without jail time which is great. The racing heart and night waking is gone too.
However, I am weepy, sad, hungry, and feeling anxious which I was not feeling before.
I guess I just want some reassurance that things may settle? It's early days, right?
I read about the patch not sticking for lots of women and got the Tegaderm idea here so feel ok about that issue but the emotional stuff is a bit tricky and I can't seem to find more info here about that.
I'm not sure about the extra vaginal oestrogen for bladder - the bladder problems seemed to have been caused by the Mirena as they are much better now that it is out (it's been 3 months now). Maybe I should mention this to the consultant next time I see him though.
I hope the Progesterone helps with the negative symptoms that the Oestrogen is causing.
Thanks for the help, this has been a lifeline.
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Hello,
I am just following this up - I started feeling better over time but then got too fatigued :'(- I mean zombie level fatigue, not able to undertake daily tasks fatigue. :(
I stopped the Utrogestan 100mgs per day and then still didn't feel better so I cut the 50mcg Ustrogen patch in half and felt a little better.
I'm now just on the 25mcg Utrogestan patch and don't have any symptoms except completely debilitating fatigue! I cannot function at all although my mood, migraines, vertigo, hot flushes, sweats, - everything has stopped.
The consultant wants me to hold steady here for a few weeks as I stopped Utrogestan and Progesterone at the same time.
I'm wondering if anyone else has intolerable levels of fatigue even on low doses?
I haven't noticed any return of negative symptoms with the reduction from 50 to 25 and I'm wondering if I shouldn't just quit the HT altogether.
Also, can anyone tell me, what is the lowest dose Progesterone that you can take and still have womb protection? I can't seem to tolerate the 100mgs but it looks like on the information here that that is the lowest dose in capsule form.
Thanks for any replies!
Verity
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The fatigue may have nothing to do with HRT. HAve you had your thyroid function checked recently??
Also chronic fatigue can be an issue for many - sometimes triggered by a virus, the fatigue can last some time.
Also, maybe diet issues? Are you low in vitamin D or iron or B12?
I'm sure your specialist is the best one to advice about appropriate dosage of HRT - from what you are saying I think you are on the lowest dose. Unfortunately Utrogestan can make one feel sedated and you are still taking this every day - you might do better to use Utrogestan sequentially (so just 10-12 days each month) and possibly vaginally but you then have to put up with a withdrawal bleed each month. The 25mg oestrogen dose is very low and at the moment you may be taking too high a dose of progesterone in relation to the oestrogen. DG x
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What support do you have with regards child care? Is there a support group or support organisation?
Crashing fatigue bothered me during my menstruating years and I remember my Mum sitting down and dropping straight to sleep …. didn't know at the time why :-\
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Thanks for the replies! I've had thyroid function, and other things checked because I had a sudden onset of lots of symptoms all at once after having the coil removed. I've had MRI scan and masses of blood work. I'm on Vit D and other supplements including B12 because I was having migraines almost every day after having the coil removed.
So right now I am just on the 25mcg Estraderm Patch and nothing else and still feeling the severe fatigue. It's only been 12 days since I halved the Estraderm and quit taking the Utrogestan so maybe I'll give it more time and hope the fatigue passes. It's so nice not having any other symptoms though - I'm so glad that it's helped all the other symptoms.
I'm ok for childcare, thank you for asking. It's a struggle but I just take 4 caffeine tablets at a time when I need to move around for a while. I'm sleeping about 12 hours at night and 2 to 3 hours during the day which is difficult but I'm managing to keep everyone fed and clothed right now. Ironically I've had difficulty sleeping my entire life and now I can lay down and go to sleep in a few minutes and sleep for hours - I've never had this in my life.
I guess there is nothing more to do but wait and hope more Estrogen clears my body and some energy returns.
Thanks, Verity
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Hi VerityDreamer
Sorry to hear about your fatigue.
Can I just clear something up for you. It is not the oestrogen causing your fatigue (it doesn't work like this in any way at all!) - it would be more likely to be lack of it or too much progesterone, or malfunctioning thyroid or low testosterone, if not a severe vitamin deficiency - but this is unlikely if you are taking supplements although maybe you are taking too many or too high a dose? It is very important to get most of the nutrients you need from your diet.
Also to clarify - you were talking about utrogestan patch - but utrogestan is the progesterone capsule. I presume you were talking about the oestrogen patch?
That oestrogen dose is far too low as Dancinggirl says - if you have reached menopause - but as you say you don't know where you are. As I/we said earlier unless you had gone several months since having the coil removed you don't know whether you are post-menopause or not so on this basis and because of the sedating nature of the progesterone I strongly recommend ( as I/we did before) that you take the progesterone cyclically and increase your oestrogen dose. Sleeping that much is not normal and has to be due to some sort of deficiency/malfunction - unless you've had a serious virus recently (so could be post-viral fatigue) or are very depressed - which can also cause fatigue.
Are you seeing a GP or menopause specialist? Please go back and ask for a referral and especially in relation to your fatigue. If you like patches I would recommend Estradot which are very small and stick well ( I probably mentioned these before) and at least a 50 mcg dose. Then you can take Utrogestan for 12 days per month - initially at 2 x 100 mg per day but if you want to take it vaginally may be able to reduce (either dose or days) with your doc's permission and depending on your withdrawal bleeds.
There is no other way - ie if you don't want a bleed then it has to be the Mirena, and taking progestogen all the time at your age is really not recommended. I didn't realise you changed to taking 100 mg per day?
Please do have another think and read more about the role of progesterone and oestrogen - and not from cranky US sites that want you to buy progesterone cream as they will make you believe that you are deficient and it will solve all your problems!!!
Also if you have reached or are near menopause - I am sure we will have said earlier that you need a decent amount of oestrogen to help protect bones and heart - and the licesned dose for this is 50 mcg minimum.
Hope this helps and let us know how you get on - and hope you manage to sort out your fatigue very soon!
Hurdity x
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Hi Hurdity,
Thank you for your reply, it's very helpful. The problem that I have is that I had a huge crash all at once and unravelling what is what is very difficult.
In the past oestrogen has caused me severe fatigue so I had thought that maybe the Estraderm could be contributing to the fatigue. I understand that Estraderm generally is energising rather than sedating but I have always been very sensitive to hormones with fatigue and migraine being symptoms throughout my life.
I am still seeing Mr. Dooley so he is prescribing what I am taking.
Although I did take only half of the prescribed Utrogestan (he prescribed 200mgs for 10 days) and I took 100 mgs for 18 days. I did not take it as he prescribed it - I had a reason for this but it's convoluted and I won't go against what he says again. He has said to hold off on the Utrogestan for now, settle on an Estraderm dose and then we will sort out the Utrogestan dose.
"Also to clarify - you were talking about utrogestan patch - but utrogestan is the progesterone capsule. I presume you were talking about the oestrogen patch?" Sorry, Hurdity, I get these names confused all the time - I now have them in front of me so I won't conflate them! Yes, I was talking about the Estraderm Patch!
Mr. Dooley said categorically based on my hormone tests that I am menopausal, not peri-menopausal. I am going tomorrow to have the 2nd blood test though (for my NHS GP) so she will eventually agree to prescribe the HRT regime that I settle on with Mr. D on the NHS. I know I am now on Oestrogen so that will cause my bloods to change but all I can do is what she said for me to do and hope she then agrees to follow Mr. D's prescriptions.
I will have to review the 25mcg vs 50mcg in regards to bones and heart with Mr. D. I am not having hot flushes or any other meno symptoms - my mood is good, I am not sweating, I don't have migraines on the 25mcg. The only symptom I have is continuous fatigue - I should say that it isn't crashing fatigue, my fatigue is not lessened by sleeping and is constant.
Today I had a 3 hour nap and had to take caffeine to wake up, I don't feel better after sleeping. Mr. D has prescribed the Estraderm 25 so I would assume that he thinks it's not too low. However, he said to try it for 3 weeks and then we are reviewing.
I am confused about the fatigue and will keep looking for causes and try to find anything that helps. It's very frustrating as I was an active, exercising, healthy person until I had the coil removed and then everything fell abruptly apart.
Anyway, sorry for the confusion in my posts. I am so tired, posting here is a huge effort which sounds whiny and exaggerating but I promise it isn't. Will try to query things with my Dr. again.
Thank you all for your replies.