Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: pepperminty on May 28, 2015, 06:59:59 AM
-
Hi ladies ,
I just thought I would put this out there for discussion.
I have been reading some old threads about progesterone options .
Utrogestan is often ,mentioned as a bio identical progesterone , and better tolerated by many women .
I found this extract on a previous thread about CYCLOGEST. which is also a bio identical progesterone.
It's not licensed for use as HRT (ie endometrial protection) in the UK through the NHS .I asked Dr Currie why it wasn't on the green menu as quite a few women are using it successfully. That's why they can't put it on there. Also explains why some GPs are reluctant to prescribe it. However it beats me why some GPs are happy to do so and some aren't!! I got it through the NHS.
Shouldn't we all be informed about this progesterone if it is an option or at least be given the choice to ask for it ?
peppermintyxx
-
I'm no expert but the more options the better in my view.
I'm using an unlicensed drug for another condition ( not menopause related) having done extensive research myself and GP was initially sceptical to prescribe it but did finally agree ( having reviewd my research) and its working very well.
Thanks for posting this Pepperminty
-
Hi Hayjude,
I am no expert either , but apparently its used in pregnancy too , so therefore one would assume its been tested well !! Apparently it is well tolerated mood wise , the only negative thing I could find is that it can give you either constipation or runny stools. To be honest that sounds preferable to mood swings , nausea , headaches and the like. Obviously everyone is different though.
I think it should be mentioned as an option on the site map regardless .
Peppermintyxx
-
Hi
Agree - awareness of all options should be available information.
There is also another progesterone that can be used as part of HRT: Crinone gel, used alternate nights for 14 days.
I've been on Cyclogest in the past - only prescribed through meno clinic though. I think Hurdity may have been prescribed it through her GP.
Cyclogest can be used as vag or rectal pessary.
This blog mentions both Cyclogest and Crinone:
http://writehealth.co.uk/hrt-progesterone-intolerance/
-
Hi Night owl,
thanks
how did you find the cyclogest?
Perhaps the site map could be updated with information on off licensed alternatives , such as these.
After all AD's are often prescribed off license for various things , so what's the difference?
peppermintyxx
-
I really don't know re: off license - just having a read of this:
http://www.nhs.uk/Conditions/medicinesinfo/Pages/safetyissues.aspx
Women still need to know the options available - and make their own decisions from there.
Maybe certain progesterones have not been researched long term to prevent hyperplasia as part of HRT (as they were designed for use as part of fertility treatment) so they are only used tentatively (via meno clinics) with regular endo scans - and not promoted. Meno HRT management is such a developing area of medicine. Some GPs are clued up, others not so.
Cyclogest was prescribed by the Panay meno clinic - and Crinone gel too.
[The whole issue of progesterone use is of particular interest as I'm highly prog intolerant and have spent years trying to find a 'bearable' way to use it. I wouldn't have got this treatment through my GP.]
-
Hi NO ,
exactly, anyway they are hardly going to use it regarding pregnancy if it was dodgy. If it's good enough for nick Panay , its good enough for me!
Has anyone else been on CYCLOGEST and how did they find it?
Peppermintyxx
-
Sorry, didn't answer your question re: Cyclogest use.
As mentioned, I'm highly prog intolerant (and have the added complication of meno migraine) so I'm not the best person to answer this as my experience is from that (somewhat negative) perspective - hopefully others will be along with their (more positive) experiences.
I found Cyclo to be less well tolerated than Utro - migraine was worse - at that particular time when I was using it.
As I recall, the first couple of uses weren't too bad - then not so good. Maybe due to cumulative effect, who knows. I tried vag and rectal use.
Here's the thing though: I think our bodies respond differently depending on how far we are along the meno journey - and what works / doesn't work at one particular stage may be tolerated / not tolerated at another time, if you see what I mean. Constant change.
For me, Utro is the 'least bad' option. It's not great by any means - I'm on the lower 100mg x 12 every 6 weeks.
All of our experiences will be so individual, so please don't listen to me as I'm off the charts prog intolerant! My stupid body is highly med sensitive.
Worth trying all the options though.
-
Hi NO,
thanks ,
I read some where that another lady tried it and found that it was better for her headaches, so you are right it is all individual and depends on where you are hormone wise anyway.
I suppose the most important thing is CHOICE and the more there is the more chance of getting it right eventually !!
I am better today , and looking forward to my specialist appointment as I am still trying to get it right !
Pepperminty xx
-
PepperMinty, couldn't agree more re: women need to be made aware that there is choice - it seems unfair that those with access to meno clinics are given this, whereas others often just get GPs without specific knowledge.
I found I had to just keep going down the HRT road, trying different things, making tweaks and adjustments. All I know now for sure is that off HRT (albeit only an ultra low dose) I'm much worse.
Hope you find a way forward.
Night_Owl
x
-
Thanks , so do I .
Peppermintyxx
-
Pepperminty I used Cyclogest during some of my fertility treatments. It gave me constipation (put in the back passage) and I found it quite messy as it's a waxy substance. I've not used crinone but a friend has for her fertility treatments and she said that was extremely messy.
-
Hi ,
If there are fewer side effects , messy would be fantastic in comparison.
-
Hi pepperminty
The quote in red was from me a few years ago!
Someone else also asked about Cyclogest a couple of days ago and I replied on this thread:
http://www.menopausematters.co.uk/forum/index.php/topic,28100.msg439771.html#msg439771
To repeat the relevant section:
"I used this for 4 years and I think when I first started utrogestan was not yet available - Cyclogest was the only progesterone. For those who want to know this has been around for years as a natural progesterone for fertility - it comes as waxy pessaries which can also be used as suppositories. It isn't licensed for HRT although some gynaes ( and my gynae specialist GP) prescribed it for this purpose. The usual dose is twice as much as for Utrogestan so for a cycle you chould have been given twice the number of 200 mg capsules. I was prescribed 400 mg for 11 days per 28 day cycle. Mine came in 200 mg capsules so I used to put one up the front and one up the back (interesting effect the next morning!). I did feel that this was too much progesterone but it seemed to produce a withdrawal bleed OK."
It can't be listed as available for HRT because it isn't licensed so if your GP hasn't heard of it then it is unlikely you would be able to persuade them to give it to you. My gynae GP had studied under Prof Studd who has used natural progesterone for years, so she has always prescribed it through NHS off license.
There is no danger in using it, it's just that the correct dose for protecting the uterus from hyperplasia, as Night_Owl points out, has not been determined through trials. It is perfectly safe to use as it is given in very high doses as part of fertility treatment.
I used to get migraines on it sometimes and also on withdrawal which I felt was due to the high dose. Using it vaginally would enables more to be delivered directly to the uterus. Using it anally means it works through systemic absoprtion (through the gut wall and into blood stream - but not through the liver - then to the uterus).
Personally I prefer Utrogestan - but which I have never taken orally.
I totally agree about choce - there just isn't enough!
Hurdity x
-
Thanks Hurdity,
I am trying to get as much knowledge as I can for when I see the nurse specialist in 2 weeks time.
I haven't made up my mind whether I need to increase my dose of femosten or move to another route eg patches as I have developed headaches that feel like my skull is in a clamp along with nausea and almost as if I go dizzy/ black out / see stars for literally a second , it's really weird. There is definitely something weird going on with the HRT and hopefully the nurse will point me in the right direction .
I am leaning towards patches and utrogestan , but I have to say I am scared .
Pepperminty xx
-
I haven't made up my mind whether I need to increase my dose of femosten or move to another route eg patches as I have developed headaches that feel like my skull is in a clamp along with nausea and almost as if I go dizzy/ black out / see stars for literally a second , it's really weird. There is definitely something weird going on with the HRT and hopefully the nurse will point me in the right direction .
I am leaning towards patches and utrogestan , but I have to say I am scared .
The symptoms you describe here, for me, were exactly what I got on Evorel 50. At the time, I thought it was too much oestrogen and was tempted to go down to 25. However, since then I have moved to something with much more oestrogen in and these symptoms - especially the weird dizzy 'not-quite-withit' feeling that really scared me have diminished.
As far as Utrogestan is concerned, I took 200mg vaginally (despite my doc saying not to!) for 12 days a month, and had no side effects at all. The only problem was when I stopped taking it, a few days later I got a withdrawal headache. I would have loved to have taken it at a lower dose permanently but doc wouldn't let me as I still have periods.
As always, with hormones it's never a case of one size fits all. Whatever you decide, be open minded and unless side effects are awful, try everything for at least three months before making a decision.
Good luck xx
-
Thanks Briony,
I am just coasting by until my appointment. I have 2 more oestrogen only pills to take before the combined part of the pack , so I don't think its the withdrawal. I know it isn't tension as my back is really relaxed , its purely my head.
I suppose I am scared of it not going, and having this headache permanently .
I have a feeling it is lack of oestrogen as I didn't have a headache on a higher dose HRT last year, I just had a bad reaction to the progesterone on that one.
It will be over 3 months on this one when I see the meno nurse at the hospital , so I have given this one a good shot.
I am an optimistic person usually , except at the moment it is difficult as I feel crap.
It feels like someone is squeezing my head and my brains will seep out. What there is left of my brains. ::)
As I have said before , I don't want perfection, just not to be in a half life.
I also am having nausea at the moment , where my food is literally rising up my throat after eating and feeling acidy , so I think that may be the HRT pill as I haven't had that before either.
I hope this nurse knows her onions !! ;)
Peppermintyxx
-
Pepperminty - your headaches sound like my migraines except I don't get the food rising thing as I'm not on pills. I get nausea though but also craving for sugar carbs. Mine last for 3 days and I'm having ones at the moment. Head squeezed/clamp is a good description. I can get rid of the headache temporarily with tabs ( but don't like taking too many pills so space them out) but even when headache isn't there I feel exhausted and foggy tight head, no energy like now. After 3 days it goes and it's like a cloud lifting. Unfortunately I haven't been able to pinpoint the cause of mine but started to get them pre-menstrually when I was peri, and then later on the progesterone withdrawal part of HRT, now sometimes on the progesterone part itself, and sometimes with alcohol (v small amount) if late in the evening, and sometimes randomly for no apparent reason! I can understand your not wanting to do anything which will exacerbate these.
In your case it could be the progestogen intolerance?
You mention you are seeing a nurse - with respect, and I know nurses are knowledgeable - but will s/he be able to prescribe what you want and in relation to your symptoms? What are you hoping for when you have you appt?
Hurdity x
-
Hi Hurdity,
She is the nurse specialist at the menopause clinic at the hospital. She apparently goes through your symptoms and advises you on which HRT to take I believe. I hope that after I tell her my symptoms she will advise me on either upping the dose or going to a patch and utrogestan. I have no idea if she can write a script but my GP will for me, if I tell him what she said etc.
I am on just the oestrogen at the moment , so I don't think it's the progesterone giving me the headaches.
I can't bear anything touching the back of my head.
I have never had headaches like these before.
I am trying to be positive , I have a feeling that it's low oestrogen . I haven't drunk alcohol for a couple of years , so it's not that.
Fingers crossed xx
-
I really feel for you as I have been there so many times (especially the nausea - I get embarrassing burping too!). I had always assumed it was too much oestrogen making me feel sick (like morning sickness) but now I think, when it's not migraine associated, it must be the sudden fluctuations as I have had less nausea since upping the amount of estrogen I take. The peri menopausal fluctuations are the one thing being on the pill controls which, for me, HRT couldn't.
Do you take anything for head aches? Someone on here recommended 4 Head to me. I was a bit sceptical at first (how could an external stick help my banging head?!!) but I have to say, it does make a difference. It's perhaps worth a try if you haven't already? xx
-
Thanks Briony,
I haven't tried that , I will give it a go. I have felt a bit better today thank goodness. It's easier to cope when you are feeling less poorly.
I am glad you have found a good answer to your meno issues . It just takes so long !!
Peppermintyxx
-
Morning all
I am so glad that I mentioned Cyclogest to a friend.
It was she that found this link for me and I am very grateful to her and will let her know :)
I was very interested with what you have all said regarding Cyclogest.
I have yet to try it as I had a bad time on other drugs. And this as made me very wary in trying anything else.
I also have migraines often for 3 days . Had them for years prior to menopause . 3 days before period started the migraine starts.
Period starts migraine goes.
The only way that I can use the Cyclogest is vaginally. I have bowel issues so the other way is not an option.
I was never told that they were off label. I have been given 200 mg dose and that is it.
The specialist who I saw . Just sat there and out of his head prescribed the Cyclogest 200 mg and Sandrena 1.0 mg gel.
I took my blood test results for him to look at but he wasn't remotely interested . He said I was either menopausal or not.
I had 15 minutes consultation . How can you discuss anything in 15 minutes. There is a bit of a is it or isn't it debate. About whether there
is such a thing as oestrogen dominance . Your thoughts please.
Looking forward to hearing from someone. I have been to hell and back due to menopause issues,
Fedup xx
-
Hi fedup - are you taking the Cyclogest every day?
The 3 day migraine at that point in your cycle sounds like progesterone withdrawal - which I used to get - and it may well continue while you are still having a cycle. If you are not progesterone intolerant then you could have it every day ( if you are post-meno) - but that isn't ideal if you are in a relationship for obvious reasons!
There is also utrogestan vaginally too - and this can be taken orally if you want to take it continuously and don't fancy doing this vag route? I don't seem to get the withdrawal migraines now - but they occur randomly - more often when on the progesterone part of HRT though.
Hurdity x