Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Keepgoing on January 28, 2016, 03:05:42 PM
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Hi just joined and would like some help if possible. I am 45 been getting loads of symptoms for 3 years fsh levels ok but doc said not really reliable in peri so went on hrt. First one prempak c took all symptoms away but put on a stone in 9 weeks and the bloating was so bad I looked pregnant to painful to continue Next one femseven was on the fourth week and took it off as it was seriously depressing me and I live with depression as it is so don't want that. If it was just night sweats I could handle it but my moods all over the place and an uncontrollable itch all over my body driving me nuts. Can a anyone advice on maybe which one to ask doc for next as I can't live like this.. Thanks x
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Hi keepgoing
Sorry to hear you feel so awful. Lots of ladies on here are more knowledgeable than me, but it sounds like the progesterone is probably causing you difficulty. You could ask to have estrogen as a patch or gel, and try a different progesterone- Utrogestan is a friendly one. I'm assuming you are on cyclical HRT not continuous? Were you ok on the Femseven on the estrogen only part? I use Evorel patches and was on Utrogestan alongside until my hysterectomy.
I hope that helps a bit - others will have more advice for you. Xx
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Keepgoing, welcome to MM!
Sorry you are having a difficult time but I'm not surprised. I think you are on the wrong type of HRT which would explain your symptoms. Firstly, prempak c is a synthetic oral HRT preparation and the dose is way too low for someone of your age. Also, oral HRT is not as effective as the transdermal variety so I'm not surprised you had problems with it.
Femseven is wrong too. It is transdermal but it contains a synthetic progestin which causes all sorts of problems for those who are either sensitive or intolerant to it and it will undermine all the good work the oestrogen does and it lowers your mood, particularly when taken for long periods of time.
I would definitely recommend you change to using transdermal, bio identical oestrogen gel or patch (I prefer the gel because it is more flexible, you can adjust the dose and I think it works better) and then to use a separate bio identical progesterone like Utrogestan, preferably vaginally, for a few days every month. This will give you a cycle again meaning periods but I think you will find it is much better at symptom control and should help lift your depression.
I've been there myself and tried lots of different HRT preparations and the best one I have found is the one I am currently using which is 2 pumps of Oestrogel every day, a tiny bead of testosterone every day and 100mg of Utrogestan (vaginally) for 7 days each month. I am severely intolerant to synthetic progesterone and also Utrogestan if taken in large quantities and this is the best regime I have found so far!
Hope that helps.
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Thanks worrywort I didn't really feel any benefit on femseven but was much worse when the progestin was added so I just took it off. I have docs on the 4th Mary G and I will speak to gp about the products you have mentioned. If i could I would do without but the symptoms are just to much hair like straw, aches and pains, night and day sweats I don't really flush, all over itch and no motivation to do anything as I'm so tired which makes me just go from day to day like a zombie. I hope I get the right preparation soon as I'm just not me and not really happy right now. Feel as if I'm always moaning lol but I will keep trying thanks for your help xx
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Yes worry wort I'm on cyclical as I have never missed a period just all over the place. I personally would rather have a period no matter what I'm on I think it's healthier when you still have your womb. I honestly never thought you could or would feel so bad going into menopause but I should have known my anxiety and depression I have had since I first started my periods it's all hormonal >:( I'm coming back as a man lol xx
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Mary G what does the testosterone do and does it give you excess hair on your face...I don't want a tash lol ;D x
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Hi Keepgoing
:welcomemm:
When you say your periods were all over the place - do you mean you had some cycles longer than 4 weeks and perhaps some shorter? I agree with Mary G and worrywart that it could well be the synthetic progestogen that is causing you problems. I use a similar combo to Mary G but I use oestrogen patches and Utrogestan. While you are only just entering peri though it is important to take the right amount of progesterone rather than reduce the number of days but you might find you are OK on it. Also I gather for some women while they are still ovulating their own progesterone can provided sufficient for a bleed even while taking some extra oestrogen (this is according to some gynaes).
You might also think of trying Femoston which is a tablet HRT but the progestogen is very similar to our own progesterone and it is very well tolerated. Some women get on very well with a Mirena coil which delivers progestogen directly to the uterus and hardly any into the system - although it is the same one as in Femseven so maybe not the best choice for you - perhpas you might be OK as it is in small doses? Then you can add a patch or gel as you wish for oestrogen.
I also use testosterone - it is mainly prescribed for low libido which can occur at any time but more so as you get further post-menopause - although for some women the decline in their own testosterone levels starts earlier. It also affects energy levels and muscle tone. I have found it especially helpful for muscle tone and energy - I found I had a lot of muscle aches and pains and exhaustion following exercise ( I got to exercise classes) and I don't get this since taking testosterone. At low levels it shouldn't cause any male side effects because it is within normal physiological levels.
Hurdity x
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Keepgoing, Professor Studd thought I needed testosterone as well and I only take a very tiny amount, less than he suggested. I doesn't cause any adverse side effects and no extra facial hair!
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Thanks hurdity and Mary g. My periods were always regular as clockwork but the past year they were coming about every 3 weeks and much heavier so not like me. I am definitely going to ask doc for the gel or patch of oestrogen and the ustrogestan and testosterone but I don't know if they will give me the testosterone as I read they stopped it in uk, don't know if you all live in the uk or not lol. I think this would help me as I have no energy and am falling asleep all the time and I never do that it usually takes me forever to fall asleep. Will let you know if I'm successful in getting these products. Thanks for all the info as its not something you get a lot of help with and all of you have really helped in the minefield that is hrt...take care everyone xx
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I think you can have testosterone prescribed Kg, but you have to be referred to a gynae for it in the UK. I'd discuss it with your GP? X
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I'm not sure whether you would need extra testosterone at this point keepgoing. If your libido is non-existent then maybe but this can also be depressed with tablet HRT too.
Also as your periods are close together and heavier then it sounds more like the "late reproductive phase" as it is called - and this is characterised by increased fluctuations of homones but sometimes very high and sometimes very low oestrogen and worse pms. Unfortunately some women do start to experience flushes at this point from the fluctuations and a low dose oestrogen might prevent your levels falling so low at the end of your cycle.
On this point have you had blood tests at all to rule out other causes for flushes and tiredness/energy levels as other metabolic things sometimes start to go awry at this stage eg thyroid function, and some vitamin/mineral deficiencies cause tiredness. I presume you are taking extra iron as you are having a lot of bleeding?
At this point you may well benefit from the bio-identical oestrogen CCP Qlaira which regulates the cycle and provides estradiol ( unlike most other CCPs which contain synthetic oestrogens) which some gynaes recommend - here is what it says on this site:
http://www.menopausematters.co.uk/contra2.php
HRT type estrogen containing pill
A new combined pill, Qlaira is now available which contains natural estradiol valerate as the estrogen component, rather than the synthetic estrogen ethinylestradiol. Ethinylestradiol is the usual component of the combined pill whereas estradiol valerate is an HRT type estrogen. This is a useful option for women in the perimenopause when it should control menopausal symptoms while providing contraception and good control of bleeding.
Hope this helps :)
Hurdity x
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Hi hurdity my doc checked all my bloods for everything so nothing else is wrong just peri. I am not bleeding very heavy just heavier flow for me. Doc thought about the contraceptive pill but cause I'm a smoker she ruled that out and thought hrt was the best route. Have a phone consult with her on the 4th so will see what the outcome of that is, I'm going to ask for the gel and the utrogestan and maybe testosterone as my libido is fine just the extreme tiredness interfering in that department x
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Got my phone consult today and doc is giving me eastrogel and utrogestan just need to wait till period appears then start it. Hoping this will work for me or doc will request appt at menopause clinic...fingers crossed x
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Update
Period arrived yesterday so that's me started my 2 pumps of estrogel so fingers crossed this is gonna be the one that works for me...200mg utrogestan on day 15 so hoping this agrees with me as think the synthetic ones have been my problem...thanks for all your help ladies xx
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good luck, let us know how you get on? Hope it works for you...
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Thanks robotwars...will post how I get on as you never know may help someone else who is struggling xx
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2nd Update
2 weeks on estrogel 2 pumps I'm feeling more settled night sweats almost gone and all over body itch very infrequent now, head also feels clearer and not so on edge. Best of all no side effects 😀 Have just started utrogestan tonight 200mg which I'm taking orally see how this goes...I'm hoping this will be fine also...will let you know, but defo a thumbs up for the estrogel xx
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How are you getting on?
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English rose I'm getting on fine I feel a bit more like myself at the moment xx
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Thanks for the update Keepgoing and glad you are feeling better - good luck with the utrogestan.
Hurdity :) x
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Trying the utrogestan vaginally now as I have had the runs for 2 days taking them orally...no headaches, nausea or tiredness so far fingers crossed taking vaginally will sort the tummy out xx
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Meant to say only taking 100mg vaginally is that ok? Took 200mg orally x
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Hi Keepgoing
The licensed dose of utrogestan in UK is 200 mg orally for 12 days per 28 day cycle.
The French instructions for this product suggest vaginal route for those experiencing adverse side effects from oral use (nausea, dizziness) but does not suggest a reduced dose.
Used vaginally the progesterone goes straight to the uterus where it is needed to protect the lining - avoiding digestion and metabolism through the liver. Some research has shown also that systemic concentrations are higher for a given dose of Utrogestan when used vaginally than used orally, and therefore that lower doses of progesterone are needed than through oral use. Half the dose has been suggested.
I use 200 mg vaginally for 12/13 days every 5-8 week cycle and this has always been OK for me. My womb lining has always been fine on this on the occasions that I have had to have scans.
However all our bodies are different and I can't say what will be right for you I will leave you to decide for yourself having given you the information! It depends on your body - how much oestrogen you are absorbing from your HRT, whether you a peri-menopausal and how much of your own oestrogen you have, whether you are ovulating (in which case you will also have your own progesterone), whether you have fibroids or polyps which could cause additional bleeding etc. My understanding is that duration of dose is as important as actual dose because the progesterone changes the structure of the endometrium and then it is shed when the progesterone is withdrawn. There needs to be sufficient time for the structure to change as well as a high enough dose but this is not a precise science and what is fine for one women may not be enough for another!
Good luck :)
Hurdity x
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Thanks hurdity I am peri so I'm just gonna try the 100mg just now as I couldn't stomach 200mg as I took them orally has really upset my stomach so hoping vaginally will be better and al see what my bleed is like...was feeling so good on just the gel...will I feel better as I get used to the utrogestan?? If not is there a different prog I could take alongside the gel?? Xx
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Thereis also Provera - listed here - but it's a synthetic one. http://www.menopausematters.co.uk/to_progestogens.php The others such as Dydrogesterone (in Femoston) are not available separately as part of HRT, even though many women would prefer to try something different.
Hurdity x
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Thanks again hurdity al see how I do with vaginal route as I think stomach still upset taking them orally as its only been a day so prob take longer to get out my gut...so hoping this works xx
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Day 7 on utrogestan and really struggling with nausea not really a nauseous feeling in stomach it's at back of my throat and the runs every morning for just first thing, I don't really have any other symptoms...the nausea eases about 8pm and then i have to take utrogestan at 9 so an hours respite...I could handle any other symptoms but not the nausea...can anyone tell me will this get better each month or is this just not for me, I'm only taking 100mg vaginally cause I can't stomach it and that's a real shame cause I feel so good on the 2 pumps of estrogel my confidence was coming back and that's just after 2 weeks...aches and pains gone, all over body itch gone and hair getting lovely and soft again and not like brittle straw...am beginning to despair of having to give up on hrt cause of prog...but my body really needs the estrogel and really good for my mental health as I lost it 2 years ago and am now realising this was the start of peri for me. Really disappointed at the moment xx
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Well what a difference a day makes no nausea today 😀 Just feeling hot but can cope with that hope this up continues...sorry for moaning last night was just so peed off xx
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Hello keepgoing.
Many thanks for the updates and no need to apologise for moaning, we all do!
Hopefully your regime continues to go well.
Take care.
K.
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Glad to hear that you're feeling better and well done for sticking it out when you felt so bad.
I've read your posts with interest as I've just had a bad experience with a synthetic progesterone - norethisterone. I've been given 200mg of Utrogestan for days 15-26 to take orally. Not got my prescription yet so I'm hoping its 100mg capsules in case 200 is too strong. I'm currently day 2 of my cycle and feeling anxious about trying the Utrogestan after the last progesterone made me so ill. I couldn't eat, felt like I was going mad and had panic attacks.
I hope you continue to do well with your treatment. Good luck xx
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Hi Lisa
Try not to be to nervous taking the utrogestan, I was a bit to but just gritted my teeth. Day 9 not so bad either...I would say give it a week I was amazed at how I went from very nauseous to gone. I will update when I get my period see how that goes but we are all different and you may do better on them than me. I would also say I am getting extremely hot on them and flushing so have upped my estrogel by half a pump and will reduce it again when I stop them see if this helps as i read another post on progestorone and night sweats and someone else tried this...can't say how it is yet I just upped it tonight...fingers crossed...I hope you get on well with this combo. Just take it easy and do what your body tells you xx
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Glad to hear that you're still doing ok. Hope the extra estrogel has helped with the night sweats. X
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Well had my period last week was substantial and just like before peri hit. I am gonna continue to take utrogestan vaginally for 10 days but still only 100g as this seems to do the trick with me...I am feeling more like my old self on eastrogel and utro, bit yucky for about 5 days on utro but I can handle that once a month...here's hoping it continues and maybe get even better as I'm only on second month...all in all I am more settled now...thank you ladies for all the help through this xxx
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Glad you are feeling better Keepgoing
Hurdity x