Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Trufflecat on March 03, 2016, 08:33:57 AM
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I am off to see my GP tomorrow to ask her to change my oestrogen patches to gel. My experience over the last 9 months of progesterone (northisterone and now Utrogestan) suggests to me that I am progesterone intolerant (pmt is the reason I am using HRT as I don't have flushes etc...yet) I know prof Studd prescribes Utrogestan for 7 days a month and I think that would be worth trying. What are the risks of doing that, to my uterus, if I am on 75 to 100 of Oestrogen as a patch or gel too?
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I agree with Stellajane - I doubt your GP would allow Studd's regime as it could cause erratic or problematic bleeding due to the thickening of the womb lining - you are also using a very high dose of oestrogen. Regular scans are not usually available on the NHS. DG x
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I see Studd and im prog intolerant so this is the regime im on. I haven't even asked my Gp as im certain she wouldn't give to me. Studd has not recommended a scan or even discussed this but said as I get a decent bleed each month and no other erratic bleeding problems it's doing its job. I may choose to go for a private scan in time though (im 41 snd peri and saw him for pmt) x
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Btw im on 2 pumps of gel Studd normally gives 3, I started on this but found it too much for me 2 has been great. I also use testosterone gel x
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Hi & thanks. She wants me to use 200mg a day for 12 days & I am worried about what this might do! Is 100mg per day for 12 days ever used?
I thought that the 50mg of Evorel that I was on was a low dose, so was going to ask to up it to 75 or 100mgs, one of the reasons for trying the gel, as it is more adjustable. What is a usual dose for someone in peri of oestrogen transdermally?
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Hi there I think with the ostrogel it's normally 3 for peri Studd started me on this but I found it too much over time so use 2. I think it's really trial and error and everyone is so different. I use 100 mg vaginally for 7 days and that's bad enough but better than my old pmt 😳😁 prog intolerance is so hard to manage. 200 mg would send me mad im sure! Yes the gel is brilliant and really adjustable you might find you absorb it better than the patch so 2 pumps might be enough....x
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Hi
Thanks, I will talk to the gp (clueless but nice) tomorrow.X
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By the way Niamh, does the prog send you mad immediately or does it take a few days?
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Well that depends the Mirena coil sent me mad immediately and my own progesterone was pretty horrific from ovulation until period arrived with the utro as im on such a low dose it tends to build so by day 4/5 so long as I use vaginally the one month I took it orally within 48 hours I felt dreadful and actually stopped for 2 days as felt it was no different to my old pmt so what was the point! The 100 mg us really ok but can be up and down for 7 days hth x
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Thanks. That's useful for me to know but not so great for you! x
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Ah honestly the utro x 100 for 7 days is fine be compared to how I was, Studd has changed my life! Good luck let us know how you get on x
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Hi Niamh
I went to see my GP for check up after going to see Studd and I can get all on prescription and she is going to organise an internal scan apparently they are mobile and come to the surgery!
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Kate50 - Wow, they are going to do the scan at the GP practise - that's amazing - maybe this is going to be rolled out to all practises - it should be - would save a lot of money and time!!! DG x
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Trufflecat, I would say the risks of you taking 7 x 100mg of Utrogestan are very low. I've actually taken less than that and cheated loads of times yet my last uterine scan reading was just 2mm despite the fact I'm on a 2 pumps of gel and have high oestrogen blood readings.
Obviously there is no guarantee you will be the same but if you are intolerant to progesterone then definitely give this regime a try. It would be sensible to have a scan after a few months to check it's working OK and you can pay for it yourself. It costs about £100 and you need to have it just after a period but if it makes your life bearable it's money well spent.
Professor Studd is the expert and there is no way he would sanction this regime if it was risky and he doesn't make scans a condition. There is no question of me ever taking more than that dose.
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Btw im on 2 pumps of gel Studd normally gives 3, I started on this but found it too much for me 2 has been great. I also use testosterone gel x
Hi Niamh
How could you tell 3 pumps was too much please? What did you find the symptoms of too much were?
It's just that I've recently (3 weeks ago) changed from oral 2mg tablets to 3 pumps of gel and I feel good right now. :)
I'm also prog intolerant, I'm on 200mg utrogestan for 12 days per month, but have used the utrogestan once every 3 months with the permission of my gynae specialist, as utrogestan still makes me low.
It's interesting and reassuring to read that Prof Studd thinks 100mg for 7 days is sufficient for prog intolerant women, and doesn't say regular scans are necessary.
Quality of life is sooooo important. :great:
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Hi Clovie
I felt really wired, jittery, anxious and had trouble sleeping. I'd wake for hours in the night panicy. Some similarities to my prog issues but it felt quite different also it happened when I was on the ostrogen only bit. I did feel dreadful. Id say I was ok on 3 for about 2 months then started to have problems. I dropped it to 2 felt better and then tested 3 again and had the same issues! Been on 2 since and feel great except for the utro!x
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Ps I do find the testosterone helps my mood and energy too x
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Thanks for this! :great:
I'll know what to look out for, I've only been on the 3 pumps of gel for 3 weeks so far. Fingers crossed - so far so good! :D
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Thanks everyone. I suspect that she will want me to give the 200 for 12 days a go but I shall go armed with info!
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Thanks everyone. I suspect that she will want me to give the 200 for 12 days a go but I shall go armed with info!
good luck! :great:
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Dancingirl I dont know why the scan is being dive at surgery. She just said what after care do you want so you don't have to keep paying and I said an internal check up and she said there is a mobile unit that comes to surgery so will see
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I am with Dr Annie Evans and on 7 days a month of utrogestin 100mg, I had a phone consult this week and questioned the low dose from what is mentioned here , her answer was it isn't actually a low dose it is a completely adequate dose for most, and so long as you are having a good regular bleed then it is absolutely fine , there's no need to give extra that is not required.
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Thanks fodr mentioning that maryjane. I am hoping my GP will look into it x
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Maryjane, how much oestrogen do you take out of interest?
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I am with Dr Annie Evans and on 7 days a month of utrogestin 100mg, I had a phone consult this week and questioned the low dose from what is mentioned here , her answer was it isn't actually a low dose it is a completely adequate dose for most, and so long as you are having a good regular bleed then it is absolutely fine , there's no need to give extra that is not required.
That's very interesting, thanks for posting that :great:
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Studd obviously shares the view 7 days is enough and I think I'm right in saying he's pioneered and researched that dose. I'd add Dr Currie also said this dose was fine as I once emailed her a question about something and she too stated it was enough x
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I feel I must once again offer a word of caution here. I have experienced breakthrough and erratic bleeding when not doing the recommended licensed Gel/Utro regime and this experimentation was under the supervision of a private specialist gynae (I have tried various ways of using Utro) - we are all different and what works for one women may not work for another. If it was safe to experiment with HRT it would be available 'over the counter' at the chemist with simple guidelines.
Prof. Studd has pioneered some wonderful work that has paved the way for far better treatment but he is not renowned for offering ongoing support and I have so often read posts on MM from women who have had problems with his regime and have become very disheartened when it doesn't work for them. There is a good reason that there are different types of HRT available and I do think there is a need for a more tailored approach to treating meno symptoms as we are all different.
The issue around the side effects of progesterone is tricky - Utro will still bring problems if you are seriously sensitive - as MaryG so rightly points out. However, many new visitors to this site will read about the quite scary experiences some have with any progesterone - it is therefore easy to assume that Utro will be perfect and it will be fine to just use 100mg for 7 days regardless of the amount of oestrogen they are using or the possible consequences. My gynae did point out to me that he can prescribe synthetic progesterones to most of his patients with no adverse side effects!!! Synthetic progesterones are more powerful but also more effective so can be better on many levels depending on what a women needs. For me, the big plus of Utro is the reduced risks that it brings and I'm hoping in time they will come up with a more effective version that will bring fewer problems.
I'd like us all to bare in mind that when we share our experiences and offer advice this can have a big impact on what others may do and believe is right. Please, please, seek professional advice before experimenting unless you are medically qualified and know what you are doing. Dg xxxx
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You're quite right of course, Dancinggirl :great:
However, I think the problem is if you're badly prog intolerant (like me :( ) the prog taking can be so unbearable that some women just forego it, weighing up quality of life over feeling totally and utterly unbelievably wretched :-\
When I first went on HRT my GP gave me a synthetic prog - to which I reacted terribly, so much so she told me to just STOP it after 5 days. I'd phoned up the surgery in tears, I really thought I had 'gone mad' :'(
Next she gave me a different synthetic prog but told me to use it on a long cycle (every 3 months only) even though I was 47(?) in peri, and she was more than happy to do this for me.
Sadly, I reacted to that too - at which point she sent me to gynae as she knew nothing about utrogestan after I'd asked for it. (I'd read about it on here - who knows what a state I'd be in if I didn't come across this forum years ago!!!!! My GP was not going to suggest it, she didn't know about it!!! :o :o)
Anyway, I was given utrogestan, and I reacted to it, but not as badly.
I was told to use it 12 days every month. I could not bear it so I told my gynae I was using it every 2 or 3 months and she was 'okay' about it saying as long as I had a good bleed........ in the meantime my periods came back after a 3 month stop. Regular as clockwork. So I was bleeding on my own cycle as well now.
I carried on using Utrogestan every 2/3 months but my moods dipped severely toward the end of last year, flushes returning a bit, mood swings, insomnia :(
Culminating in me reaching out to my new GP (we'd moved) last month, and changing to estrogel and using 3 pumps I felt much better. :great:
Incidentally, Using the utrogestan this month has been a breeze. Not much of a plummet AT ALL. :) I don't know if it was just a fluke and next time I use it, it will be bad again, or my upping of oestrogen has made it more bearable? My GP yesterday didn't know either ;D If I have the same reaction next time I would be happy to use the Utrogestan more often.
What I'm trying to say is, if my GP and then gynae was Ok for me to use the 200mg Utrogestan once every 3 months, then surely 100mg every month for 7 days is a similar low dose which the experts have indicated would be sufficient for most women? (MOST, I know we are not all the same)
I just think perhaps the 12 days at 200mg is erring greatly on the side of caution, using a sledgehammer to crack a tiny nut?
After reading - and someone correct me if I'm wrong please! :)- that it is the progesterone element in HRT which raises the risk of breast cancer, (although I know about the old studies being flawed) surely to use as LITTLE prog as possible has got to be better for us?
The way I look at it is I've never smoked, I don't use recreational drugs, I don't drink very much at all. I think if I want to forego the prog every other month it's a balanced risk I'm willing to take in order to feel 'better' and function as a human being, wife and mum of teens ;D Quality of life is everything. No-one knows what's just round the corner....
Any-hoo, just my opinions and thoughts :)
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Clovie - good post - however, you were doing all this experimenting with the your GP and gynae fully informed of what you were doing and if there were any consequences e.g. unusual bleeds etc. then relevant monitoring and testing could done. My gynae explained that using any progesterone for a reasonable length of time (at least 10-14 days) is really important to ensure a proper shedding of the womb lining. MaryG is having scans and her womb lining hasn't built up despite only using 7 days of Utro so clearly, for her, this regime is working.
I have tried 200mg for 14 days and my womb lining has still not shed sufficiently, I also tried 100mg on a conti basis (NICE standard dose) and still got erratic bleeding - so this illustrates that the NICE guidelines on the use of progesterone is not overkill - we are all different and the average safe dosage on a sequi basis is 12 days of 200mg Utro per month for very good reasons. Moving away from these tried and tested regimes will inevitably cause problems in SOME women.
Particularly in the peri meno stage, when there is a natural reduction in the amount of progesterone we produce and yet often we still produce varying amounts of our own natural oestrogen, this is where the problems can arise as the womb may thicken, erratic/problematic bleeding will occur and the risk of womb cancer increases. Even without any HRT treatment often the first signs of hormone irregularity, due to peri meno, will be problematic bleeding.
The breast cancer risks are associated with the use of combined HRT but why this is I think the jury is still out - studies show different things but we do know that if there is a close family member who has had oestrogen receptive breast cancer then one will be at greater risk. However, the risks generally are very small - even beyond 60. Being over weight is a far higher risk.
It is great that you have found the regime that works for you and if your womb lining wasn't shedding properly then you would get problems - just keep your GP and gynae informed.
There are very good reasons why the guidelines on HRT use are there, so all variations in use really should be under specialised professional guidance. Sadly we usually have to pay to have a more tailored approach - hopefully in time this will chance. DG x
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Those posts are very interesting. I agree that doing things with the help of a dr is the way forward. I am back from the GP. She has prescribed me the oestrogel on the grounds that it is easier to find the best dose by starting low and gradually upping it if necessary, as an alternative to the oestrogen patches. Looking at my diary (poor woman) of moods and bleeding etc she noted that I have been getting more irritable over the past few months, after she mistakenly gave me the utrogesten for 25 days per month. She is agreeable to me trying the Utrogestan 100 for 7 days a month for three months to see how that goes, alongside the Oestrogel (she hasn't specified how many pumps though). She was quite emphatic that I must record all bleeding. She stressed that because I am in peri and having periods of my own anyway, there is a risk that the endometrium can build up due to the oestrogen I am taking to a level where it sheds but might not shed enough and this can cause cancer. She will review me in 3 months and if she has any concerns at all she will refer me to a gynae for an opinion and a scan.
I am happy with this as I feel that she's good enough to let me try something that might relieve my atrocious pmt but keeping a close eye.
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That's great that you can do the 100mg for 7 days :) Good luck :)
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Hi Trufflecat - what a great GP!!! I would definitely start with just one pump per day because you are peri meno and see how you feel after the first 4 weeks. Do keep us posted. Dg xxxx
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Thanks.☺
I will indeed start with one pump and go from there. X