Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: jaydee on March 30, 2016, 08:52:12 AM
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I've just been to the Dr and asked for Estrogel and Utrogeston as I'm 61 years old and feel that I'd be more suited to a transdermal HRT (after reading much appreciated advice on this website)! I'd been on Femoston 2/10 for 15 years and the Dr only agreed to continue prescribing it if I reduced to 1/10, which I did.
This morning, the Dr was very reluctant to prescribe the Utrogestan as she said it's the Progesterone that causes all the problems. As I still have all my bits, I thought I needed to have a bleed to prevent the womb lining thickening? Am I missing something here?
My other question is, the Estradiol I've been prescribed its 0.06% gel (750microgram per actuation) Is this the right dose?
Many thanks in anticipation
Jaydee
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Hello jaydee.
Unfortunately I cannot help with your enquiry but I am very interested in the responses you get. I'll be 60 in September and despite using various Evorel Conti patches for about 2 years I have continued to suffer daily flushes and jitters. I am thinking of asking my GP if I can try a different preparation such as Femoston and was wondering what your experience of the patch has been?
Many ladies worry that the progesterone part of HRT can cause problems but we are told that it is necessary to keep the womb lining thin so I can understand your concern at your doctor's comments!
One thing that may help you is that I experimented with a 75 mcg patch about a year ago which caused very tender breasts and bleeding and had to reduce again so if this corresponds to 0.06% gel that could be too high for you.
Hopefully someone more knowledgeable will be along soon.
Take care.
K.
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Yr Dr needs a slap! If you have all your bits still as in your uterus, you most def need a form of progesterone to oppose the oesterogen and to avoid thickening of the endometrial lining....
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I dont think shes been prescribed the Utrogestan, thus the query, but I may be wrong of course.... :-\
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I do have the Utrogestan prescription (I threw myself on the floor and started having a hissy fit!!) but was concerned that I'd got the need for progesterone wrong. I'm so thankful for this forum though. The doctor didn't explain how I should take it but I assume it'll be in the instructions.....
Just in case though, can one of you kind ladies tell me how I should take both the estradiol gel and Utrogestan?
Thanks
Jaydee
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I would imagine, and someone more knowledgeable will be along, that you take 100mg of Utrogestan each evening for 25 days out of 30. The gel you apply each morning to inner thighs or upper outer arms and allow to dry before getting dressed. I apply mine to my legs as I don't want to risk getting it on one of our cats.....dh knows to avoid any gelked areas for fear of growing bosoms!
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Why don't GPs ask :bang: :bang: :bang: - maybe speak to a Pharmacist in Lloyds (other Chemists are available). Read the instructions too and let us know how you get on!
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Hi jaydee
How terrible that your GP queried prescribing a progestogen - what did she think would happen if you used oestrogen continuously FFS?!!!
As Trufflecat says the standard post-menopausal dose of utrogestan is 100 mg daily for 25 days out of 28. However in practice many women take it continuously - although the 3 days break allows any lining that has built up to shed. The Utrogestan is given as a one size fits all but in practice women take a variety of oestrogen doses - so sometimes 100 mg orally is insufficient to keep the lining thin.
In your case - you have been taking cyclically HRT and having a bleed so I would continue this way at least at first - and then you can see how you react to the progesterone, as well as seeing the sort of bleed you get with the dose of oestrogen from the gel - which is new to you. The cyclical dose is 12 days out of 28. The licensed dose is orally so you could try it this way first and see how you feel. if it produces too many side effects then perhaps switch to vaginal use.
Personally I would try with 1 pump to start with - for the first month or so - because you have been on a low dose of tablet HRT. Although 2 pumps is the standard medium dose some women seem to absorb it very well so that 1 pump provides a medium dose (higher levels than my patch!). Also because at 61 I would want to have the lowest dose that eliminated symptoms - and you might absorb it very well. Personally I would spread it on legs rather than arms - which is where I apply my testosterone gel. You could then increase it after a couple of months if it wasn't working well enough.
The other reason at our age (I'm 62) - to use as low dose of oestrogen as you can get away with - is if like me you don't like taking the progesterone - then you can gradually move to a longer cycle without having to put up with a very heavy bleed. I use a 50 mcg patch for example (medium dose), and take utrogestan 200 mg 12 days per 2 calendar months. The bleed I have is still lighter than my normal menstrual bleeds used to be.
I know some women will disagree with this (keeping the dose low to start with) but I am trying to have a practical solution that will hopefully last me years into the future - and I know I have sacrificed some enhanced well-being as a consequence - but I am fine with this!!!
Hope this helps :)
Hurdity x
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Hello jaydee.
Unfortunately I cannot help with your enquiry but I am very interested in the responses you get. I'll be 60 in September and despite using various Evorel Conti patches for about 2 years I have continued to suffer daily flushes and jitters. I am thinking of asking my GP if I can try a different preparation such as Femoston and was wondering what your experience of the patch has been?
Many ladies worry that the progesterone part of HRT can cause problems but we are told that it is necessary to keep the womb lining thin so I can understand your concern at your doctor's comments!
One thing that may help you is that I experimented with a 75 mcg patch about a year ago which caused very tender breasts and bleeding and had to reduce again so if this corresponds to 0.06% gel that could be too high for you.
Hopefully someone more knowledgeable will be along soon.
Take care.
K.
Kathleen - I would think that your daily "jitters" could be down to the norethisterone contained in the Evorel patch?
Taz x
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This thread is interesting.....I also still have a uterus, I am back to taking 0.5mg Sandrena gel on a Monday, Wednesday and Friday only, this is enough to alleviate my symptoms. I also take progesterone on the same three days only......I don't have a bleed, ever, but worry about womb lining building up. My doctor is good but he hasn't a clue and is happy for me to continue like this. I'm 65 and don't want to bleed....but should I?
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Hello Taz2.
I was also wondering if my problems are being caused by the Norethisterone. I see from my diaries that I did have the jitters with Utrogestan but I have been using Evorel Conti patches for about two years so maybe it's worth trying a patch that includes a different progesterone.
Thank you for your suggestion, food for thought indeed.
Take care.
K.
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skkb - could your GP refer you for a scan to check the womb lining?
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Thankyou Hurdity for such a detailed explanation of how I should take the Utrogestan. Hopefully I'll be able to collect it from the chemist later today, when it's in stock, and read through all the instructions.
I'm so grateful this forum exists.
Jaydee
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Thanks CLKD that's just what I've been thinking, maybe I'll go down that route.....it's worth a try
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Good luck with it jaydee.:)
skkb - continuous combined hRT - which is what you are taking - is designed not to give a bleed and as you are on a very low dose it's obviously doing its job. If your lining was getting too thick you would have spontaneous bleeding as it broke away. Also aren't you taking norethisterone as the progestogen? This is a powerful progestogen in protecting the uterus lining (as are the other synthetic ones) so it may well be that you are taking more than enough to prevent any build-up. However you could request a scan from your doc if you are concerned - but unlikely you will get this on NHS in the absence of symptoms ie bleeding.
Hurdity x
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Hurdity, I'm grateful for your reply as you seem very knowledgeable. I take Micronor 350 micrograms, which is northisterone, as I said on the same three days, and have been doing so for over four years (up until my recent "rest" from HRT) and never had any bleeding of any kind. I have resumed this regime as it would appear to suit me, at least for the moment....hope it continues. I agree, I doubt the doctor would send me for a routine "womb lining" check unless I was having symptoms ( although amazingly the consultant at my local meno clinic has agreed to this procedure every twelve months for my friend who also has a uterus and takes estrogen only three days each week!!). No idea what it would cost privately ??? Thanks again
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That's sorted then ::). Watch and wait?
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They cost about £200.00 ish for a scan well worth it.
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Thanks MaryJane that's good to know
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There was a post recently, but i can't find it by someone who was having a private scan by a company operating nationally in Boots the Chemist I think.
£99 I think she said.....
someone else may remember the name but my meno brain won't let me ;D
pollie
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Pollie - it was Chi Chi - on this thread and it was Mothercare!:
http://www.menopausematters.co.uk/forum/index.php/topic,31382.msg497443.html#msg497443
Hurdity x :)
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Sigh.
Teachers Pet.
;) ;) ;)
pollie
x