Menopause Matters Forum
General Discussion => New Members => Topic started by: cheezel on April 25, 2016, 10:52:04 AM
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Hi all,
Im a newbie and looking for some advice. Im early menopause and will be 42 nxt sat with 3 kiddies 2 to 7. Im having an absolutely horrific time and cant take much more. Im living in ireland so our choice in hrt is much more limited with no bioidentical progesterone available. So anyway my story is last yr when my baby was 10mths old i missed a period. That continued for 4mths and i dev prolapses so went to my gynae/obs. She said as i have autoimmune conditions and a crazy lifestyle (working 70 hrs plus gym at 5.30am) it was prob stress related and i needed to sort my life out. Anyway my fsh was 125 so blds all post menopause levels. Started me on Evorel Conti and was ok at start but then dev severe nausea n cramps on day of change. So she then put me on Prempak C which i had huge rxn to...hives all over my body. I have hypersensitive immune system and dev rxns...anyway i stopped taking them and felt better and by the time i saw my gynae my blds were normal again and i had regular periods until jan this yr. Im now back to Sq 1.....my gp great..started me on estradot 37.5....was ok for 2 days then dev severe nausea n diarrhoea...by wk 2 i could only really tolerate 6mcgs...then started provera 5mgs x 3 and felt ok ish for 2 wks...when i stopped had horrific cramps headaches etc and patch made it worse so tried to go without. Developed severe nausea and diarrhoea which i think was due to severe prog def symptoms....was so bad felt like i couldnt go on....saw new gynae n she said to stay on evorel conti for 12 wks whilst sending me to allergist endocrine etc for other issues. Sorry for long story but im 2 wks on evorel conti and getting worse...got increasingly better for the 2 wks but dev hives after changing patch and yest and today feel dreadful. In bed sonce 8pm last night. Have bad PMS symptoms...like womb cramps lower back pain but worst is this feeling i get in my head like pressure around my eyes and horrible dry mouth and pain in jaw n teeth like i was clamping them shut. Im wondering if dose just too high for me or progesterone not suiting me as i feel v v down. I cant tolerate anything including my kids and they need me. Just emailed gynae there but not sure what she can do. I feel like my life is over. Can hrt actually work and make life liveable??? Im meant to be back in work nxt wk....also at 41 ive no one to talk to about this as all enjoying life......tks girls...
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:welcomemm: why is there less support over there :-\ it's often bad enough on the mainland to get GPs to accept that ladies can begin menopause at any age >:(.
Some don't react well to progesterone ……. if you 'search' you'll see how others are coping.
You need a :bighug:. Listen to your body, if you need to rest then do so. Make sure that you eat little and often and keep hydrated. Exercise when possible, remember housework is exercise ;)
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Hi and welcome to MM cheezel - I had a premature meno which started in my mid 30s. Clearly you are having difficulties as your own hormones sent to be still kicking in at times that must also be having an effect.
I believe there are number things going on here. Yes, you are menopausal and at your age you do need HRT to protect your heart and bones for the long term. Finding the right HRT is the challenge. Early on in my meno journey I tried a variety of HRT types and strengths all of which gave me headaches and other side effects. I was eventually put on just one ump of Oestrogel each day with 10 days of progesterone each month which then gave me a short withdrawal bleed (about 4-5 days). Provera is one of the better progesterones but you may find Utrogestan better but I'm afraid the PMT when you come off any progesterone is common with most women and may be something you simply have to cope with - I certainly get this - headache and nasty cramps for a few days each month. It's all about balancing the positive with the negative and fro you I think a continuous HRt regime would not be an option due to your sensitivity to the progesterone. If you expect to feel good every day then I personally don't think that is realistic.
Unfortunately Evoral conti is probably not the right one for you as it is a medium dose (so possibly too high) and the progesterone is one of the more synthetic ones which is tougher to tolerate.
I personally like Oestrogel as, though it can be a bit of a nuisance applying it each day and allowing it to dry for 10 mins before dressing etc. - it seems to give me the more consistent dose and it allows adjustments, so you can simply increase the amount you use if need be.
If I were you I would definitely start fresh - so give yourself a 4 week break. Ask for Oestrogel and just use one pump per day - it may be best you use this either morning or evening on inner thighs (you will need to be careful not to allow you children physical contact with the area you have applied this to for a couple of hours) then either use Provera (just 10mg daily ) for 10-12 days each month after which you will get some PMT and a withdrawal bleed but on this low amount of oestrogen it shouldn't be so bad. Ideally you should try Utrogestan (it's called micronised progesterone in the medicine book) - I am surprised you can't get this as it used for IVF which I'm sure is available in Ireland? It's worth pointing out that is it 'micronised progesterone' to see if you GP can find it - however, do bare in mind that Utrogestan gives side effects as well so doesn't suit everyone. Negative reactions to oestrogen is very, very rare as most women feel really good on this, however I've always preferred the Oestrogel as I don't get a consistent dose with patches.
May I also comment that your lifestyle does sound absolutely bonkers. To work 70 hours a week, go to the gym at 5.30 am and cope with 3 small children - Something, somewhere is going to give. Where on earth is your relaxation time?????? Relaxation is just as important as exercise. Please, please be kind to yourself. I am 60 now and 25 years on I'm still using HRT - it is a compromise as I do get ups and downs (hate the tummy cramps) but I've tried life without HRT 3 times and that is really NOT GOOD. BTW I get horrible headaches around the eyes without any oestrogen or if I'm using too much - it's about finding the right amount, so just do one pump per day for 4 weeks before changing.
I'm sure others will be along with help but do try the sequential regime I have suggested. Dg x
Dg x
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Hi Cheezel,
Welcome to the forum.
Out of interest, what autoimmune conditions do you have?
As for the pain you are experiencing around your eyes, jaw and teeth with the dry mouth..that can all be related to sinus issues? I suppose at times, we put every symptom down to peri but if you have autoimmune conditons, some of these may be causing a lot of your symptoms.
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Very good points Halfpint - many women blame HRT for symptoms they are getting when in fact it is often the lack of oestrogen that can trigger things like sinus problems etc. For me HRT definitely calms down many of my bodies sensitivity issues - eczema, dry nasal passages etc are all far worse when i'm not on HRT. Dg x
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Geeeeeeeezoooooo how the hell do u manage???????
3 kids and running a house is hard enough nevermind 70 hours a week doing a job n gym.......
You are probably running on empty..... We all need a "day off" .....I'm not criticising- I'm amazed and astounded!!! Don't take this the wrong way but remember we are not getting any younger and life's a race
Btw if you don't feel ready to be back to work ask your doc to extend your sick note xx
Be kind to yourself and sending big hugs
Love m xx
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Hi Cheezel
I'm on Everol Conti and have been on that patch for about 8 months. I had a lot of similar side effects you are experiencing at the start of using these patches. I cut them down to a third and built up slowly and things settled.
Hope this helps and you feel better soon.
Vicky x
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Hi cheezel, I'm only now seeing your post, but want to reach out. It is hard, isn't it? I'm 39 with two kids. I found that on the 37.5, I only felt a little better while on the progesterone too and still awful when on estrogen alone. After increasing the estrogen a little, it seems to be improving. Seems like it would be the opposite, but I'll take whatever works. I saw your reply on Mandz' post and can absolutely relate. Keep posting and let us know how it's going.
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Hi LisaB,
Im currently lying in my bed sick as a dog. Not sure how much more i can take of this. Tried Lexapro last wk and went dolally. My prob is im v sensitive to all meds. Im still on the Evorel Conti as my gynae wants me to stay on it for 12 wks. I didnt sleep a wink last night as ive such strong uterine cramps and headaches. Cant eat. Cant do anything. Im so down about it all. Gynae doing me a script today for uterine cramps. Id love to maybe half the patch and see what effect that has but gynae doesnt want me too....defo think the progestogen not suiting me and way too strong. My mother is living with me as im incapable of doing anything. Will be going to no pay in work in 2 wks time as we only get 12 wks sick leave in 4yrs. Had enough....LisaB its horrendous. I feel like im a ghost looking on from the sidelines
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Hi. I had a lo of the bad side effects in the first month with Evorel conti. I I patches to to third to start with. Hope you are okay soon xx
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Hi cheezel - sorry to hear you are feeling rough. How long have you been taking the Evorel conti now?
Also how long were you without HRT at all and how many periods did you have during this time? If you are having (natural) periods then Evorel conti is the wrong HRT for you anyway - the gynae should not have give it to you unless you were late peri perhaps. FSH levels are irrelevant in the sense that you cannot say you are post-menopause from the readings, just that you are peri-menopausal as they fluctuate a lot at this time.
At your young age anyway I would not want to be taking progesterone all the time and would be better to try to mimic your natural cycle even if it means having a withdrawal bleed.
Is your gynae referred from your GP at a menopause clinic? Can you ask your GP to change - you can't go on like this with such young children. Also if your cycle has restarted this may also contribute to how you're feeling.
As you are so young - have you thought of the combined Pill eg Qlaira which has only 2 tablet free days, and the oestrogen is bio-identical. If you can tolerate the progestogen in this you may well feel heaps better.
Hurdity x
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Ooo, Lexapro. I shivered reading that. I took one tablet years ago for a sinus infection misdiagnosed as anxiety. It was awful. Changed gp after that experience.
It is horrendous. I was practically bedridden from several weeks. I am building up to normal again. It's been a slow process. My doctor and all the ladies here told me that it could take weeks or months, and I didn't want to hear it. I had already been so low for too long. But it's true. You will feel better. I am not 100% yet but so much better than I was. I wonder if it hits harder and faster for those of us that are younger, and maybe more drawn out for older ladies?
You can take it though. I was sure I was dying, and if not, I was certainly losing my mind. I wish I could offer some advice for how to get along until you get settled, but I'm not even sure how I did it. It was a lot of crying, a lot of boredom, a lot of optimism, a lot of failed efforts, I think it's really just waiting. I tried meditations and yoga. The yoga is good especially if you aren't getting out and exercising. Some days I only got out of bed to do some stretching exercises and some yoga. Keep checking in and posting. It helped me to know that others are having the same. Let us know how you're doing.
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Hi Hurdity and LisaB,
Hurdity i havent had a bleed in 4mths now. After 2 wks of provera i had a day of maybe spotting. Gynae only kept me on Evorel Conti as i had put myself on it as i still had it from prev yr. Because of my other issues ie hypersenstivity etc she wants me to get tests done before changing me but said she felt id do better on a tablet as so young or oestrogen and mirena. I asked my gp about Qlaira and she said that had v high doses of hormones and prob wouldnt suit me??? Anyway gynae gave me script for Ponstan for uterine cramps and headaches and has worked wonders. As i work through each symptom another seems to pop up...ive noticed all along i feel kinda jittery esp in my chest even at rest and last night couldnt sleep a wink...i honestly dont think its anxiety and ive never suffered anxiety before. I think the dosage might be too high EC 50mcgs and have emailed my gynae this am asking if maybe i could try cutting a 1/3 off to see if any difference as i need to sleep and dont want to take yet more meds. My thyroid is currently underactive so i know it isnt that so can only be the hrt. She must be sick of me at this stage as i email nearly every second day with queries but if i dont look out for myself who will? Ive my allergy testing nxt tues so id say based on that she will try sth else although we both expect it to come back neg and ive come to realise alot of my hypersensitivity reactions is srlf induced through fear and panic!! Sorry for the long post. Hurdity you are right in that im still peri menopause. Last yr i was 8mths no periods then they returned for 5mths now nearly 5 mths again with none. Im only on Evorel Conti consistently 4 wks now and was prob a good 12 to 14 wks with nothing really in my system. Tks for taking the time to read this. LisaB what hrt are you on and good to hear things improved
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If you have not been for 12 months without a natural period - ie when not on HRT, then you are not post-menopausal and should not be on Evorel conti.
If you are late peri-menopause, then it may well be OK - and some gynaes do prescribe it, but also if that was the case, 50 mcg is not too high a dose - it is more likely that the norethisterone taken continuously is causing these symptoms and it is ridiculous to have to take extra medication, to cure symptoms that maybe caused by the medication in the first place!
Please do ask for a different type of hRT - a cyclical one initially so that you have a withdrawal bleed and have some time on oestrogen alone - ideally as Dancinggirl suggested in her main post below, or patches.
Hurdity x
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I know Hurdity....i emailed her this am re feeling kinda jittery etc and should i maybe decrease the patch a bit...she said this not normal and she will talk to my gp about it. Freaked me out cos im afraid she wants me to go on psych meds and after going on Lexapro 2 wks ago and being horrific on it i dont want to go down that route again. My thyroid is still underactive so could possibly be that. Changed my patch today and even with the Ponstan i can feel the cramps..i deffo think its the northisterone but getting no feedback on this when i suggest it. I wish i hadnt emailed now and just put last night and today down to a bad day. Just getting fed up with it all ...i know its still early days as im only 4wks on hrt but im the type that questions things alot and i see no wrong in that. Also being v sick since Feb and stuck at home is starting to depress me. As you might know from my previous post i used to live a v manic life and i find doing nothing v hard. I know its a blip in the grand scheme of things but just finding it all v v hard.....took 1mg of valium to calm me as so stressed today. Hurdity its hard going...somedays i feel so down and cant see the point of continuing but keep telling myself....This too shall pass....nothing lasts forever!!
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Hey cheezel - don't be hard on yourself - you're right it will pass but hard when your hormones are surging. Have a look at this thread from Mandz who was desperate and feeling really down and see how many posts there are. If it helps you just keep posting if you need to offload or need some ideas OK? There is usually someone around to answer!
http://www.menopausematters.co.uk/forum/index.php/topic,31031.0.html
Hurdity x
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Tks Hurdity.....gynae and gp want me to have a pelvic scan now cos said norethisterone wouldnt cause my severe uterine cramping and headaches symptoms!!! Scared now!! Just took patch off for 1st time in 5 wks cos cramps so bad even with Ponstan....sick of this....
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The thyroid could certainly be part of it. I am treated for underactive thyroid also. But in fact, before I started hrt, I presented with hot flashes and anxiety, and the doctor suspected I was overmedicated for the thyroid. Long story short, it wasn't the thyroid. It was low estrogen. I am on Vivelle Dot .50 (uk Estradot 50).
I know how you feel about being fed up and stuck at home. I was housebound a few months while sorting this. Several ladies advised me to take it easy, accept that this is my condition for now, be patient and it will improve... I refused. Staying home while life carried on without me was killing me! But fighting it only made me feel worse. Really, as hard as it is, sort of giving in to it and accepting that you need some time to get well will probably help your recovery. Confess your situation to your closest friends or family and allow people to support you for a few weeks. It won't last forever. You've got your gyne and gp working on it. Keep posting and reading others' posts on here. It helped me so much to know others were going through the same. I would read some posts and cry for all of us because it's heartbreaking what we go through with this hormonal stuff. Really stopped me dead in my tracks. You aren't alone.
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LisaB - excellent post - such sound advice and support. Cheezel do take note of what LisaB has posted. DG x
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Still having tough time...trying Cyclogest 400mg pessaries now...anyone use these? My gynae wants me to use them continuously not cyclically??? Im on Evorel 50 too...had good day yest but not great today....
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Oh cheezel - not sure that cyclogest is such a good idea - Utrogestan is the progesterone that most use these days. Why is your gynae/GP wanting you to use these pessaries every day???? I though you were still peri meno??
All seems very confusing to me. I would have though you would do better on Oestrogel with Utrogestan taken cyclically e.g. 12 days each month?? Many of us find that progesterone taken continuously causes problems - I would ask the specialist about this. DG x
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Dancing girl i live in Dublin Ireland and we dont have oestrogel or utrogestan here. I had severe uterine cramps on evorel conti...so she said we could try this as its most natural...im 6 wks on 50mcgs of oestrogen and still feel crappy but way better than without. Now im windering if BCP might be better option for me?? Gynae says if this doesnt work i can go to UK and see what i can get there but i cant really afford that. She wants to put me on coil longterm but as she said continuous prog better?? I dont know anymore...totally despairing here
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Hi cheezel - sorry, I forgot you were in Ireland. Pleased to hear you are feeling better on the patches and after I had done my post to you I then looked up the cyclogest and remembered that, before Utrogestan came out in the UK, some women used Cyclogest as part of HRT - so basically it is worth giving it a go. I still think using it continuously is not a good idea though!!!! I think you are still technically peri meno???- so a sequential regime would be better.
If you don't like the cyclogest and it aggravates your bladder etc. then another alternative would be to try Medroxyprogesterone (Provera/Climinor) on a sequential regime, as it is a kinder synthetic progesterone - if you can get this in Ireland?
Here is the section on MM about this proegesterone:
http://www.menopausematters.co.uk/to_progestogens.php
If bleeding and cramps are an issue for you then a Mirena coil would be a good option - so I would seriously consider this - it could well settle all the cramps and would eventually result in no bleeding - you can then use as little or as much oestrogen as you need while the Mirena is in place. Keep us posted. DG x
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There was a facility here to send Dr Currie a personal e-mail cheezel - might be worth a try? The fee should be at the top of the page.
Also, if the Gynae and GP are in agreement about the Cyclogest and it eases symptoms for the now, it will give you breathing space ;-).
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Well feel awful today.....girls was wondering how do you know if dose of oestrogen is too high or too low for you?? I constantly feel internal tremors which i read are 1 of the 34 symptoms of menopause. But today i feel increased anxiety...went to shopping centre sth i normally love and wanted out....im 6 wks on hrt now and really despairing as to how you find the correct dose or fit for you. So far i was on Estradot 37.5 but was v sick on that...maybe i didnt give it long enough but had extreme nausea etc...provera was prog and was ok ish on that but was only applying 6mcgs of oestrogen, a quarter of a 25mcg patch...some days i took it off....tried no hrt..was so sick with extreme nausea and diarrhoea....put Evorel Conti 50mcgs on and whilst i saw some improvement im still not what i would call functionable...im out of work 7 wks now...was really hoping Evorel 50mcgs with Cyclogest might work...started this fri...wasnt great after changing patch fri and sat....had tolerable day sun but bad yest and today....just wondering why i dont appear to be settling at all.....getting more n more down....my parents have had to move in as i cant cope with my 3 kids and im shouting at them...no tolerance....tried Lexapro but was sick as a dog on them but i dont think my anxiety is anxiety per say just cos im feeling so sick and not improving..my parents driving my hubbie mad and feel bad their lives are on hold.....might email Dr Currie as maybe my flucuating hormones are causing my situation...my hubbie says i need to try getting back to work n see how i cope but i have a v stressful responsible job and dont think i can handle it feeling like this.....i hate this menopause and honestly cant continue through life like this.....
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cheezel - I think one of the main problems you are facing is the chopping and changing. NO HRT will work straight away and each regime needs to be given at least 2 months before changing anything. The peri stage is tricky as the oestrogen levels will be fluctuating. Progesterone is often a big issue and it's about finding the right one for you.
If the Provera wasn't too bad then I would have stuck with this with a 50mcg oestrogen patch - using the Provera on a sequential basis, so just 10-12 days each month, to see how that goes once you are using a proper amount of oestrogen - you will get a withdrawal bleed each month but it's often taking progesterone all the time that gives the problems. I know you have been given the Cyclogest and maybe you need to give this a good 4 weeks to see how that goes first.
Sadly it is about trial and error. The nausea may be more to do with your anxiety than anything else - can your doctor give you something to calm the nausea? Have you tried some Mindful Meditation as well - I find I really have to keep practising this to help me cope.
It sounds to me as though you need to 'stop the world and get off for a while' to let you gather your breathe? DG x
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Tks Dancing girl for replying...really cant tolerate anymore....bawling here im so nauseous...havent felt nausea like this in ages....btw that the headache and my aching womb im thinking of just going cold turkey although i was as sick pre hrt so dont know what to do...cant see any light today at the end of the tunnel.....sorry for the negativity but im so ill i want it all to just stop....i had such a great life before all this and feel at 42 im way too young for my life to be over......again sorry for being so negative
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cheezel :hug: I am sure the solution will be found for you. The nausea is truly miserable I'm sure - so difficult to see the light at the end of the tunnel but I suspect the Mirena may be your best bet with either oestrogen as patch which will give you total trandermal and reduce any trouble with the stomach. Keep us posted. Dg xx
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Hi again cheezel
So sorry to hear you are still feeling rough.
First to say Dancinggirl is right about the Cyclogest pessaries - I used these for the first 4 years of HRT (because utrogestan was not available - and my GP had been prescribing it for years) and the same dose as you - although I was prescribed it cyclically - at 400 mg daily for 11 days per 4 weeks. I wouldn't want to take it continuously though as it is quite strong and used to make me foggy headed and sometimes give me migraines - but I also got these on withdrawal ie when I stopped the pessaries and went back to oestrogen only. I felt fine once it had cleared my system though. That dose is too high for continuous use - and especially for a low dose of oestrogen. It would only be given continuously at this dose to maintain a pregnancy.
Secondly I'd just re-iterate what Dancinggirl has said about peri-menopause and remaining on a cycle - and I also said it in my earlier posts below. If you are peri-menoausal then it would be better to be on cyclical HRT although I can understand your gynae wanting to try to eliminate fluctuations in your prog levels if you suffer when you start taking it and when you come off it. However if the problem is the progesterone itself then you want to keep it to a minimum. As I said my GP prescribed it for 11 days per 28 for a 50 mcg patch in late peri-menopause and it was fine for me. I found that I did not get a monthly bleed when I eventually became fully post-menopausal - at around 56/57 - on 11 days x 400 mg Cyclogest with a 50 mcg patch - so that prog is quite strong!
In your case I would take as little as possible orally as you seem to suffer from nausea. Although you do need a higher dose of oestrogen due to your age - and if you are going through an early menopause, in your position building up slowly is key - but as Dancinggirl has said you need to give each treatment a chance to work and especially with the oestrogen and the nausea - if you can ride this out it should ease.
Maybe as your gynae and Dancinggirl suggests - a Mirena coil and separate oestrogen might be the answer - provided you can tolerate the small amount of progestogen that gets into the system.
Also just to add - are you taking thyroid meds - I know during menopause Thyroid levels can play up so maybe you are going a bit hyper - which could account for some of your symptoms? Are your levels being measured?
So - in the first instance - with doc's permission I would try to change to a cycle and then build up the oestrogen gradually.
Hope this helps!
Hurdity x :bighug:
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Thank you Hurdity and Dancinggirl......i agree about the cycle but to be honest dont know whether im peri or menopausal..i havent had a bleed in 5mths both on and off hrt......the nausea from the initial oestrogen has died....when i say im really sick its more as if i feel my system is being poisoned if that makes sense?? I feel dreadful all over and like i can literally feel the hormones racing through my system. Thats why i was thinking the 50mcgs is too high a dose for me. Ive very meds sensitive in any case....im nearly 8wks on this 50mcgs dose but symptoms appear to be worsening??? I cant function i feel so unwell....started getting headaches yest too so dont know if its the progesterone....when i started hrt in feb my gp put me on estradot 37.5...i was sick as a dog and found i could really only tolerate about 9mcgs without extreme nausea and diarrhoea...strangely i was a bit better when on it with progesterone but had severe withdrawal from the provera but at this stage id almost take that. Ive asked my gynae does she think its prog intolerance via email but she never answered that directly just told me to stay on the hrt for 12 wks....i feel like ripping the bloody patch off at this stage....only changed it yest...im wondering as the level of hormones are building is it too much for me?? As i said i feel as if im trembling internally which i know is drug related and not anxiety or depression so im wondering if the starting on 50mcgs was just too high for me?? Its so hard to figure it out when there are so many elements at play. My thyroid is actually fine....endo rang and all my hormone levels fine acc to her..no Addisons etc.....so sick of being unwell...5 mths of this now and still in a hormone heap!! You guys seem to know more than my gynae which is v frustrating....as she is seen as one of the best in ireland and has links to UK and Dr Nick Panay and only recently she launched Femoston 1/10mgs here