Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Stellajane on June 02, 2016, 01:02:50 PM
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I feel I need to say this to all the women who are struggling with the progesterone part of HRT.
You need to try the different options for yourself.
We seem to have gone through a spell recently where Utrogestan in particular has been spoken about as some kind of gold standard for progesterone in HRT. The trouble is its just as problematic as any of the synthetics. As a result, I have to wonder how many women are just being put off HRT altogether when they find they can't tolerate it?
I, like many others, am stuck with Utrogestan because the synthetics caused me difficulties of one sort or another. Fortunately I'm able to tolerate using it vaginally, otherwise it would also be a definite no no.
However, as I've often said before I actually FELT tons better in myself taking the often maligned synthetic Norethisterone. It just happened that in my particular case it aggravated a pre-existing hairloss condition. If this wasn't the case I would definitely 100% have preferred to remain on it.
I think we need to stop "promoting" one thing or another. What do others think?
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Stellajane - very good post. I agree that many women are being drawn to Utrogestan, believing it is the ideal, when in fact it can bring more side effects than other types of progesterone. I know many women have reported that they get problems with Utro, then tried Provera instead and did much better!!
I have personally struggled with Utrogestan - the high dose of 200mg making me really dizzy and unwell. I tried using it vaginally and got awful discomfort and the lower dose of 100mg doesn't seem to control the bleed well and I get breakthrough and erratic bleeding.
The only real plus of Utrogestan is the evidence that it is lower risk re: breast cancer but even this is not necessarily a reason for sticking with Utro if it gives nasty side effects. HRT is supposed to bring 'quality of life' - feeling dizzy, spaced out and shaky is really not good for me.
All of us posting on MM must keep in mind that we are all different and the HRTs with the synthetic progesterones do suit many women very well so we shouldn't automatically tell someone trying HRT for the first time that the Elleste Duet or Femoston etc. they have been given is not good. The HRTs with synthetic progesterone are on the market because they are popular and effective so we shouldn't knock them.
DG x
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I too did better with norethisterone than utrogeston but as you say it sometimes does seem as though it is often brought up on here as better than anything else,it might well be for some but not everybody. ;)
Glad you brought it up thought itwas just me. ::)
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Hello Stellajane.
I'm so glad you posted this message!
I have just started a new regime of Oestrogel and Utrogestan and I'm having a hard time.
I started off with one pump of gel instead of two but now I'm wondering if it's the oral Utrogestan that is causing me to feel so awful. I had used it in the past both orally and vaginally but with a different oestrogen.
I agree that appearing to promote one type of HRT over another is not helpful but everyone wants to find the magic formula and is looking for guidance. It would be so much easier if we were all the same!
Take care all.
K.
P. S I wish I knew what to do for the best and really hating this meno business at the moment!
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Agree with this post! I'm feeling fine with my one pump of Oestrogel, but I seem to go downhill mood-wise whilst on the Utrogestan phase, especially when I come to the end of the 12 night phase. I'm watching points this month, last month I had a bleed right in the middle of the cycle and didn't even get to the Utro stage. One good thing about the Utro for me is that it knocks me out and I get a good sleep, although lots of very strange and busy dreams whilst on it.
I honestly feel like having a phase of trying without the HRT sometimes, but the sleep issues concern me.
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I agree that Utrogestan has its side effects. I was once told by a medic that everything used in medicine has side effects.
I experienced dizziness and just generally not feeling good emotionally. I also get withdrawal headaches when I stop taking utrogestan. I take it vaginally but occasionally that can cause bladder irritation.
I find I feel better if I keep my estrogen levels up when taking utrogestan and even upping the dose of estrogen at the time of using utrogestan. Seven days is enough for me and fortunately I do get a decent bleed after just the seven days and no breakthrough bleeding so far.
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A very good post. I recently started taking HRT estelle duet continuous combined, six days in and I felt great sleeping great aches and pains gone it seemed like a wonder drug. Then on the seventh day the most horrendous pains in my head. I rang my gp who asked me to stop taking them and go get my blood pressure checked. Blood pressure was fine so three days later I started taking them again and fingers crossed I'm fine. What my gp did say is if the pains happen again stop taking them and I can try something different.
If I had just followed what I'd read about progesterone on MM I might not of persevered. Everyone goes through their own menopause and hopefully everyone finds a gp who will tailor a treatment that suits them.
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I couldn't agree with you more Stellajane. It has often been my concern that there is always a tendency on MM to promote "bioidentical" HRT. Of course in the ideal world we should always try to keep things as natural as possible, but I think that bias can be to the detriment of a lot of women.
Some may feel they must persevere with something, simply because it's "natural" or because it's what they've been encouraged to use, but maybe if they looked outside the box they might find something that works better for them. Sadly because of this bias some may give up on HRT because they don't want to take the "risk" of using something else. HRT should always come down to what works best for the individual, and it should always come down to quality over quantity (IMO).
For me, Utrogestan was not the best choice, and I will say again, there are reasons why it hasn't been approved for use in Australia. However, since I've been on Provera I have been a lot better. I'm happy using estradiol patches, but I know there are a lot of women who actually do better using something like Premarin. One should try all the options before giving up on HRT.
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Interesting and reassuring post! I take Prometrium (Utrogestan) because of what I read on this forum and because I had hormonal issues with Mirena years ago. I am tolerating it fairly well for now, but have often wondered what to do if I can't tolerate it. I think I would prefer the convenience of everything coming from a patch if I later switch to a continuous hrt, but the forum led me to worry that I'm already on the best available and the synthetics will be miserable. It's not a current concern for me, but it's reassuring to know that the other options could still work.
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I too agree, horses for courses. There are many more options that work for many women.
I had the benefit of knowing that a progestin used in a mini pill really suited me, although it's not available as an HRT. So when Norethisterone caused me problems, I just tried a different one in Femoston and so far so good.
I guess(with my limited knowledge) that part of the problem with utro is the amount that has to be taken. I take 5mg of prog daily in my Femoston Conti, but the utro equivalent is 100mg (yes, I know you can't compare them directly, but even so).
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, but the forum led me to worry that I'm already on the best available and the synthetics will be miserable. It's not a current concern for me, but it's reassuring to know that the other options could still work.
That's the problem with leading women to think this, but there will never be a one size fits all with HRT. The only advice that people should give on MM is from personal experience, and if you've had a hard time on a synthetic of course you are going to report that, but that doesn't mean other women will be the same.
Personally I didn't like Utrogestan (Prometrium), but I have no problems with Provera (medroxyprogesterone). I've also tried norethisterone, but I prefer Provera. On a continuous basis none of them really suit me, but on a 2 monthly cycle I'm doing pretty well.
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Hi Stellajane I too think you are making an excellent point here, i will update the other thread I have been following but have decided to give Provera another go. I can't be sure the Utrogestan is making my hair loss worse but without trying the Provera again I won't know for sure until I try. My HRT doctor is very keen on Utrogestan as being the preferred progesterone but I really think it is down to the individual. I just hope I don't get the terrible joint pains but if I do I'm hoping they may pass in time. I will update the other post when I've given the Provera a good few weeks. Thanks again for your helpful posts.
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This is an interesting post.
I started using oestrogel and Utrogestan two and a half years ago. I quickly discovered I could only tolerate 100mg of the Utrogestan and would start to feel dreadful after about 7 days on it. I had a scan over a year ago which showed I had no build up. Over the last year I tried reducing the dose further and now use 100mg twice per week. I had another scan recently and again I have absolutely no build up. My hormones feel balanced using it like this.
I know that this isn't recommended and may well not work for other woman, but I think it does prove the point that several of you have made here, that the 'one size' approach doesn't work.
In my case my doctor thinks that my oestrogen level is too low to cause a build up. I will of course keep an eye on it but I wonder if the prescribed dose of progesterone is simply way too high for many women.
Clearly I wouldn't recommend that other women play round with their dose without GP support. But it makes such a difference getting the balance right.
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This is what Dr Annie Evans Prof Studd agree with there is not a one glove fits all at all. I am a can't tolerate progesterone person also. So I have less with yearly scans. My bleeds are definitely big enough.
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It's all about trial and error and finding what suits. I have been using Femseven Conti and been fine with the progesterone which is Levenorgestrel. I had been thinking of maybe switching over to Utrogestan as I'd heard so many good things about it but then I thought why rock the boat? If it ain't broke, don't fix it.
Just because something is natural doesn't necessarily means it's the best, I remember years ago I bought a whole set of skincare products from a company in Switzerland. The creams were made from high quality natural plants etc and I suffered the most horrendous skin reaction when I used them. I went back to using Nivea and had no problems so yes, stick with what works.
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Chrislm and Maryjane, you have hit the nail on the head, one size very definitely does not fit all. If you don't have any problems with any type of progesterone then obviously this does not apply to you but if you do then you need to have a tailored dose otherwise you will stop taking HRT altogether because you can't cope with it and then you will have to face the endless problems of oestrogen deprivation.
I have tried practically all types of progesterone and don't get on with any of them but Utrogestan is the lesser of several evils and it works extremely well when used vaginally. You do not have to be progesterone intolerant per se to have problems with it, you can be just sensitive to it or simply not feel good when taking it in large quantities. For what it's worth, I think the NHS are over-prescribing the progesterone part of HRT because they don't offer scans but obviously this does not affect women who do not have a problem with progesterone. The NHS recommended dose is completely out of the question for me and if you look at it closely, by the time you have taken the 12 days of progesterone and had a bleed it only leaves you with just over a week of the month left before you have to start the whole process again.
It should also be noted that overdosing on progesterone also comes with problems and my gynaecologist said it can cause womb erosion and told me not to take any more Utrogestan than I do now. I am on the Professor Studd regime of 100mg for 7 days but I now stretch my cycle to about 5 weeks but I know I can safely do this because I have regular scans and my last post period scan measurement was just 2mm so clearly I do not need to take any more progesterone than I do now and could end up with problems if I did. Utrogestan is strong stuff when taken vaginally and I would urge women who don't get on with it to try and find how much they need by having a scan. You can't guess how much you need to find out and you could be taking too much (most likely) or too little.
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Good thread. As mature and intelligent women that we are I think it can still be easy to err towards something that seems to be working well for (what appear to be) the majority.
I was prescribed Provera but felt I should try Utrogestan as it was considered natural, unlike the others.
I think it's important that ladies report on what goes well and what doesn't as it helps give others more choice and know there's something out there that might work for us.
Some of the feedback on this thread highlights that there are custom hrts that can make such a difference.
Mary g I think what you say about not being able to guess how much to take is quite true. The only thing is, I don't have the confidence that there are GPs or even 'specialists' who really know. When I saw my gynae he was brill for dealing with a physical problem but when he started talking about hrt I just knew that he wasn't 'clued up' on variations.
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Mary G, I too have been thinking that the current guidelines are simply over prescribing progesterone for many women!
I have tailored my own dosage through trial and error, but I could tell right from the start that the prescribed dosage was very much too high for my body.
From reading this forum it is clear that many women aren't able to do this - because they don't feel confident in doing so, or because they can't access scans to check what is right for them. And that is such a dreadful shame. I am sure many women are having to put up with a poorer quality of life as a result.
The NHS sadly is significantly underfunded and as things stand this is only going to get worse. Unless we, the voters, accept that we need to pay for good services, then I doubt that things like tailored HRT regimes will ever be anything more than a vain wish.