Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Rosie500 on January 09, 2017, 10:31:04 AM
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Just a quick question - I have just changed from taking utrogestan 100mg 25/28 to 200mg 12/28. I'm 4 days into the non-prog stage and feel terrible - down etc. However it is quite possible this is wholly a result of some fairly big family revelations yesterday. Ideally I would like to dismiss any suspicion it might be the influence of (lack of) hormones. I had always understood most women felt better while not taking utrogestan which was one reason I was testing the different regime! If it is unlikely to be hormone related then I can concentrate on tackling my head and develop more strategies to cope with relatives.
Thank you!
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Search the forum for progesterone withdrawal or utrogestan withdrawal. It seems to be very common to feel down after stopping the progesterone. For me, I usually feel it about day 4 or 5 after stopping. I also begin to feel bad in a different way about 4 to 5 days in on the progesterone, so I'm not getting a lot of good days in the month right now. I think it's the change in hormone level, up or down, that makes us feel off.
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It depends if you need it or not. Progesterone withdrawal can be very severe and initial use can indirectly increase oestrogen levels a few days into it due to it the rebalancing allowing dormant oestrogen receptors to wake up.
I only take progesterone and know how hard it's been getting my body used to it to finally have some great effects but with the stopping and starting of when you take it non continuously with oestrogen it may never go beyond the stimulation stage and I think a lot of women here struggle with it. I would go back to the lower dose for more days so you have less volatility.
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Thank you for that, it was unexpected to feel so down and I do think "life" has at least something to do with it but I do feel "hormonal" too. I will carry on with the 200mg regime for a couple of cycles more and see what happens. Next time I am due to stop I have a quiet few days lined up and I will avoid all contact with relatives ;D so it will become apparent if it is a hormonal thing or not. If so I'll go back to the other option. I'd just got it in my head that people tended to feel bad while taking it but reaction to change in levels does make sense.
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Hi Rosie500
Not everyone feels bad while taking the prog but as Lizab says progesterone withdrawal is a common phenomenon which most womnen experience every month during their menstural cycle - it is what you experience as pms the few days before your period ( and sometimes the first couple of days of it).
It is not a question of needing progesterone to stop you feeling like this - but the feelings are just a consequence of withdrawing it and the physiological changes which occur. Most women end up feeling much better once the progesterone has gone from the system. Those of us who are on a longer cycle for example ( and post-menopausal) put up with a few days of progesterone withdrawal symptoms for the sake of several weeks of oestrogen only - bliss! if you are on a 28 day cycle as Lizab says - this means sometimes you don't get many good days if you feel rough while taking the prog too.
Dangermouse - I have read many times in scientific articles that progesterone receptors are activated in the presence of oestrogen not vice versa - which makes sense because biologically we don't need extra progesterone unless we have lots of extra oestrogen (ie in pregnancy). :-\. Do you have further information - eg any links to articles please? Ta!
Hurdity x
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Sorry I don't have any links (probably to do with a lack of research as it's natural hormones and not drugs) but was told this by an endocrinologist and have also lived it so I can say it 100% happened to me. Doing so much better now I'm up to 4 pumps a day of prog and it's not been easy getting to this point as my migraine nausea, dizziness and mood was untenable around ovulation and very nearly gave up.
It's to do with rebalancing where the hormone you're lacking causes the others that are then too strong to downregulate the receptors in an attempt to redress the balance. When you then start to replenish what is needed the downregulated receptors upregulate and symptoms get worse until you are fully topped up. I suspect this works for low oestrogen too when you add it back and it causes progesterone receptors (and perhaps adrenaline receptors etc.) to wake up.
It's a similar effect to drug withdrawal where you get a rebound effect when you stop as the de-sensitised receptors awaken.
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Thank you Hurdity. I think I have read too many posts about people being progesterone intolerant so I was rather taken by surprise! I never had PMS back in the day (lucky). My lack of problems with periods and childbirth have caught up with me now. I may just go back to the 25 day regime as I'm fortunate not to be too affected by the utrogestan and I can do without these feelings of despair! I'm pretty sure this is hormonal now and my husband agrees - he says my reactions are reminiscent of the way I was before HRT. Maybe that's a tactful way of saying something else ;D !
Trial and error, trial and error... Every time I think I am getting my head round HRT something new pops up. As you have said, we are all different. Thank goodness for this forum.
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Dangermouse, I'm liking youre thinking on this! :)
It's actually very helpful to me - my receptors became 'dormant' and that's why I've had so much trouble with estrogen, so I've been told! (And also estrogen only makes me anxious - again, may be a receptor thing but we'll see)! ;)
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Hi there
Just jumping onto this thread as I'd like to understand this "down-regulation"/waking up dormant receptors things better. Dangermouse, how did you work out it was progesterone you need and not estrogen? Your regime is really interesting because most women in menopause talk about needing more estrogen etc. Can you explain why progesterone receptors (and maybe adrenaline) receptors would up-regulate when adding back estrogen? And did you then go through a period of transition while your receptors "reawakened" until you felt better? How long? What you are describing marries with what Prof Studd has said about feeling worse before you feel better on estrogen. And might explain why some women feel really anxious on high doses of estrogen? What I find a bit confusing is how to distinguish symptoms of estrogen excess from 'transition'?
Would be very grateful to hear from anyone who can explain this phenomenon to me!
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Rosie500 - you will read more about progesterone intolerance on this forum because those women who tolerate it well and just get the usual prog withdrawal pms as with periods - will not join and not need to post - so this forum is not a representative sample of all women I'm pleased to say! All these HRT types would not be on the market if the majority of women didn't get on with them - since they go through trials before being approved and side effects monitored!
Dangermouse/Frankie - maybe start another thread about the receptors because I don't really understand what dangermouse is saying either - but this is Rosie500's thread.:-\ The whole subject of hormones receptors is extremely complex!
Hurdity x
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Yes!! Just to add I'm day 5 after stopping utro and had a horrible mood drop today I just posted about it elsewhere! I am prog intolerant so feel awful on it and normally much better as soon as i stop but about day 4/5 just after my period comes I can get the low mood irritable flat feeling X
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I still think we need a thread for surgical menopause ladies, but I digress.......
Time and time again, especially over at another forum called Hystersisters for ladies such as myself in surgical menopause, it has been reported that many, many women feel HORRIBLE when taking estrogen only. At no point in all of our reproductive years did we EVER walk around with just estrogen in our bodies. It drives you crazy, and this has been very well documented for YEARS over at the forum I mentioned. Estrogen and Progesterone work in tandem in the body to produce balance - estrogen is energising, progesterone is calming. Your body is a finely tuned machine that does this job for you throughout your reproductive years, and then menopause hits and things go haywire.
Essentially, HRT is a pretty clumsy replacement for this, unless you get very lucky. That's why so many women post here with the problems they have with HRT.
There is nothing 'puzzling' about women feeling horrible on estrogen only HRT, nor is there anything 'unusual' about women feeling horrible on the progesterone phase of their HRT. As I say, unless you are LUCKY HRT is a clumsy replacement in broad terms for what our bodies can do naturally. Hence why - and this is well documented - so many women abandon HRT altogether after trying everything as the side effects are just unbearable.
We're all individuals, and everyone reacts differently. HRT should fit YOU, you don't need to feel bad if you do not fit IT or if it seems everyone else is doing marvellously on it but you feel rubbish. I think it's very, very important to remember this!
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Well said, Tempest!
Hello again ;)
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MENOMALE!!!!!!! I'm so very, very glad you're back!!! Huge welcome!!!! :bighug: :bighug: :bighug:
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Well said Tempest. I can't do oestrogen only. It worked perfectly for 13 years after my hysterectomy whilst I had a cycle of sorts plodding on in the background. Suddenly felt like god knows what, bloods show hardly any progesterone yet NO ONE listened to me. Just kept trying to give me higher doses of oestrogen that I couldn't cope with.
We are all different and require different levels of hormones and sometimes probably need the ones deemed unnecessary ! X
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Hello All and Happy new year.😁
Tempest well said!
I'm for some reason producing so much oestrogen and little or no progesterone and I can't shake off these awful symptoms.
I'm back to gynaecologist on 19th January for blood results and scan as she discovered I had a fibroid.
Menomale so good to see your name again😁😁😁😁hope you are well.
I hope the gynaecologist has some answers and solutions for me.
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Wow! I hope your gynaecologist can help you out, dear Autumn! Yep, to be so wretchedly rammed full of unbalanced estrogen is awful. I can honestly say that for those that have never experienced this phonemena, I just want to say - YOU WOULDN'T WISH THIS ON YOUR WORST ENEMY!!!!
Estrogen IS wonderful - rejuvenating, energising (to the point of mania, in my case ???), joint preserving etc. etc. but to be rammed to the gunwhales with it is beyond horrible! And yes, you're right - it can cause horrible mischief in the body too if it's out of control and unbalanced. I too had years and years of cysts and fibroids and in peri things went REALLY haywire and that's why I no longer have ovaries as the mega cyst appeared, and my gynaecologist just couldn't risk keeping them in any longer.
Sending you biggest hugs, Autumn - and yes - I'm super chuffed Menomale is back with us too! :)
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Very interesting thread ladies! I'm from the other camp where im severely intolerant to progesterone my own included which was giving me crippling pms now my own cycle has been suppressed by hrt but I still have the hell of progesterone I wouldn't wish that on my worst enemy either! I see Studd and have now been referred for a hyster but personally I do really well on ostrogen and can't wait to be free of progesterone forever I simply can't continue as I am long term (I'm only 42 now). I guess we are all so different :) good luck to everyone xx
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Hello Autumn! I'm fine, thank you. I also have fribroids (appeared in peri) and my latest blood results show my hormones are still too low (apart from DHEA that is normal now). I'm on Estradot 25 for almost a month but no improvement so far, still having hot flushes day and night and morning anxiety. I will start Utrogestan at the end of the second month and maybe up the dose of oestrogen.
Thank you and Tempest for such kind words!
:bighug:
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Yes welcome back Menomale!
I think I covered the receptors explanation as clearly as I can but in answer about my progesterone needs my specialiat said that if my symptoms are all worse mid-cycle (day 10-21 on average) this is clearly a high oestrogen, low progesterone pattern. I also saw a GP doc in Oz as I had a wrist injury and she wanted to know all my history and when I told her I was peri but not FSH rise as yet she also said I should be on progesterone. Had a good month considering I'm right on top of ovulation right now and that's compared to last few years I'd say and that's taken 2 cycles of progesterone.
Anyway, for this thread as Tempest and Hurdity have pointed out, we are all different and we aren't a cross section of all women who possibly have more subtle imbalances that are easier to correct.
I think any strong imbalance at either end feels unbearable and as hormones are so complex it's often trial and error that gives us the true answers. Feeling worse before better is how most natural healing takes place which would be the case for those on soy or yam based hormones (Estradiol, Utrogestan or creams) - which are still incredibly potent!
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Yay menomale - just realised you're back!! I really missed you. Did you manage to start your own meno site? Just for the record, I used to be dawncam but deleted my account and couldn't work out how to re-register in the same name - menobrain! It's so lovely to hear from you again and I never found anything you said offensive! Quite the opposite in fact. Hope you're well.
Apologies for jumping in on post and I could go on about prog......
Mx
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Apologies Rosie500 - just read entire post and can now give my tuppence worth. Although I'm quite badly prog intolerant, I do feel better with than without. It's the damn balance - it's like trying to catch mist! I currently have a Mirena - 7 weeks - and although I know it's early days, im already feeling too many side effects so am going back to Utrogestan which is a little more controllable. It'd be wonderful if those prog creams worked on uterus as apparently women feel great on them.
Good luck finding your balance.
Mx
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Hi murphydurf - I expect the reason women feel great on the prog creams is because the concentration is not very high - if sufficient was absorbed that was high enough to keep the uterus thin, I expect many would not feel so great! I mean the closest we have to the creams is vaginal progesterone - and in fact this should be superior because the concentration close the uterus is highest compared to serum levels, whereas with the creams you need to achieve a high serum level to be transported to the uterus - - so in my view it is never going to be better than vaginal prog - if you see what I mean. We just need more research on actual dosage and length etc using today's oestrogen preparations, as well as a lower dose prog capsules for lower dose oestrogens etc - some chance of that though....
Hurdity x
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Hello Dawncam/murphydurf
Good to know you're here! :-* :-* :-*
I stopped my compounded mix (prog 50mg, estradiol 1mg, estriol 2.5mg) and now on Estradot 25 (will start again Utro in a month), but feeling quite awful. I am having a scan soon and probably a hysteroscopy (although some cardiac issues have to be sorted before) and a polyp biopsy. Right now I feel really bad! Next month will up the oestradiol dose to 50 µg. It may be a placebo effect but I was feeling better on the prog cream...
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Oh my goodness, dear Menomale! I'm so sorry to hear you're struggling so badly at the moment - and with added cardiac issues too! Sending a gentle hug your way.....xxxxx
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Thank you sweetie! I wish it was just the menopause troubles but family ones are even worse! :'(
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Hi menomale - so sorry you're feeling so bad. I know we keep saying it but finding the balance really is a rollercoaster and certainly not helped with all the external stresses that come along in mid life.
Thinking of you.
Take things easy.
Mx
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Thank you dear, your posts do help!!
Back to the op question, I have mixed feelings now about starting Utrogestan again... :-\ if it makes me feel worse I'll jump from my 16th floor... :o
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My word! Really interesting thread. I'm about 4 months into trialling hrt and reacted really badly to progesterone tablet form but same (norethisterone) in patch I feel actually really good after a few days on the prog/oestrogen but after finishing and back to oestrogen only around day 3-4 get really anxious and feel slightly mad! Then day 5 start feeling okay. Had terrible mood swings pre hrt but finally starting to feel much more balanced and happier on hrt. Not sure I've got it right yet as no joint pains on tablets but with patches has returned noticeably worse on prog phase. Also missed a couple of periods but had light bleeding from day 3/4 off prog and has carried on all through oestrogen which I'm changing back tomorrow to prog/oestro phase (on Everol sequi). Is it okay to have light bleed/brown discharge (sorry for details) this long? Have had to post as this appears to be the experts post ☺ x
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Hi Menomale, why did you switch from the compounded mix?
I find the lower doses so much more therapeutic but when you are menopausal and take the off the shelf high oestrogen, you also have to take the high progesterone (which many struggle with) where the compounds can be personalised to what you need.
It does cost more though although my pharmacy is mixing me a double dose (as it's going so well and I'm on minimal amount) and it's the same price for double the strength so less pumps, think it was £110 for 3 months supply but that's £8.50 a week and definitely worth that to feel so good!
Anyway just wondered because you had been on them and not many here in U.K. use them. Hope you are ok and remember good times are always ahead of the bad ones.
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Hi dangermouse,
I stopped it for 2 reasons. First, I had itching and redness since the first day and when I phoned the pharmacy asking which were the other components in the formula they said that was a secret formula etc. I thought that was not professional to say the least. Second, I have to confess I was fed up with that nightly routine of spreading the cream, I just don't like the sensation, guess it's an Asperger's trait, I rarely use creams, gels these days, even water sometimes gives me some weird feeling and I have to dry it right away. That's why I didn't even considered the oestrogel option. I simply can't doi it every night. The patch is just twice a week (according to Dana's experiment on another thread even once a week could do) which suits me better.
Talking about costs... in Brazil it´s the opposite, compounded drugs have become so popular that the prices have skyrocketed. Last time I checked, Estradot plus Utrogestan and the compounded cream had basically the same cost per month.
It's still early days on the patch so nothing is impossible, I am opened to try any options available to make me feel functional again. Even go back to the componded formulas, I'm sure I can find a pharmacy that will provide me the info I need.
Thank you very much for the encouragement, I really need this!
XXX
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My word! Really interesting thread. I'm about 4 months into trialling hrt and reacted really badly to progesterone tablet form but same (norethisterone) in patch I feel actually really good after a few days on the prog/oestrogen but after finishing and back to oestrogen only around day 3-4 get really anxious and feel slightly mad! Then day 5 start feeling okay. Had terrible mood swings pre hrt but finally starting to feel much more balanced and happier on hrt. Not sure I've got it right yet as no joint pains on tablets but with patches has returned noticeably worse on prog phase. Also missed a couple of periods but had light bleeding from day 3/4 off prog and has carried on all through oestrogen which I'm changing back tomorrow to prog/oestro phase (on Everol sequi). Is it okay to have light bleed/brown discharge (sorry for details) this long? Have had to post as this appears to be the experts post ☺ x
Probably the reason you feel a bit twitchy after going back on to the oestrogen only part of your HRT - is due to normal pms symptoms - similar to what you would feel when fertile, just before your period. it is due to progesterone withdrawal and the body has to reverse the physiological changes which take place in the presence of progesterone. Once these have reversed, and you are stable on the oestrogen only the feelings subside - hence your feeling normal.
Yes fine only to have a light bleed - according to this website 15% of women actually don't get a bleed on sequential HRT.
Menomale/dangermouse - compounded oestrogen/progesterone creams are not recommended/licensed in UK - we've had lots of discussions about these before!
Hurdity x
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I'm aware that it is not recommended/licensed in the UK (yet) but I think it should be ok to talk about it, not advocating its use, after all no one here has the expertise and legal right to do such thing not only regarding compounded products but the licensed ones as well. Just my humble opinion.
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Of course it's OK to talk about it!!! I am just aware of other women reading this forum in UK and thinking to go down this expensive route not recommended by the medical profession! In fact there has been a recent article in the magazine about it which Emma promoted on this forum a few days ago:
http://www.menopausematters.co.uk/pdf/article%20Bio%20identicals%202017.pdf
Whenever I see reference to compounded hormones - I always post what the current view is of this - for women who just chance upon a thread :).
Hurdity x
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Ok, whenever I type the word "compounded" I'll make sure to add in sequence "NOT recommended/licensed in UK" (thanks copy/paste inventor!!!) for the benefit of all ladies here who deserve the best information available. ;)
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I think compounded sounds wonderful and I know Marion Gluck in London prescribes these. Sadly I can't afford to go down that route as I've already spent quite a bit on prof studd. It's about time we in the U.K. Had a more tailored approach vs. the try it and see what happens method which can result in a fair bit of misery. My understanding is that all the compounded HRT is also BHRT. The prob in the U.K. is obviously that the NHS could never support these formulas nor the testing to determine prescriptions.
Hopefully they'll start to become more commonplace and we can all benefit from another option.
Mx
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Dangermouse - are you prescribed through Marion Gluck?
Mx
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There is a LOT of talk about this over at Hystersisters! I smell a rat - 'Big Pharma' is NOT getting a slice of the compounding 'pie" so is going at it hammer and tongs. Why aren't I surprised. ???
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Nail on the head Tempest!
Mx
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There are many issues concerning drug's regulation all over the globe. An island is still a part of the globe, no matter how much water surronds it.
I think the big problem of drug's regulation is that technology develops faster then science for many reasons (tech needs less bulk of accumulated knowledge, is opened to innovations, creativity, etc, and most of all is not hindered by buraeucratic public investiments and the scientific method steps).
Compounded pharmacy (NOT recommended/licensed in UK) is becoming very popular because it is based on technology rather than science. Most countries cannot afford to test all available products and new ones keep coming every day. Add to that a massive marketing structure that rules the world now, then you have the perfect nightmare for TRUE scientists that want to study all possibilities but are tied by money/power interests.
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Patents = money/power. This is an interesting discussion and progesterone itself is a good example of how patenting natural substances can be done by sideways. Utrogestan and Prometrium are identical to the natural progesterone produced by humans, but they could be patented under the name "micronized progesterone" because they are processed in a formulation that can be delivered in small amounts (sustained release and increased half-life). The progesterone used in compounded products (NOT recommended/licensed in UK) is exactly the same molecule extracted from plants (soybeans and Mexican yam) but cannot be patented because it is natural and is not processed in a formulation that can be patented (yet, because this is only a matter of how much money/power and time you have to develop a new delivery route, such as a patch).
I would appreciate if all pharmaceuticals (big and small) were interested in developing a progesterone patch!
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Wonderful idea Menomale - perhaps you should look into it?
Mx
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I'm not sure how... ???
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Dangermouse - are you prescribed through Marion Gluck?
Mx
It's through Jan Toledano who now has her own practice but I did initially see her at Marion Gluck several years ago when she said she didn't think she could help me as I reacted so badly to the creams, so we assumed it wasn't my hormones. I returned to her as my symptoms had become stronger and more apparent (and clearly linked to my cycle) and she realised I'd been having migraines triggered by high oestrogen so now just on progesterone, which reacted badly to during first cycle but now doing great and best I've been in years these last few weeks! She's great as really tries to get to the bottom of your issue and doesn't just fob you off with the same as everyone else. I also couldn't afford to see her for follow up (and wanted to try the higher dose before reporting back) so I emailed her assistant and I only had to pay for the prescription.
My GPs have no issue with me using compounded products - they aren't against them, they just can't prescribe them because they can't be bulk made and affordable by the NHS and, as Menomale points out, patented. The BMA have no warnings about them (as far as I know) as they are the same ingredients in the stronger formulations of estradiol patches, gels and Utrogestan. I believe they differ in formulation in terms of the carrier, so the possible 'magic' ingredient that helps absorption, hence the pharmacy may have their own formulation they don't want others to copy!
If women do well with what they can get on prescription (as I'm sure many do) then yes always try those first of course. However, if another poster hadn't mentioned seeing Jan and doing well with the compounded HRT, I probably wouldn't have thought to give them another try so I'm very glad they were mentioned!
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That's really interesting dangermouse and also that you discovered it was prog you needed and not E. I'm sure that would've been difficult to uncover in conventional treatment. Great that it's working for you and you've found your solution. Hopefully one day that option will be available to more women.
Mx
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Well my GPs (I use the plural term as you tend to see one of about 20 each time!) did also pick up it was high oestrogen and said the HRT would probably make things worse - despite them not picking up the hormonal connection after visiting about 30 times over an intense period of symptoms!
I just read that article thanks Hurdity. I do understand how this site has to follow the medical model and NICE's apprehension with supplements so I think it's best if we view compounded BHRT as herbal. The same concerns of quality and interactions apply to herbs and so it's at the individual's risk to take them.
In order to convert the natural hormones into pharmaceuticals, a drug needs to be added (e.g. valerate) and then it can go through the drug testing process in order to guarantee its efficacy and safety, which is how BHRT is available via the NHS and private BMA docs (who also follow NICE's guidelines).
For those who would never take herbs or supplements then please do take note of this if you are considering compounded BHRT.
Hopefully those who do try it have proper docs prescribing it to ensure oestrogen is opposed with the correct dose of progesterone - which I agree is a concern if this isn't happening, although I haven't seen any options to purchase compounded oestrogen by non-BMA docs in the UK.
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Ok, whenever I type the word "compounded" I'll make sure to add in sequence "NOT recommended/licensed in UK" (thanks copy/paste inventor!!!) for the benefit of all ladies here who deserve the best information available. ;)
Haha! What a hoot! ;D.
Hurdity x
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Utrogestan and Prometrium are identical to the natural progesterone produced by humans, but they could be patented under the name "micronized progesterone" because they are processed in a formulation that can be delivered in small amounts (sustained release and increased half-life). The progesterone used in compounded products (NOT recommended/licensed in UK) is exactly the same molecule extracted from plants (soybeans and Mexican yam) but cannot be patented because it is natural and is not processed in a formulation that can be patented (yet, because this is only a matter of how much money/power and time you have to develop a new delivery route, such as a patch).
I would appreciate if all pharmaceuticals (big and small) were interested in developing a progesterone patch!
This is completely wrong! I can't believe that this misinformation is still out there on the internet! The progesterone that is used in all progesterone products whether micronised, compounded, commercial cream or whatever - is all exactly the same ie a compound that is biologically identical to the progesterone in our bodies!
All of it has to be synthesised/manufactured - or whatever term you like to use - in the lab or factory from the raw product - DIOSGENIN - which is extracted from soy and yam. The body cannot make progesterone, DHEA or anything of our steroid hormones from Diosgenin.
I tried to look into where all the pure progesterone came from that all the companies ( pharma, compounders, cream-makers etc) a while back but couldn't find the supply chain/manufacturing pathway and the companies responsible - but they will likely all get the raw material (pure progesterone) from the same sources - and the resulting product will have no trace of soy or yam. It is all "natural" (or not) depending on how you define this.
Progesterone cannot be made into a patch because it is extremely unstable which is why it has to be taken in very large amounts in the body. It is great that the micronising process was invented - thus opening up this treatments to thousands of other women :). As far as I know even dydrogesterone ( the progestogen in Femoston) can't be made in patch form for the same reason - but I might be wrong there....!
Hurdity x
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Well my GPs (I use the plural term as you tend to see one of about 20 each time!) did also pick up it was high oestrogen and said the HRT would probably make things worse - despite them not picking up the hormonal connection after visiting about 30 times over an intense period of symptoms!
I just read that article thanks Hurdity. I do understand how this site has to follow the medical model and NICE's apprehension with supplements so I think it's best if we view compounded BHRT as herbal. The same concerns of quality and interactions apply to herbs and so it's at the individual's risk to take them.
In order to convert the natural hormones into pharmaceuticals, a drug needs to be added (e.g. valerate) and then it can go through the drug testing process in order to guarantee its efficacy and safety, which is how BHRT is available via the NHS and private BMA docs (who also follow NICE's guidelines).
For those who would never take herbs or supplements then please do take note of this if you are considering compounded BHRT.
Hopefully those who do try it have proper docs prescribing it to ensure oestrogen is opposed with the correct dose of progesterone - which I agree is a concern if this isn't happening, although I haven't seen any options to purchase compounded oestrogen by non-BMA docs in the UK.
Thanks dangermouse - I think sometimes it's the trial and error and countless trips back to various GPs that leaves some women despondent. I just wonder if compounded BHRT might save some of the misery as it's more tailored to the individual.
Mx
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Utrogestan and Prometrium are identical to the natural progesterone produced by humans, but they could be patented under the name "micronized progesterone" because they are processed in a formulation that can be delivered in small amounts (sustained release and increased half-life). The progesterone used in compounded products (NOT recommended/licensed in UK) is exactly the same molecule extracted from plants (soybeans and Mexican yam) but cannot be patented because it is natural and is not processed in a formulation that can be patented (yet, because this is only a matter of how much money/power and time you have to develop a new delivery route, such as a patch).
I would appreciate if all pharmaceuticals (big and small) were interested in developing a progesterone patch!
This is completely wrong! I can't believe that this misinformation is still out there on the internet! The progesterone that is used in all progesterone products whether micronised, compounded, commercial cream or whatever - is all exactly the same ie a compound that is biologically identical to the progesterone in our bodies!
All of it has to be synthesised/manufactured - or whatever term you like to use - in the lab or factory from the raw product - DIOSGENIN - which is extracted from soy and yam. The body cannot make progesterone, DHEA or anything of our steroid hormones from Diosgenin.
I tried to look into where all the pure progesterone came from that all the companies ( pharma, compounders, cream-makers etc) a while back but couldn't find the supply chain/manufacturing pathway and the companies responsible - but they will likely all get the raw material (pure progesterone) from the same sources - and the resulting product will have no trace of soy or yam. It is all "natural" (or not) depending on how you define this.
Progesterone cannot be made into a patch because it is extremely unstable which is why it has to be taken in very large amounts in the body. It is great that the micronising process was invented - thus opening up this treatments to thousands of other women :). As far as I know even dydrogesterone ( the progestogen in Femoston) can't be made in patch form for the same reason - but I might be wrong there....!https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800604/
Hurdity x
I dont't know if you don't get what I'm saying because I'm not expressing myselft clearly or if there's any other reason.
When I say Utrogestan and Prometrium are identical to the natural progesterone we produce, what's wrong with that? I am saying exactly what you said, that they are all biologically identical, or isomolecular.
Nowhere in my post I said that they don't have to be manufactured...
When I said that the prog used in the creams is extracted from natural sources... maybe I forgot to put a comma after "exactly the same molecule, but extracted from plants..." meaning only that the sources are different but both (compounded or regulated) are the same molecule.
The process of micronization is patented, not the progesterone itself, what's wrong here?
I'm aware of the challenges to make a progesterone patch. You have to understand that this is just a matter of time, effort, research, money and interest. There is no such thing as "Progesterone cannot be made into a patch...." this is a line of research under development, it only depends on finding the right technology to achieve it.
I'm sorry if I don't express myself as clearly as you like but I'm not advocating anything here. I'm a biologist and know that all progesterone (molecule, not label) available on the market is processed in some way. There are very different produtcs available marketed as "progesterone creams" but only the ones that are graded USP and manufactered by established Compounding Pharmacies can be trusted to some extent, not the ones sold online that emphasize the natural, yam, soy, etc aspect in order to deceive people.
I sincerely hope that you can understand that I'm not saying that someone would benefit from compounded produtcs in any way. I also hope that you can understand that this is all about informed decision (what HRT do you want to put in your system) and there is only one way to be informed: discussing whatever information/technology/science/products are available to discuss. I have an open mind to discuss approaches that seem to work, despite no scientifc evidence is available, YET. It seems to me that this is the main difference in this discussion with you, you seem to be stuck on rules, guidelines and regulations (which I highly appreciate) but this field (menopause) is not so black and white as you put it. I know that many women come to this forum in emotional distress or don't have time to read or is not interested in reading the more technical info and you are concerned that they may read some posts and jump into conclusions. That is a possibility and it's a risk we have to address more frequently, but that is valid for every HRT regime that is discussed here, not only "compounded".
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Hello all, an observation - I think that when Hurdity sees "compounded" her picture is unregulated, small scale, dubious pharmacies who are trying to get your money and don't care about purity / consistency etc. When Menomale sees "compounded" she clearly is visualising a pretty professional organisation who are tailoring a specific solution to a specific patient. Also I think that we have got a bit heated....maybe there are different approaches /solutions in different countries, and just because some of those offering compounded hormones in UK are the lowest type doesn't mean all compounders are....
On the original topic, I think the explanation of receptors being activated on receipt of the "other" hormone is fascinating. I've only very recently realised (duh!) that the body can change one hormone into another if it has more need of that one.....
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Hello All and Happy new year.😁
Tempest well said!
I'm for some reason producing so much oestrogen and little or no progesterone and I can't shake off these awful symptoms.
I'm back to gynaecologist on 19th January for blood results and scan as she discovered I had a fibroid.
Menomale so good to see your name again😁😁😁😁hope you are well.
I hope the gynaecologist has some answers and solutions for me.
Hi Autumn16!
How are you doing? I hope yor blood results are ok!
xxx
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Hi Menomale
I saw the gynaecologist in January.
My scan results showed no fibroids!!
Gynaecologist was happy with bloods. She started me on evoril sequi so I'm in week 3 and progesterone patch on today!!
I had initial symptoms of surging with first patch but put that down to already having lots of oestrogen and just adding more so kept busy to distract myself.
I have had good days and days when just wanted to cry for no reason!!
A few aches in the hips the initial patch gave me a few headaches, I don't normally get headaches.
Waiting to see what the progesterone patch will bring, good or bad? With previously very low progesterone and high oestrogen I'm waiting to see if I'll feel any difference.
I keep telling myself I'm strong and I won't let this beat me or define me.
Every day is so different so for the moment trying to take each day as it comes.
I have been reading but not posting as wanted to give patches a chance to kick in.😁
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Good to know you're still around and no fibroids!! Oh, I used to be proud not having this extra weight but now I've got at least 3, but just 2 showed in last scan.
You're strong dear, and wise! It's early days and you'll be experiencing the roller coaster, but hopefully it will settle soon.
XXX
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Hi All
Just a quick update.
Put the progesterone patch of my evoril sequi on yesterday morning and by early evening I thought why do I feel different and then it dawned on me...I felt like my old self!! Dare I say normal. The foggy head, surging just disappeared.
I am one of those ladies that needs progesterone.
Hope everyone is doing ok
Xx
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That's good news, yes the feeling like yourself is such a relief I agree!
I was reading earlier that our progesterone in the follicular phase comes from the adrenal cortex (like men's progesterone) and perhaps it's why low levels allow more adrenaline in, as well as the unopposed oestrogen given free reign to upsurge.
Adrenaline surges are great when you need to run for your life, and I'll even accept them when I'm about to do something scary (as I can then control those levels with my rational thoughts - I'm a CBT therapist) BUT I DO NOT want to feel churning fear and intense nausea when I'm relaxing at home watching Coronation Street! It's really not that scary.