Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Peacegirl on June 25, 2017, 02:26:40 PM
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Hi I know this has been widely discussed but my searches haven't found a thread dedicated specifically to it. Does anyone know if there is one?
I'm 57 and post meno currently following a continuous regime but I wondered if there was any benefit health-wise to using it cyclically and having a bleed. Is the bleed beneficial - sorry to be ignorant on this but I've seen some on here refer to 'a good clear out' :) I worry slightly about getting very occasional spotting (which is very clotty and unpleasant looking discharge).
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What is 'v' exactly :-\
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What is 'v' exactly :-\
Sorry 'versus' I should have used 'or' though really.
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Really :-\.
Why would you want to have a bleed. Continuous progesterone means that the womb lining is kept thin so no need for a bleed. It's one of the few advantages of meno as far as I'm concerned.
I wouldn't go back to that for anything and I'm nearly 57.
I also found when I tried a cycle with Utrogestan that it gave me the worse cramp of my life. I had to wear pads which made me sore and I couldn't use a tampon as it was painful too. I'm on half of a continuous patch and that seems to work fine for me.
Have you had your bleeding checked out. Sorry if you have already said.
Mrs Brown
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Tnx for the explanation ......... ::)
What would suit you the best?
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Really :-\.
Why would you want to have a bleed. Continuous progesterone means that the womb lining is kept thin so no need for a bleed. It's one of the few advantages of meno as far as I'm concerned.
I wouldn't go back to that for anything and I'm nearly 57.
I also found when I tried a cycle with Utrogestan that it gave me the worse cramp of my life. I had to wear pads which made me sore and I couldn't use a tampon as it was painful too. I'm on half of a continuous patch and that seems to work fine for me.
Have you had your bleeding checked out. Sorry if you have already said.
Mrs Brown
Hi thanks, perhaps I should get it checked, I'm probably nervous because although I'm using the Utro continuously, I'm only using it every other day (100mg) which is still more than some of the women under prof studd. I cant tolerate more without feeling really ill. Im about to switch to provera and wondered what was best. I mean if I did have periods isn't that good because the lining is being cleared? I'm afraid I'm not that well-informed re how this works really.
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If your current regime 'works' why rock the boat :-\ ?
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If your current regime 'works' why rock the boat :-\ ?
Because of the concerns I've mentioned.
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It is how this particular HRT is designed. Maybe ask a Pharmacist in your area, most have private rooms for discussion. They have access to medications across the UK and can if necessary, check with the manufacturer regarding your concerns. Some ladies feel that a bleed means that internally everything is 'working normally' ........ clearing the womb as we are used to each month. Others are glad to see the back of any bleeding. Personal preference?
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The whole point of continuous progesterone is that the womb lining does not build up so there is no need for a "clear out" . Basically there is nothing there to clear.
When I switched from a sequi....had bleeds ....to a conti. ....no bleed. It took about six months to settle from bleeding to spotting to nothing.
If you haven't been on a conti prep for that long then it's perfectly normal to spot occasionally. However if you have been on a conti prep for a long while all spotting to be investigated.
Not sure if that's particularly clear.
Mrs Brown
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I am on a cyclical hrt with 100mg x 12 days and would hate to use it continously. The bleed doesnt bother me much its short and sweet. I am sure that you are getting blips because of your utrogestan being used only every 2nd day. But yes if you are on it continously, the lining stays thin, so there is essentially, nothing to be shed, that is the reasoning behind it, so its pretty much what floats your boat.... :-\
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The whole point of continuous progesterone is that the womb lining does not build up so there is no need for a "clear out" . Basically there is nothing there to clear.
When I switched from a sequi....had bleeds ....to a conti. ....no bleed. It took about six months to settle from bleeding to spotting to nothing.
If you haven't been on a conti prep for that long then it's perfectly normal to spot occasionally. However if you have been on a conti prep for a long while all spotting to be investigated.
Not sure if that's particularly clear.
Mrs Brown
Thanks that is clear and helps. I've been on continuous Over a year though only been on utrogestan 3 months. I did wonder if it's my alternate days use of utrogestan with the odd day when I forget 🙄. Also, only been doing estrogel for 3 months so I'm not sure my administration is as consistent as it could be I.e I've got very short legs and 2 pumps take a lot of rubbing in lol.
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I know that lots won't agree and that having a bleed suits those who are progesterone intolerant...but
If we were all going down the natural route then Mother Nature says...menopause and no more periods.
I know it's not as simple as that but as one who can tolerate progesterone on a continuous basis I don't miss having a period one little bit.
Different strokes...but for me at almost 57 it's the very last thing I want or need.
Mrs Brown
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Peacegirl, don't you get a coil,e of days on a bleed on the 3 days off the Utrogestan on continual? I did. It came on the second day and lasted for 2 days.
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Peacegirl, don't you get a coil,e of days on a bleed on the 3 days off the Utrogestan on continual? I did. It came on the second day and lasted for 2 days.
Hi, well as I take it alternate days, I don't have 3 days off as such.
Mrs brown I agree, and I can tolerate progesterone just not utrogestan in the dosage it's prescribed. I'm going to try provera at full dose and see my gp about the spotting just in case. (Unfortunately I seem to have become a bit of a hypochondriac🙄 During meno). Interesting that my specialist was adamant that I must not take less progesterone but when I said I had, she didn't ask me any health-check questions in case I had endometriosis symptoms.
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I prefer cyclical to mimic what the body does in its natural state as closely as possible. I would not use continuous HRT, just my opinion. To address the original posters question, the 'advantage' to cyclical is less exposure to progesterone (whether synthetic or natural), as progesterone causes untoward side effects for many women.
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I prefer cyclical to mimic what the body does in its natural state as closely as possible. I would not use continuous HRT, just my opinion. To address the original posters question, the 'advantage' to cyclical is less exposure to progesterone (whether synthetic or natural), as progesterone causes untoward side effects for many women.
Thanks TovahFell. What's confusing me is this: say I was getting some thickening of the womb lining (due to my reduced utrogestan use) and I stopped the utrogestan thereby inducing a bleed, would this not clear the thickening? I'm probably being really dumb here 🙄
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peacegirl, I've read before that estrogen is like fertlizer in the womb (growing lining) and progesterone is the lawn mower, cleaning it up. Because the estrogen part of HRT is continuous, the progesterone - once withdrawn, as in cyclic HRT - will shed whatever lining has built up. I can't speak to whether it would all be shed out, but a bleed should suffice I would think.
Do you have any reason to think you're lining is thickening? If you are on continuous HRT and still having some erratic spotting/bleeding it may be because you're skipping days of the Utrogestan. If you are only taking 100mg every other day, that might be why. It's probably best to take it every day, whether it's for the full month (continuous) or for a cyclic regimen where it might be 10-14 days/month.
One would probably only be concerned about over thickening if on high dose estradiol and very low dose progesterone. The progesterone dose level needs to be adequate for the level of estradiol being taken. Provided you are not on higher dose estradiol, you are probably fine. For instance, I'm on a 0.037 patch - quite low dose. I take progesteron (utrogestan) 10 days per month. I barely have any bleed. Mostly just some pinkish brown and very, very light. The estradiol is not enough to build up much of anything in my lining.
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Peacegirl, I wondered about that. Taking it for 10-14 days at 100mg and then not taking it for the rest of the month. I had no trouble with
norgestimate, drospirenone and gestedene, but i don't think they are available as hrt.
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if you take utrogestan at the recommended dose on a cyclical basis, it's 200mg for the 12-14 days.
If you take it on a continuous basis, it's 100mg for 25-28 days so it's roughly equivalent. This would be the same with other preparations- if you take it daily, it's a smaller dose spread over a longer period of time.
For those that are truly intolerant of progesterone, smaller amounts can be take under medical supervision for shorter periods of time. The risk of endometrial cancer increases so I'm not convinced that cyclical bleeding would insure against this happening thus the need for annual scans. You need to make your own mind up- there is a vocal school of thought that it's automatically ok to take smaller doses of progesterone as some eminent doctors say it's ok. It may be ok- it may not. The risk is yours and yours alone and even if I thought this regime was the best thing since sliced bread, I certainly wouldn't be advocating that it's the answer for everyone. Tovahfell is correct- too much oestrogen and too little progesterone is potentially an ill advised combination.
Maybe another progestin would work for you? I've tried utrogestan cyclically, sequentially, every alternate day - I've decided to come off as I'm not comfortable taking it for 7 days a month- I'll give it a go if I need to but the stuff makes me feel awful and I don't need the worry of having to go for annual scans.
You need to make your own mind up but please do seek medical opinion from a consultant if in doubt. X
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Not sure I agree with this
"I prefer cyclical to mimic what the body does in its natural state as closely as possible."
When we go through menopause then bleeds stop so how does replicating what our body does before meno become natural.
Sorry if I have miss read this.
Mrs Brown
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michelemabelle, great points. I feel the same way. The only reason I am/was comfortable taking it 10 days/mo is I'm on such a low-dose patch. You bring up great points. And trying another progestin might be the best idea. I've heard of some women not tolerating Utrogestan but tolerating a synthetic better. It's trial and error. Peacegirl, can't remember what you said you were on prior to the Utrogestan - was it a synthetic?
As for the progesterone itself, I feel the same way. Other than it helping greatly with sleep, I wish I never had to touch it. I would love to use a transdermal progesterone cream (compounded by a pharmacy) but they are not covered by insurance here in the U.S. and the potency cannot be guaranteed. More trouble than it's worth.
How have you been doing michelemabelle?
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No you didn't misread it. ;) Yes, of course meno means no bleeds but it also means severely reduced hormones which are the only reason we aren't still bleeding. If we're going to add back exogenous hormones, it seems it might be best to mimic what our bodies were doing prior to menopause - or at least some facsimile thereof. Our bodies would never be producing a steady state of progesterone all month long (nor of estradiol for that matter). It's all essentially a science experiment we are doing and one just has to be comfortable with the individual choices.
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Hi Tovahfell- I'm a bit up and down to be honest. Joint / muscle pains are back and so are night sweats but I feel more like me than I have in a long time , although I can barely remember what me feels like.I'm going to persevere and see how I get on. Damned if you do, damned if you don't!
I've previously tried 3 different HRT's all containing norethisterone- sent me loopy. The utrogestan/ estrogel combo gave me even worse side effects when I was on the utrogestan part but I didn't get on with the oestrogel either. I feel very strongly that if less progesterone is taken, it must be done under medical supervision and not based just on what you read on here and other people's experiences of what has worked for them. There is no right or wrong answers but overall I think we owe it to our fellow sisters to be as balanced as possible when voicing our opinions... :-X :-\
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I agree michelemabelle. I think it has to be whatever each person works out with their own doctor or provider. Some providers are fine with using a lower dose/less time, some are not. A great deal depends on how high the level of estradiol is that one is using. I was not suggesting that someone should use less. Only speaking regarding my own personal experiences/thoughts. I think the caveat is always (or should be) understood that we each have to work with our provider on determining what is best for each of us. We can only speak to our own experiences with our providers. I find it incredibly helpful hearing about so many varied experiences that others have.
There are different regimens for different levels of HRT, for sure. My first go around with HRT my provider was fine with me using the progesterone 10 days/month and had experienced no negatives with his patients on this routine. But he also prescribes mostly low dose. Definitely no right or wrong. :) It may be different depending on where you live (what country) but in the U.S. continuous is not necessarily the 'standard'. Most practitioners are pretty flexible and it can be cont/sequential depending on the individual patient, their circumstances, and the practitioner.
I'm sorry your pains and flashes are back. :( I have them too. I try to just get on with my day and make the best of it and I find keeping busy and occupied (don't have much choice with my job! LOL!) to be a good distraction and a good way of refocusing my mind. I hope you continue on and things start to level out. Good that you are feeling more like yourself though! :sunny:
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Thank you- hope you get to feel better soon x
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:foryou: :thankyou:
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peacegirl, I've read before that estrogen is like fertlizer in the womb (growing lining) and progesterone is the lawn mower, cleaning it up. Because the estrogen part of HRT is continuous, the progesterone - once withdrawn, as in cyclic HRT - will shed whatever lining has built up. I can't speak to whether it would all be shed out, but a bleed should suffice I would think.
Do you have any reason to think you're lining is thickening? If you are on continuous HRT and still having some erratic spotting/bleeding it may be because you're skipping days of the Utrogestan. If you are only taking 100mg every other day, that might be why. It's probably best to take it every day, whether it's for the full month (continuous) or for a cyclic regimen where it might be 10-14 days/month.
One would probably only be concerned about over thickening if on high dose estradiol and very low dose progesterone. The progesterone dose level needs to be adequate for the level of estradiol being taken. Provided you are not on higher dose estradiol, you are probably fine. For instance, I'm on a 0.037 patch - quite low dose. I take progesteron (utrogestan) 10 days per month. I barely have any bleed. Mostly just some pinkish brown and very, very light. The estradiol is not enough to build up much of anything in my lining.
Thanks tovahfell. I tried taking utrogestan every day but felt wretched, couldn't speak to anyone about it until my next appointment so weighed up lots of pros and cons and decided to try alternate days. If I'd listened to so-called experts I wouldn't be on hrt at all, so for me it's now a weighing up of all the information. I.e others experiences, (which like you I think are really valuable) my experience, research papers and 'experts' and balancing thst with quality of life which has mostly been so poor these last two years I'd almost risk anything to have it better. I just picked up a provera prescription, so fingers x'd 🤞🏼 Hope you get some relief soon too. I had to give up my super-amazing demanding job but it is what it is. We have to play the hand were dealt to some extent. Sounds like that what you're doing! 👍🏼
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No you didn't misread it. ;) Yes, of course meno means no bleeds but it also means severely reduced hormones which are the only reason we aren't still bleeding. If we're going to add back exogenous hormones, it seems it might be best to mimic what our bodies were doing prior to menopause - or at least some facsimile thereof. Our bodies would never be producing a steady state of progesterone all month long (nor of estradiol for that matter). It's all essentially a science experiment we are doing and one just has to be comfortable with the individual choices.
Very good and useful points.
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peacegirl, you're right, we have to do whatever is necessary to feel better and have quality of life! I'm sorry you had to give up your job. I feel horribly that it has been that bad for you to reach that point. :( (hug) I hope that you find the Provera works for you. Fingers crossed for you!
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peacegirl, you're right, we have to do whatever is necessary to feel better and have quality of life! I'm sorry you had to give up your job. I feel horribly that it has been that bad for you to reach that point. :( (hug) I hope that you find the Provera works for you. Fingers crossed for you!
It's fine, I'm 57 and whilst some women (my tennis playing, charity volunteering et etc 80 year old ma-in-law) power through into their older years, I'm clearly aging less gracefully! Mindfulness helps me have a little acceptance of how things are, mixed with a bit of striving to improve things. I've got a p.t easy job which I can just about manage (money and energy-wise). Really hope you get some relief too, I am lucky enough to have better days/periods of time, hope you do too x
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I am on Estradot 50mcg patch, 2x week vagifem and 100mg progesterone vaginally on alternative days with no spotting. I have yearly scans and so far so good.
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Hi shortie- interesting points. I'm slim ( not as much as I was though )
Another friend who's also slim has had problems and some of my more well upholstered friends haven't had any issues. Probably a total coincidence! X
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I am on Estradot 50mcg patch, 2x week vagifem and 100mg progesterone vaginally on alternative days with no spotting. I have yearly scans and so far so good.
This was my plan except severe hair loss has started up again so having to switch from utrogestan which is a real shame. Is the Estradot daily?
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Actually, this has reminded me of something I read at least a year ago that said it wasn't good to be thin going into menopause. I wasn't having any symptoms then and i totally dismissed it
I'm slim. Although I've put some weight on over the last year. I'm fighting with the he Utrogestan some don't out more on m
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I'm 5'5" and 8.5 stone, I had loads of horrid symptoms and am on patches...my plumper friends/ sisters are fine...my skinny best friend is on hrt! Mmmm interesting! 🤔 Off to eat junk 😂
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That's interesting, I think a few petite women on here have similar symptoms to me. I'm 5 ft 2 and a shade under 8 stone - wouldn't mind putting on a wee bit of weight if it wasn't for the fact that it only goes on my waistline and stomach and is really uncomfortable.
From my non scientific point of view, larger women my age seem to sweat more, especially on their faces - not sure if it hot flushes or simple exertion from being larger though.
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Think I'll start another thread on this as it's unfair to hijack Peacegirl's thread. I'm really interested in views from women with different cultural backgrounds too as I know Japanese women have very easy meno (generally) because their diet is so high in soy.
Sx
Though I have read that they have the same problems, but don't tend to pathologize menopause because of Japan's completely different attitude to the ageing process. So much research could be done on the menopause!
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Think I'll start another thread on this as it's unfair to hijack Peacegirl's thread. I'm really interested in views from women with different cultural backgrounds too as I know Japanese women have very easy meno (generally) because their diet is so high in soy.
Sx
Awwww, I really don't mind - it's been so interesting and I've had more than what I need from my original query. OTOH it's definitely worthy of a thread of its own as well :) :)
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I always find it strange about the Japanese women as their diet is so high in salt. I wonder if it's genetic? Like sickle cell developed to protect against cerebral malaria. Maybe climate? I've friends who said they don't get the hot flashes when they are in a hot country. All interesting suff :)
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Very interesting thread.
The extent to which progesterone and the synthetic counterparts keep the lining thin is dose and duration dependent (this was re-iterated in a paper I was looking at this morning) and dependent also on the dose of oestrogen, as stated by several posters early on in this thread.
Gynaes are split on whether continuous or cyclical HRT is best. There is definitely an increased risk of endometrial hyperplasia and also cancer (even though the absolute risk is small) on cyclical vs continuous regimes so some gynaes prefer this, especially as the casual relationship is pretty well established (even though there are other factors involved in endometrial cancer). However there is also evidence that the risk of breast cancer (where the causal relationship has not been established and where there is still controversy) is increased through the use of progestogens and therefore some gynaes prefer to advise their patients to keep this to a minimum - in which case cyclical progestogens would be preferred. This is aside from progesterone intolerance where cyclical regimes would naturally be favoured.
I totally agree with Tovahfell's point about adding exogenous hormones. Anyone who takes HRT is going against "nature" and therefore we need to choose whatever is best for us and weighing up all the other risks. I would HATE to take progesterone all the time and a bleed is infinitely preferable ( while on a longer cycle anyway)! Also those who prefer the bio-identical route like myself - means taking utrogestan - which may be associated with some side effects due to the large doses needed when taking it externally (as it is unstable in the blood stream) compared to ovarian production.
Peacegirl - I think others have already said that if you are spotting it means the balance is wrong and the progesterone may not be keeping the lining thin. Noone should ever assume that if you bleed this is a good thing. The only normal bleeding is progesterone withdrawal bleeding - but bleeding can be due to other issues such as an over-thickened lining ( oestrogen breakthrough bleeding) - which is very common leading up to menopause.
The clear-out you have read about - I have posted about this. My GP suggested I took a course of norethisterone once a year in order to ensure the womb lining was completely shed - as she has approved my long cycle HRT and couldn't be sure that this would be sufficient to keep the lining thin.
In combi HRT types like patches - there is no way of adjusting the ratio of progestogen to oestrogen so although it is theoretically designed to keep the lining thin without a bleed ( after the initial settling in period of time) it doesn't always work like this so some women do still bleed and have an unstable endometrium on a conti regime.
I think I've rambled on a bit but hope I have added something useful that hasn't already been said!
Hurdity x
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Peacegirl, I found I had as many side effects taking the Utrogestan every other day as every day. It didn't seem to make a differnce for me. But my hair and skin are better when I take it every day.
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Hello,
I'm a new member but have been reading your forum for the past 6 weeks since starting my Bio hormones.
First I am really impressed by the forum.
There are so many threads which I want to add to but feel I am a bit of a hormone virgin, so am worried that my tuppence worth is not of much value.....here goes anyway.
I'm 50 and had my last, longest period of my life in January. I had been reading about Bio-identical hormones for nearly 8 years. I wanted to go down this route but up until now have only dabbled with progesterone cream. I realise from reading this forum that the term bio is a bit American but what I didn't realise was these are available on the NHS.
Since January my hormones hit rock bottom and my anxiety levels hit the roof. I was annoyed with myself for not starting bio-hormones earlier. I had seen a gynae privately about my bleed but he told me nobody could prescribe me bio hormones in Scotland!
I contacted a private doctor specialising in this in London.
I was prescribed 1 pump of Estrogel in morning and one at night. I pump of testosterone in morning and 1 dhea (10mg). I asked to go down the cyclical static dosing. My doctor asked my why would I want this when surely the benefit of menopause is no bleed. For me having a monthly bleed and determining the length and heaviness of the bleed helps me determine where my hormones are at and personally I feel is normal or natural for me.
I understand that this is not everyone's choice.
I take Utrogestan on days 21-28 at 200mg dose. I'm not sure why it's the 8 days and not the 10 days that seems to normal (I will be asking on next appointment). I started my hormone replacement on what I decided was mid-cycle as due to mucus and other symptoms I felt I had estrogen that month. My doctor ok'd this agreeing I probably knew my body. So 8 days later I started my Utro at night.
First morning after I could hardly focus my eyes. Next night I took earlier and was so dizzy. Doc said I could lower dose to 100mg but wanted the progesterone protection and bleed so continued. The progesterone didn't help me sleep better in fact in made me very sweaty and anxious when waking. As I was waking I started taking one dose at 10pm then one dose about 1am (on waking). This stopped the dizzy head and spaced out feeling the next day.......................but I think the anxiety is definitely an issue.
I have now just finished my second cycle (just realised I've been incredibly anxious on the utro) and am starting my 2nd bleed.
It's reassuring to me to have my cycle and it feels natural - clearly the anxiety isn't and I need some tweeking.
I do feel that this month I have been a little bit estrogen low and can feel this in my less full breasts. (last month freaked me out how full my breast became and how tender that I went for half a dose some mornings.
I really like the cyclical static route but would prefer the Rythmical Route (TS Wiley). My doctor says she's not keen on this and will discuss in more detail next time after monitoring my hormone levels.
Does anyone have any experience of the Rythmical Route (not a static dose but a varied one depending on day of cycle)???
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1 pump is low I am on that and only use 100mg for 10 days a mth, you may find less symptoms using 100mg I couldnt cope with the 200mg made me feel awful. You would need to try and have a scan of your uterus perhaps annually to see if it is doing its job but on that low dose of gel it should be 100%
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Hello life at fifty- :welcomemm:
There's a few of us on here who are in Scotland and quite a few Scottish specialists too.
I've never heard of the Rhythmical route - apart from increasing/ decreasing the amount of oestrogel depending on symptoms. How would you know how much oestrogen and progesterone to take each day and at what time?
Are you taking the utrogestan vaginally?
I've had a similar treatment regime, but bio identical or not, the utrogestan hasn't worked for me. I'm intolerant to any sort of progesterone but there are lots of ladies on here who swear by it and taking it longer cycle, under medical supervision or at a lower dose seems to work for them. You'll just need to see how you go with it. Anxiety is difficult to treat with HRT- in fact, it can make it worse.
Keep ousting and let us know how you get on x
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Hi lifeatfifty
:welcomemm: from me too.
At you stage in menopause you should still be on a cycle anyway as you are still peri-menopausal - continuous combined no-bleed regimes are only recommended for women who are post-menopause ie without a natural bleed for 12 months. Many of us continue with a cycle for the same reason - it doesn't feel "natural" to take progesterone all the time for years on end and certainly does not occur in nature ( pregnancy only lasts for 9 months!). Also the side effects either form large doses of progesterone or the synthetic progestogens are not tolerable for some women.
Some HRT preparations are cyclical as is one of the CCP types that is similar to HRT. Trisequens has two different oestrogen strengths and QLAIRA ( CCP) has 2 different doses of estradiol during the 28 days. However if you are still having some sort of cycle then this will add to the mix so trying a regime with different oestrogen doses is less if an issue since you will be cycling anyway? Some women also take a higher dose of oestrogen when on the progestogen phase of their cycle - but again this should be under supervision to ensure the prog dose is sufficient to protect the lining.
Also HRT is designed to prevent the oestrogen dip that occurs at the end of the cycle so avoiding the worst of pms - surely the rhythmical method isn't designed to do this? As has been said you can get bio-identical hormones on NHS and the problem is that of misunderstanding the terminology. Estradiol and progesterone are the hormones available - estradiol as tablet, patch or gel , and progesterone in micronised form as utrogestan,. No need to see a private consultant. Yes the recommended minimum for progesterone is 10 days although some private gynaes prescribe less for progesterone intolerant women but must be done under medical supervision as you are doing. Many of us prefer to use the vaginal route for progesterone - as this avoids the liver and the dizziness/tiredness is lessened. Exactly the same capsule is used - but this is off licence too, although demonstrated to be at least as effective (if not more so) than the oral route.
What testosterone are you using? If it's Tostran then 1 pump daily may be too high, I would suggest. Also what type of gel?
Hurdity x
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Thanks as always Hardily - lots more helpful info for me to chew on :)
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Hi Ladies,
sorry I've been offline.
Thank you all for your welcome and response.
Shortie - here's a link to the Wiley Protocol http://www.thewileyprotocol.com/about/
Basically your estrogen is increasing over the first half of the cycle with it peaking, as it would in nature, at midcycle. You are given tailored
doses to take on each day and if you don't know when your last cycle was you follow the cycle of the moon!
I did ask my doc about this and she said she wasn't keen as the levels of estrogen taken at mid-cycle are huge (exactly as a 20 year old girl
would).
I have read many interesting reviews with woman saying how fit they felt. The premise is that you need the peaks and troughs to turn on the
estrogen and progest receptors in the brain to trick it into remaining in homeostasis and the body healthy.
Cassie - I'm on 2 pumps daily (1 in morning and 1 at night)
Michelmabelle - Nice to know that the scots are here. So many of my friends have been struggling with prescriptions for hrt. Many just offered the
one tablet fits all for or the mirena coil!
I'm not taking the progest vaginally but have ask to try this - I will update my changes at the end of this post.
Hurdity - Thank you for all the info. I've read many of your posts and they are always so informative - are you medical?
My bloods taken by local gyne stated I was postmenopausal - but then that's only a snap shot in time and not over my cycle.
The Testosterone I take is a compounded cream. Each pump provides 0.75mg of Testosterone.
I have been on my hormones for 7 weeks now.
I definitely feel that every second month I am definitely producing my own estrogen but not so much on alternate months. This month my estro was low and I had a very light bleed.
Although hot flushes have gone I'm still not sleeping well and sweating at night.
I am due to have hormone blood profile taken on day 21/22 of this cycle and then we will alter and fine tune again.
At the moment I am to swap to the vaginal Utrogestan. I did ask if I could just use the oral stuff but was told it wasn't licenced for that. Although I haven't received it yet. I am also to add some progesterone gel to my daily routine to see if it helps with sleep and sweats?
Also recommended some 5HTP for the anxiety.
It really is a minefield out there and although I feel I've asked all the questions I'm always then left a little confused as more questions dawn on me latter.
Thank you all again.
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Hello life at fifty- the bio identical hormones are readily available on the NHS ( oestrogel or equivalent and utrogestan) -they're not normally the first choice of most GPs - not sure if this is down to lack of knowledge or cost? Might be both.
If your friends struggle they could go back and ask to change. Many of the tablet formulations have bio identical oestrogen but many contain a synthetic progesterone, norethisterone which can cause problems. There is another formulation Femeston which contains a synthetic progesterone and this sometimes can be better tolerated if they don't fancy the idea of a Mirena.
Hope you find a regime that suits- hang on in there for a bit longer. And taking it vaginally is ok. It's licensed for IVF treatment vaginally but not for HRT although most consultants are happy for you to just shove it up there!
Let us know how you get on x
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Thanks again michelemabelle
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Hi Lifeatfifty, what is the progesterone gel you refer to? A it the Crinone gel? Ive been reading some posts that it is better tolerated, but I think hard to get it prescribed. I'm struggling with the depressive effects of the Utrogestan, but want to complete a month so that I've given it a fair go
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Katia, I've wanted to ask about using Crinone gel. It comes as 45 mg and 90mg. I believe the 45 mg would be used in HRT. Unfortunately, at least here in the U.S. it is not approved for use in HRT so I think insurance will not cover it and it can get quite expensive. Why it is not approved, I have no idea. Doesn't make any sense to me!
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Katia & Weathergirl.
I haven't received the prescription yet so not sure what the progesterone cream/gel is yet, but will update once I do.
I have used Progesterone cream in the past which was prescribed by a homeopath. Then the pharmacy stopped supply so she recommended Source Naturals which had the same %progest and was available on the internet - this is an American brand.
I used this for a number of years in my mid 40's in the second half of my cycle. I actually found this was very helpful with stress incontinence after I ovulated!
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Lifeafterfifty, did the gel come from the GP/gynae or is it from a health shop? I wondered about putting a Utrogestan into some cream and using it that way to see if it had less side effects, but I imagine it would be unclear if it would absorb, or how much of it absorbed.
Weathergirl, I believe it's not licenced for use in the UK for HRT either. There is a thread on it where some ladies get it off licence. I'm looking to move back to the states. you may have more progesterone choices than in the UK.
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I came across a link in a thread yesterday which is about varying the dose of estrogen and progesterone not in accordance with how your cycle would naturally be. I can't for the life of me find the thread now, but it seemed an interesting idea.
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It's earlier on in this actual thread Katia - at the beginning of the lengthy post (4th July) from lifeatfifty. This is part you are looking for:
"Shortie - here's a link to the Wiley Protocol http://www.thewileyprotocol.com/about/
Basically your estrogen is increasing over the first half of the cycle with it peaking, as it would in nature, at midcycle. You are given tailored
doses to take on each day and if you don't know when your last cycle was you follow the cycle of the moon!
I did ask my doc about this and she said she wasn't keen as the levels of estrogen taken at mid-cycle are huge (exactly as a 20 year old girl
would).
I have read many interesting reviews with woman saying how fit they felt. The premise is that you need the peaks and troughs to turn on the
estrogen and progest receptors in the brain to trick it into remaining in homeostasis and the body healthy."
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Hi Katia,
my cream was prescribed by a homeopath who was also a registered GP.
As mentioned there are creams available. Have a look at https://www.johnleemd.com/ who pioneered low dose progesterone in a bio-identical form.
However many "Uzzi Reiss" and many other 'experts' feel low dose is not enough...................so like everything there are complicating views.
I have used this in the past https://www.healthmonthly.co.uk/source_naturals_natural_progesterone_cream.
Hope that answers?
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Lifeafterfifty, did the gel come from the GP/gynae or is it from a health shop? I wondered about putting a Utrogestan into some cream and using it that way to see if it had less side effects, but I imagine it would be unclear if it would absorb, or how much of it absorbed.
Weathergirl, I believe it's not licenced for use in the UK for HRT either. There is a thread on it where some ladies get it off licence. I'm looking to move back to the states. you may have more progesterone choices than in the UK.
Katia - I sympathise with your struggles with utrogestan ( I am feeling very tired this cycle - I'm on Day 6 now) please do not put your Utrogestan into a cream because you're right - it will probably not protect your womb when used like this! Even progesterone creams from compounding pharmacies (as mainly in US) are not standardised nor consistent enough for this purpose.
Hurdity x
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It's a bummer that the OTC progesterone creams (Pro Gest, Smokey Mountain Naturals, Life Flo, etc) do not provide enough protection for those on exogenous estradiol via HRT. :(
In the US there are compounded hormone creams but they're expensive, not covered by insurance, and potency unfortunately cannot be guaranteed, even though there are some very reputable compounding pharmacies that have been trusted by patients for years.
If I were using compounded formulations, I would insist on regular uterine scans for testing as well as full hormone level testing. On top of that, the potency can vary from batch to batch as it is compounded in smaller batches. My doctor, who is generally, very open to most suggestions, does not advocate the use of any compounded hormones (at least in the U.S.) as they are not regulated and do not go through rigorous, strict testing. I queried a compounding pharmacy on this and they told me that they do not even submit all batches for testing. They are only required (at least in the state where I live) to submit a given batch quarterly, or thereabouts, for testing. It just did not sound regulated or controlled enough to allow confidence.
Hurdity, I'm on day 10 of my Utrogestan and am tired, sluggish and my digestion seems to come to a crawl....ugh. Will be so glad to be done with this cycle!! You have my full sympathies!
Katia, hmmmmm.....there are no more options for gestagens here in the US than anywhere else, at least I don't think so. We have natural progesterone (Utrogestan), the IUD (Mirena, etc), Provera (and mini pill), etc. I'm not aware of better or more superior solutions here than what you have in the UK......