Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Donna-paul on December 19, 2017, 04:01:29 PM
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I'm new to this hrt. Just want to know when they say increase oestrogen to 2 pumps do you do it morn then even. Also when is it the best time to take progestrone ? At present I take one pump oestrogen in even and progerstrone in the morn. Also do the headaches get better and fluid rentention.
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You can use 2 pumps of gel at the same time - one pump on each thigh. Some ladies like to split the doses to morning and evening - it's what you find most convenient. Which progesterone are you on ? If it's Utrogestan then this needs to be taken before bed but any other progesterone can be taken at any time in the day. DG x
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I do 2.5 pumps each morning on the same thigh, alternating each morning x
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I am on three pumps a day, I use two and night and one late morning.
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You can use 2 pumps of gel at the same time - one pump on each thigh. Some ladies like to split the doses to morning and evening - it's what you find most convenient. Which progesterone are you on ? If it's Utrogestan then this needs to be taken before bed but any other progesterone can be taken at any time in the day. DG x
I'm taking utovlan 5mg (norethisterone) but to be honest I feel so ill I feel like giving up on hrt. The consultant wanted me to take for 3 weeks then 1 week break I've only been taking a week. I've got awful stomach cramps and upset stomach pmt symptoms and the aniexty coming back which was better on Oestrogen and tearful again. I've been trying to take hrt since Aug! Don't know what to do?
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You need to try a different progesterone - do look under TREATMENTS on this site and print things off to show the doctor. Perhaps try Utrogestan (micronised progesterone) or Provera (medroxyprogesterone), as both these are kinder and less likely to give PMT type symptoms. I would also stick to a sequential regime - so take progesterone for just 10-12 days each month and, though this would mean you have a bleed each month, you might well get fewer side effects. I would also stick to 2 pumps of Oestrogel per day for the time being unless the flushes are still bad. DG x
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Thanx for that advice I will have to try something else as feel awful today! I will have to have a word with the gynaecologist in the new year I will print of the two you mentioned.
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Also - why are you taking so much norethisterone and are you seeing someone privately? This is not the usual treatment for HRT ie norethisterone and nor is taking it for 3 weeks (I presume your consultant meant to take the norethisterone for 3 weeks and the oestrogen all the time?). Do you have fibroids, heavy bleeding, thickened womb lining or something like that meaning you need to take a high dose progestogen, or maybe endometriosis? Also can you remind us where you are in menopause ie what your periods were doing, cycle length etc before you started hRT (which I presume you've only just started?).
The usual dose of noresthisterone for cyclical HRT is 1 mg per day for 12 days in a combi preparation. Taken at this much lower dose you might actually be able to tolerate it! Have a look at the Treatments as Dancinggirl suggested and you will see them all listed and the doses!
Please do not give up on HRT - it's no wonder you are feeling rough on this regime. You will find a better product and dose certainly!
Hurdity x
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I was allergic to Femoston and Elleste so my gp didn't know what to prescribe. I had to pay private as my local hospital could not give me an appointment for menopause specialist. The consultant I saw was very nice and I saw him 19 years ago for pmt clinic. As I use to get migraine type headaches when I was on the pill the week you have free he thought it was a good idea to take progestrone for 3 weeks he really wanted me to have the Mirena Coil but I'm reluctant as I might react badly. I'm 50 and haven't had a proper period all year just spotting ,in aug I had a lot of family stress and it put me in a hormonal melt down. I've got such awful stomach pain and cramps I think I will stop after 5 more days and half the dose until i can speak to my gp he's very understanding but not knowledgeable. I will continue with the oestrogen and try to up to 2 pumps.
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Donna-paul - the Mirena may be a good idea. If you haven't been at least a year without any bleeding or spotting then a conti HRT regime won't be suitable really. You are on a progesterone that is more likely to give PMT!! Taken for so long it could be making you feel awful.
The you say you had a allergic reaction to Femoston and Elleste - what sort of reaction did you get? Your doctor has put you on the same progesterone as in Elleste!!???
Headaches are common when peri meno hits and are common when using many progesterones! Teh Mirena delivers teh progesterone more locally to where it is needed, so often brings fewer side effects after the initial settling time of 4-12 weeks. DG x
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Thanx for all the advice. I came out with a painful eczema rash on both tablets the consultant thinks it what's in the tablets and I think he's right. So far on oestrogel ok! I've never got as far as the progestrone in the tablets as I got the allergic reaction. I've been on northestrone 8 days and I feel awful physically and emotionally. The hot flushes and sweats and awful aniexty has come back which makes me realise how much better I was on oestrogel and was only taking 1 pump. I know you have to take some form of progestrone am I right in saying the minimum is 12 days of least 1mg. Just got to get through Christmas as best as I can and re look at it all in the new year.
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10-12 days of progesterone is the recommend dose for most progesterones but, if under a private gynae and getting regular scans, a lesser dose can be tried. I still think you are reacting to this particularly progesterone. Do try Provera or Utrogestan as I suggested in my previous post.
I am loath to give this advice about how to use progesterone but as you have only been using one pump of Oetrogel until recently, 10 days of the progesterone may be enough this month and you will then get a bleed to shed the womb lining. When I did one pump of Oestrogel daily and used the progesterone (Dydrogesterone) sequentially to shed the womb, I only ever had 10 days of this progesterone - I did this regime for several years. Try to see your gynae early in January to change the progesterone. I certainly wouldn't do a continuous regime (which means taking progesterone all the time or most of the month). By using a sequi HRT regime, you can tell whether the progesterone suits you or not but for some there will always be compromises with any progesterone. DG x
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Just question I've half the progestrone and going to stop after Xmas day will be 13days. When do I start taking again? I've tried to do 2 pumps of oestrogen and I've got awful fluid rentention and swollen bust and feel so emotional. I think for now I stick to 1 and 1 and half and speak to my gp in new year.
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Donna-Paul - stick with one pump of the gel per day - I wouldn't increase until things have really settled. Don't half the dose of progesterone as it's important to take the whole pill for at least 10 days each month. You should get a bleed a day or two after finishing the progesterone if the womb lining has built up enough ( this could be a very light bleed, if at all) but you can continue to use the Oestrogel on it's own. If you see your gynae in the first couple of weeks of January and get a different progesterone, you won't need to start this progesterone again for 2-3 weeks if you are going to do a sequential regime - you need to discuss things with you gynae so you fully understand how a regime works. I got a rash with Utrogestan, so I would suggest you try Provera(medroxyprogesterone). DG x
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I thought as 5ml was high I would half it after 8 days. I think the gynecologist thought I would get less pmt symptoms if I took for 3 weeks. But I definetly feel worse on progestrone. I aren't do see the consultant until 3 months as it's so costly private!
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If you half the progesterone dose then there is a good chance the womb lining will build up and this could result in Erratic or problematic bleeding. It would be better to take the full dose for 10-12 days each month until you see the Gynae.
I think the standard dose of Norithisterone is 10mg for 10-12'days. The 5mg dose is for continuous HRT, so should be taken every day alongside the Oestrogel - 5 mg is the low dose not a high dose. DG x
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I'm confused as someone on here said 5mg was to high and that was why I was feeling awful. When I looked at the tablets it says 1mg northestrone now I don't know?
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Sorry - I have confused things for you. IF you are on 1mg of Norethisterone daily then that is the normal dose. 5mcg would be a half dose I think and would be too low with either a conti or sequi regimes. Essentially, take the daily dose you have been prescribed but for just 12 days and then stop - continue with the Oestrogel on it's own for the next 2-3 weeks and then add in 10-12 days of the Norethesterone again. You may well get a few days of withdrawal bleed after finishing the progesterone phase. You can do this sequential regime till you next see your gynae to discuss trying a different progesterone.
Doing this will allow your body to adjust to the oestrogen and will also allow you to see whether it's the progesterone making you feel awful or whether you just feel awful on any hormones.
From what you have been telling us - you should be able to take your last progesterone tablet either today or tomorrow and then have 2-3 weeks with no progesterone. I suspect you may find you feel better when you are just on one pump of Oestrogel per day. DG x
Hope that helps. Do make an appointment with you gynae as soon as possible to discuss further.
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Hi Donna - Paul
Northisterone is the strongest progesterone. I used 3 pumps of gel per day and 2.5 northisterone 7 days every 5 weeks. Worked fine for me, had a good bleed no build up.
Wx
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It's 5mg I'm taking I've started spotting today. I definitely feel worse since starting progestrone got all the worse symptoms . Tearful and skin and hair iffy and aniexty coming back which went just on oestrogen. I will stop progestrone after Xmas day and get advice in new year. I wondering if it was only 1mg I might have tolerated it better?
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1mg Norethesterone would be far too low a dose to be effective. A different type of progesterone might suit you better eg Provera. Stick with the dose you have been prescribed. If you have started spotting this may be because you took half a dose for a few days. If you have done 12 days of progesterone, then simply stop, have a proper bleed and then start the progesterone again in 2-3 weeks. On a sequi regime you should really use 10mg Norithesterone for 12 days each month, so you are already in a half dose. DG x
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I'm really confused now having conflicting advice from 2 different people don't know what to think. I will have to talk to my gp and gynecolgist in the new year. All I wanted to know his what's the minimum norethisterone I can take and shortest time I've been given different advice!
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Donna-paul, when I was struggling badly with norethisterone, I was told I could take 2.5mg for 7 days and it worked very well for me, I got a very heavy bleed and good clearance. It is a very strong and effective form of progesterone. One month, I took just one 5mg tablet and had to give up because of a really bad migraine and I still had a heavy bleed.
I think you need a review and to consider changing to a different progesterone.
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Donna-Paul - I am really sorry that we are confusing you - I have made a mistake. I do get mixed up about the different doses and the difference between mg and mcg etc. I had mixed up the different progesterones - it's Dydrogesterone that is meant to be 10 mg per day.
Do look under TREATMENTS on this site:https://www.menopausematters.co.uk/perimeno.php.
I am baffled as to why you have been given such a high dose of Norethisterone - is it really 5mg per day? Your gynae should have known that this progesterone is more likely to cause problems!!!!
1mg Norethisterone seems to be the standard dose per day for both sequential and conti HRT and as this is the most powerful type of progesterone and is also the most likely to give PMT type symptoms.!!! If you look at most of the combined sequential HRT types, 12-14 days of progesterone are the standard amount of days needed for a sequential regime.
I still think you need a different progesterone. Here is the page on this site that shows alternative progesterones you could try:
https://www.menopausematters.co.uk/to_progestogens.php
Sorry again for the confusion. DG x
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Just couple of question wonder if anyone can answer. My Gp said I've got to take either 5mg norethisterone for 7 days or 2.5 for 12 days. I'm really struggling with it took it for 10 days and awful stomach cramps and pmt symptoms I notice a couple of you replied and said you only take 2.5 for 7 days is this enough? Also when you take last progestrone what's the minimum amount of days can you have free before you have to take again. This is all new to me so want to try and persevere and get it the best I can tolerate. Also when I picked the second lot of estrogel up it's different and called oestrodose does it make a difference.