Menopause Matters Forum
General Discussion => New Members => Topic started by: Rosie63 on February 27, 2018, 10:26:50 AM
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Hi everyone. Although I have read many posts on this forum over the last couple of months, I've only just registered to be able to post. I'm hoping that you will be able to give me some advice before I see my consultant again tomorrow.
I'll try to keep my background brief ! I'm now 63 years old and up to about 6 months ago, I had been on Prempak C since I was about 50. As you probably know, Prempak has been discontinued and I've been seeing a gynaecologist consultant over the last 4 months to try to find something else that suits me. To date I've tried Femoston lowest dose, Everol Conti patches, Tibolone and Elleste Conti duet 2mg. The only one that seems to help with low mood and muscle and joint pains is the Elleste but the downside of these is the stomach pain and discomfort I'm now suffering. It's kind of a cross between period pain in lower stomach and back and wind ( hope that's not too much info!). The others I've tried just don't seem to touch the other meno symptoms so I feel I need to try to find something that helps with symptoms but is kinder on my stomach. Just as an aside I have tried coming off everything and my stomach was a lot better but after about 6 days meno symptoms returned.
So one of my questions is, is it likely to be the estrogen or progesterone that's causing my stomach discomfort?
Also, after reading some posts, I'm thinking of trying Femoston but a higher dose as this seems to be kinder from a progest point of view. Any views on this would also be appreciated.
Sorry for long post but wanted try to put as much info as poss which might help with your advice.
Thanks in advance.
Rose63
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Oestrogel and Utrogestan would be a good choice. Dosage of the gel is 2 -4 pumps according to your needs.
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Thanks for your quick response Dotty. Is this both in one gel?
Rosie63
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Hi and Welcome Rosie63
I had the same problem as you regarding cramps with HRT, especially as I got older. My uterus simply didn't' want to play ball anymore and I even had erratic bleeding which was a nuisance. The only non bleed HRT regime that I would consider now(I gave up on HRT 18 months ago and doing OK) is going back to the Mirena with Oestrogel alongside.
The only thing I use now is local oestrogen (Vagifem) which keeps the urogenital atrophy under control.
I do think the bowel can be effected when on HRT because the uterus is reacting to the oestrogen and progesterone causing cramping etc. However, oestrogen does often help with digestive and bowel issues as well.
Utrogestan, on a sequential basis of 10-12 days each month, might be worth trying ( it's a capsule that can be taken orally or used vaginally!!) but you would have a bleed each month. Oestrogen can then used as pills, patch or Oestrogel alongside.
I think some women really do find continuing with HRT into our 60s, 70s or beyond is simply too much hassle. There does need to be a way found to help us get some oestrogen without the progesterone problems. DG x
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:welcomemm:
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Thanks you CLKD 😊😊
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Broswe round. Make notes. Some ladies find that keeping a mood/food/symtpom diary useful ;)
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Will do that. Thank you 😉
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Hi Rosie63
:welcomemm:
If women suffer from digestive problems with oral HRT ie tablets, then the transdermal route is preferred anyway (this has been suggested to you). What dose of Prempak-C were you on? In your position I would go for Dancinggirl's suggestion of the Mirena coil along with patch or gel oestrogen (totally nil-by-mouth) or else separate oestrogen ( patch or gel) with utrogestan. If you have been having a bleed up until 6 months ago you may not mind having one again? The reason I say this is that if you want to be more "natural" and be nil-by-mouth then the utrogestan ( progesterone) would be taken vaginally - but not many women would want to do this daily for obvious reasons, but it becomes more palatable when used cyclically, the downside being a withdrawal bleed! If you can get by on a lower dose of oestrogen then you might be able to have a longer cycle as I do (with agreement of my doc) which limits to the duration to take the progesterone as well.
I realise now reading back I've repeated lots of Dancgingirl's post but giving my own perspective as you and I are almost the same age and I am on that type of HRT (patch oestrogen with utrogestan vaginally on 6-8 week cycle).
Hurdity x
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Thanks very much for your advice Hurdity. This is all really helpful and I now feel well armed for my appointment with consultant tomorrow. I was on the 0.625 dose of Prempak. I've suffered with gut problems since I was a teenager (diagnosed as IBS) and always felt that those problems were worse at certain times of the month so I'm not that surprised I'm having problems again now ! Although I was ok on the Prempak most of the time. My doctor said I should perhaps think about having my stomach checked out again but I'm pretty sure it's all tied up with my hormones as it definitely improved when I stopped taking my hrt for a week. I think we get to know our bodies as well, don't you?
Thank you again for your help.
Rose63 x
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Hi, just wanted to let you know that I had my appointment with consultant today. He has prescribed me oestrogel and 100g Utrogestan. He said to try taking the 100mg Utrogestan every day rather than 200mg so many days a month as this might not give me a bleed. He also mentioned the Mirena coil if this doesn't work out for me. Fingers crossed it will though.
Thanks again for your advice and support .
Rosie63 x
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Thanks for the update Rosie63 - great news and hope it works for you! Do let us know :)
Hurdity x
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Hi all
I know it's still really early days but feeling a bit despondent again today. I started my new regime of oestrogel and Utrogestan last Thursday and I suppose I was hoping to see some improvement. However, I'm feeling pretty bad at the moment with really bad aches in my joints, tiredness and general feeling of awfulness ! The first couple of days I had 2 pumps but because I felt really unwell yesterday, I added another one this morning. I was just hoping that because I'd already been taking another hrt and would have had some oestrogen in my system, I wouldn't have taken such a dip. I'm guessing these symptoms are as a result of low oestrogen ?
A question for you please Hurdity if you don't mind. I saw from one of your earlier posts that it could be fluctuations in oestrogen from perhaps just changing from one hrt to another so perhaps this could be the case at the moment with me?
Am I expecting too much after only a few days do you think? Your thoughts would be appreciated.
Thanks again for your support.
Rose63
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Rosie63 - Changing from one type of HRT to another will bring some side effects - your body has to adjust and this will take time. Nothing is going to be instant. I wouldn't have started with the conti version of this regime - we tend to advice always starting with a sequi regime first to see whether the progesterone suits you and to give the oestrogen time to do it's magic without the progesterone having an influence. Many women stick with a sequi HRT well into post meno and put up with the withdrawal bleeds to avoid the negative effects of progesterone.
It is early days though and I would stick with 2 pumps per day at this stage. You need use this regime for at least 6 weeks before deciding whether it works for you or not. I found Utrogestan made me feel slightly sedated most of the time - it was a nice feeling actually as I felt quite high!!! Unfortunately I got a rash on my face and erratic bleeding with Utro on a conti regime so gave up on it.
BE patient - it may well settle. DG x
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Thanks DG. Sorry to be dim but could you just explain the different between the conti regime and the Sequi please? Does the Sequi mean I would just take the gel for the first half of the month and then add in the prog? I really wouldn't mind having a bleed if I felt reasonably ok on this regime.
Thank you.
Rosie63 x
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Hi Rosie63
We tend to use shorthand on here to save writing it all out in full so no wonder you are puzzled.
Conti = continuous combined HRT where you take oestrogen and progesterone all the time and is designed to be a "no-bleed" HRT ( although often women do bleed at the start of this regime for a few weeks or months until settled). This is normally prescribed for post-menopausal women otherwise bleeding might occur unpredictably.
Sequi = sequential or cyclical HRT which means you take oestrogen only for half the month and the other half ( or a few days less) you add in progesterone and take them both together for the rest of the month. This is designed to give a monthly bleed to mimic the natural menstural cycle and is prescribed for women who have not yet reached menopause. Some women ( like me for example) choose to continue with a cyclical HRT even when long post-menopausal, to avoid the sdie effects of continuous progestogens.
Hope this explains it! :)
Hurdity x
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:thankyou: Hurdity.
Sorry Rosie63 that I wasn't more clear. DG x
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Thank you for clarifying Hurdity and your help DG. I think I'd prefer to do the Sequi regime as it does seem the prog is causing some stomach issues for me and perhaps that's why Prempak suited me better. So bearing this in mind, and I've only been prescribed to take 100mg of prog. is this something I could still do or would I need to take 200mg really? Sorry for all the questions but want to try to get it right :)
Thank you.
Rosie63 x
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How to take Utrogestan is in the Progesterone section under TREATMENTS on this site. Many women use Utrogestan vaginally when using it sequentially and this can reduce side effects. The dose can be 100mg per day for 10-12 days each month when using it vaginally as it goes more directly to where it is needed. It's 200mg per for 10-12 days if used orally. DG x
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Thanks very much DG. I'll leave you in peace now ;) x
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We are all here to help each other. Good luck. DG x
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Hi again ! Sorry, but I have another question. I've been taking 2 pumps of oestrogel on my inner thighs for about a week now and planning to add the Utrogestan in for the last 12 days of a 28 day cycle so that I can gauge how I'm doing on the oestrogel. I'm still a bit up and down on how I'm feeling but appreciate this might settle down with time.
My question at the moment is that I'm getting a kind of ache underneath, I have a bit of a discharge too, and I'm still getting some discomfort in my stomach and back which I thought might be caused by progesterone in the past but as I'm not taking that yet, I'm not so sure now. It does feel a bit like wind but having this ‘feeling' around the vaginal area too.
Has anyone else experienced these feelings and do you think they are likely to pass once I'm more settled on this regime?
Thanks.
Rosie63
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Rosie - your body is starting to ‘wake up' again as the oestrogen slowly absorbs and does it's magic - you might get tender breasts, tingling and aching around your ‘lady bits' and this is all normal when starting with HRT after being without oestrogen for some time. You will get discharge - the natural vaginal fluids are returning and the ache in the stomach and back will be the uterus coming to life. It will take at least 3 months for things to settle. BE patient, it's early days. Be prepared for the Utrogestan to make you feel a little relaxed and sedated. Dg x
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Thanks DG that's reassuring to know :)
Rosie x
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Hi, oh my goodness, the ache down below I'm experiencing is really getting me down. I've been on my Estrogel/Utrogestan regime for just over 2 weeks now and was hoping it would have started to ease. It's keeping me awake at night too so no getting away from it at all. I'm starting to wonder if there might be another reason for it ! I'm going to start my 100mg Utrogestan vaginally tonight and not sure whether that's likely to make it better or worse or will make difference. I'm also still getting a discharge along with the ache. I've increased from 2 pumps of Estrogel to 3 on consultant's advice because 2 wasn't dealing with other meno symptoms. I didn't get any of this when I was on Prempak C, although I do understand that Estrogel is a totally different kettle of fish.
I guess my questions are - from your experiences - is the discomfort down below likely to improve with time (in other words I need to be more patient) and is the Utrogestan likely to have any affect, good or bad? Or should I think about getting my ‘under-carriage' investigated.
Thanks ever so for your continued advice and support.
Rosie63 x