Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Seven8Nine on May 14, 2018, 08:28:21 AM
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Hello
I'm new here and about to start HRT next period, i'm 47, I will be on Ustogen 100mg and Oestrogen 0.625, I don't know much about HRT and taking 2 pills seems complicated what with one pill taken for limited days.
Has anyone been on similar and did you have any side effects? What have the positives been? I didn't do well on the mini pill as I felt like I had permanent PMS.
Current issues i'm having includes insomnia, mega skin breakouts, anxiety, hot flushes...
Any thoughts experiences would be much appreciated. Thanks.
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Hi and welcome to MM
You have been given a good regime to try. All HRTs may give some side effects but it's best not to think about these when starting out as it can result in you ‘overthinking' everything and becoming anxious. Generally the oestrogen will make you feel better all round and sometimes the progesterone can have a slight sedative effect and possible some PMT but, as every women is different, the type of side effects and how severe they are will vary greatly.
Basically, don't expect problems but perhaps keep a diary so you remember when to take the pills and note anything that you feel might be a side effect. Just enjoy feeling better - and remember that you are young, so your need some quality of life and you need to protect your heart and bones for the long term - this HRT could give you all these benefits but no HRT will be perfect. If you find it doesn't suit you then there will be other HRT regimes to try.
Let us know how you get on - we are here to support you. DG x
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Thanks DG for message, very useful and yes you're right about overthinking... x
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Hi Seven8Nine
Sounds like we are a similar age and are on a similar regime - can I ask if you are taking progesterone every night or on a cycle?
Tx
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TNM45689 - Seven did say she is taking the Utrogestan for limited days each month so she is doing a sequential regime. She is peri menopause so must use a sequential HRT regime. Continuous HRT is for post menopause, either at least one year after the last natural period of over the age of 54. IT's always best to start with a sequential regime, whether peri or post meno, to see if the progesterone suits you or not. DG x
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I am so confused as I am post menopausal (I year of no periods) but the clinic did not explain the options just put me on the continuous cycle of one tablet a night....
Tx
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Sadly the doctors rarely take the time to explain things properly so it can be so confusing. This is why this site is so useful. Do read up all
The factual information to get really glued up and keep asking us questions. DG x
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I am so confused as I am post menopausal (I year of no periods) but the clinic did not explain the options just put me on the continuous cycle of one tablet a night....
Tx
This is because that is the standard prescription for post-menopausal women and it is assumed that most women would not want to return to a bleed. Unfortunately this means that many women might give up on HRT mistakenly thinking it's not for them, when it;s actually the continuous progestogen that could be causing the adverse side effects.
Hurdity x
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I am so confused as I am post menopausal (I year of no periods) but the clinic did not explain the options just put me on the continuous cycle of one tablet a night....
Tx
This is because that is the standard prescription for post-menopausal women and it is assumed that most women would not want to return to a bleed. Unfortunately this means that many women might give up on HRT mistakenly thinking it's not for them, when it;s actually the continuous progestogen that could be causing the adverse side effects.
Hurdity x
Hurdity, do women with a Mirena coil suffer the same effects of continuous progesterone or is it too low a dose for that to happen?
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I'm on utrogestan 100g every night and 2 pumps of gel, I haven't gone a year without a period and my consultant has put me on continuous regime, which I'm unsure about, so far I'm 6 days in and the worst side effect I have at the moment is I feel so heavy headed in the morning, like you have had a heavy night the night before, a bit of a sedative effect, I'm hoping this is going to improve a bit. good luck I hope it goes well and as the others have said try not to think about the side effects, which is what I'm trying to do
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SueLW
I'm not sure whether Hurdity will respond or not but I can respond with my personal experience of the Mirena. I found the Mirena with Oestrogel was the best non bleed hrt option I ever used. If you look at the info under TREATMENTS on this site you will read that the Mirena is recommended for women who struggle with progesterone for a variety of reasons because it delivers progesterone more locally and there is less systemic absorption.
I did feel an initial hit of progesterone for a while after the Mirena was fitted (a little sedated) but it quickly settled. The spotting stopped after about 6 weeks and I then had 4 years of very few problems.
After it was removed I then tried Utrogestan as I thought it was a better alternative but I had awful cramps, erratic bleeding, a rash on my face and I felt sedated.
I did worry whether the Mirena would suit me and I think there are some ladies who are very sensitive to progesterone that don't get on with the Mirena but I believe there is roughly a 90% success rate with the Mirena with many women opting to renew it after the 4 years if its life.
Hope that helps. DG x
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TNM45689 - Seven did say she is taking the Utrogestan for limited days each month so she is doing a sequential regime. She is peri menopause so must use a sequential HRT regime. Continuous HRT is for post menopause, either at least one year after the last natural period of over the age of 54. IT's always best to start with a sequential regime, whether peri or post meno, to see if the progesterone suits you or not. DG x
Hi DG
Just got back on here to see these messages, thanks so much and to all for writing.
Unfortunately I haven't started HRT yet as I am still waiting for AF! 😬
Totally agree about GP's not really explaining things.
On looking at the box PROPERLY of Premarin 0.625mg coated tablets (conjugated estrogens) it says to take the tablets daily without a break, I thought I was to take a break? does this sound right? I'm still having periods, although very late this month.
I've read I should take it the last 14 days of my cycle but how would I know when that is? Do I just count 14 days from starting progesterone then start the Estrogen for 14 days? I've been prescribed 3 months so have 3 full months worth of Estrogen.
Also do you know if it better to take the tablets in the evening as in easing progesterone side effects?
Any thoughts would be very welcome.
Thanks so much x
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Severn8nine - I am baffled as to why you have been given Premarin???!!! This is the old fashioned type of oestrogen so is rarely used now! I would ring you doctor and question this. I would ask if you can use oestrogen patches as this would be easier for you.
Utrogestan should be taken before bed on an empty stomach or used vaginally (like a pessary) from days 15-28 of the cycle. You may find the capsules are 100mg so you should be using 2 of these on days 15-28. IF you still have periods, I would wait until you start a period and start the oestrogen a day or two into the bleed and count this as 'day one'. Oestrogen should be used every day and you simply add in the progesterone alongside the oestrogen on days 15-28 and then go back to oestrogen only and a bleed should arrive a day or two after you finish the progesterone phase. This gives you a 28 day cycle. If you look under TREATMENTS at the top of this page and go into ‘Progesterones', you will see the info on the regime you are using.
Hope that all helps. DG x
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Severn8nine - I am baffled as to why you have been given Premarin???!!! This is the old fashioned type of oestrogen so is rarely used now! I would ring you doctor and question this. I would ask if you can use oestrogen patches as this would be easier for you.
Utrogestan should be taken before bed on an empty stomach or used vaginally (like a pessary) from days 15-28 of the cycle. You may find the capsules are 100mg so you should be using 2 of these on days 15-28. IF you still have periods, I would wait until you start a period and start the oestrogen a day or two into the bleed and count this as 'day one'. Oestrogen should be used every day and you simply add in the progesterone alongside the oestrogen on days 15-28 and then go back to oestrogen only and a bleed should arrive a day or two after you finish the progesterone phase. This gives you a 28 day cycle. If you look under TREATMENTS at the top of this page and go into ‘Progesterones', you will see the info on the regime you are using.
Hope that all helps. DG x
Hi DG
Thanks so much for the speedy reply and advise, very helpful thanks, you are amazing to take your precious time out to do this thank you. I am completely clueless about HRT and desperate for some relief.
Argh! I have no idea about the Premarin, it's what my GP prescribed, are there any implications taking this? She offered me patches or tablets I picked the latter as I worried that patches would come off as I do HIIT classes and in general get hot a lot! What's the other brand option for tablets?
Thing is I am suddenly feeling a bit pre menstrual/bloated so could come on very soon and what with tomorrow being Friday I highly doubt I can get this changed immediately. It might take a month before I get a scheduled appointment with my GP so would it be ok I start on this for a month then change to other tablets/patches? Do I take this in the evening too?
In terms of the progesterone good to know to take before bed thanks, my tablets are Ustrogesran 100mg, why would I take 2? I was hoping to start on the lowest dose as from experience of the mini pill I am not great with progesterone, is that ok?
Thank you so much, you have no idea how relieved and grateful I am to find this forum and get some help. Tbh my GP wasn't that clued up on what to put me on and I don't want to see the other male GP's at my surgery.
Best wishes
💐🍾
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Seven8nine
Don't worry about the oestrogen at this stage - you can switch to a different one at a later stage. Perhaps ask for Estradot 50 patches when you ask for a repeat prescription as these are small and stick well. You can take the oestrogen at any time of day but do take it at the same time of day each day. If you have a smart phone you can probably set an alarm or download an App to remind you when to take your pills. As you you are peri meno it will be important to take 2 Utrogestan per day as you will need the good dose to ensure you shed the womb lining properly. You could use the Utrogestan vaginally as this may reduce side effects - simply push the capsules up inside as high as you can before bed.
DG x
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Premarin is manufactured from the urine of mares, and not a nice Oestrogen at all. I would ask for a patch or the rub on gel. I use 100mg of Utrogestan for 12 days per month, vaginally, much easier for me than swallowing tablets and it does the job. Good luck.
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Hi Seven8Nine
I was just wondering how often your periods are at the moment and when your last one was? If they are very few and far between and you've been waiting some time (several weeks?) for your period and it hasn't arrived then why not just start? - (although I do agree with the others - Premarin is probably not the best one to start with). If you want to take a tablet then Elleste Solo would be a better one.
As Dancinggirl says the licensed dose of Utrogestan is 200 mg orally for 12 days per month but as Cassie says used vaginally some women are OK with half the dose - but probably best to start with 200 mg and see how you get on with your bleed?
Hurdity x
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Thank you so much DG, Cassie and Hurdity 💐💐💐
Urgh urine of mares doesn't sound good at all, I'll call the surgery tomorrow and see if they can help.
Thanks for the Estradot 50 patches and Elleste Solo suggestions, I prefer a tablet, is there a specific dose I should ask for? What are the pros to using a patch or gel opposed to tablets?
Hurdity, It's been 40 days since my last AF, for the past week I've been getting the odd boob pain and tonight felt bloated after a small dinner but could just be phantom symptoms as I'm so desperate to get AF out of the way before I head to Spain next Friday. :-\ I'd Love to start right away but don't want to mess up a bleed if it's due, then maybe start spotting. I might just have to wait until next cycle when I have the correct Oestrogen.
Thanks again, you have all been very helpful, it's super appreciated.
Have a nice evening.
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Hi
I now have elleste solo now but I am still waiting for AF so I can start, however my symptoms have been awful.
I'm not sleeping well at all, I am getting around 3-4 hours of broken sleep a night, I am knackered, teary, super anxious, feeling low, having hot flushes, tender boobs (so I keep thinking AF is coming), no libido and more, it's very grim.
Pharmacist advised I shouldn't start until AF comes as it could cause issues with spotting. My GP doesn't seem to know much about treatments so not sure if I should try to see her?
I eat healthily, gluten and dairy free. I train with weights at the gym, my BMI is 20, I am very active averaging doing 16K-22K steps a day.
Help, what should I do? I am feeling so low and anxious. :'(
Thanks
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Hi Seven8Nine
Sorry to hear you are feeling rough.....
I presume you've been given 1 mg dose which would be the one to start on and then increase (after at least 3 months) if you find it is not sufficient?
Have you already been to Spain and returned or still there? The thing is there is nothing you can do if you want to wait for your period - but it sounds like it could be on the way? I would give it a couple of weeks and if it hasn't appeared then I would just start the oestrogen. If you are starting on oestrogen only anyway - this should not cause a bleed to come on early anyway, as you won't be taking the progesterone then, until after 16 days?
Hurdity x
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Hi Seven8Nine
Sorry to hear you are feeling rough.....
I presume you've been given 1 mg dose which would be the one to start on and then increase (after at least 3 months) if you find it is not sufficient?
Have you already been to Spain and returned or still there? The thing is there is nothing you can do if you want to wait for your period - but it sounds like it could be on the way? I would give it a couple of weeks and if it hasn't appeared then I would just start the oestrogen. If you are starting on oestrogen only anyway - this should not cause a bleed to come on early anyway, as you won't be taking the progesterone then, until after 16 days?
Hurdity x
Hi Hurdity
Thanks so much for getting back. I hope this finds you well.
I'm back from Spain, I had a lovely time away with my girlfriends (child free break) but it was pretty hard trying so hard to be upbeat when I felt so anxious and having so many symptoms but I faked it well :( I did confide with my girlfriends but no one is Perimenopausal like me. It hasn't helped I now have huge patches of brown (melasma?} on my face despite using very expensive anti dark spots factor 50 facial sunscreen, £42 for 50ml!!! 😩
Thing is I've been having these phantom symptoms like AF is about to begin for weeks now and really losing hope it will ever come, maybe it's just taken it's toll on me, my last AF was late too (actually thought I was pregnant!). No chance this time as no relations have been had.... I had no desire and the scare quickly put DH off to my relief!!
I'll see if I can give it another week or so as I really want to do this right but if it won't cause a bleed what harm could I do starting before a bleed? I am really clueless about all this.
I have 2mg of the elleste solo, I didn't actually see my GP as appointments where I am are difficult to get, I phoned and passed a message on to my GP explaining I didn't want to take the mares urine oestrogen and requested the elleste solo 2mg (don't ask me why!) and a prescription was faxed to my pharmacist for me to collect. I told them I was convinced AF would arrive on the weekend so would need to start hence their efficiency, I do have a great surgery and GP.
Do you think the 2mg is too much, I don't want to mess my GP about, she's already been so accommodating, I guess I could half the pills? What do you think?
Thanks so much Huridy and to all on here reading and that might know more than me.
Xx
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Hi there - you won't do any harm by starting the oestrogen before your bleed - it's just that if one was about to start then you might get out of sync with your natural cycle. You may well be fine with 2 mg and depends how you absorb it - probably if you can half the pills to start with and give your body time to acclimatise that might be an idea - but otherwise just go for it. If you do start the tablet then best to keep on with the regime for a few weeks to allow any initial side effects to settle.
Glad your holiday was good despite feeling a bit rough some of the time - nothing like a holiday is there! :)
Hope you manage to sort it and do let us know how you get on.
Hurdity x
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Hi there - you won't do any harm by starting the oestrogen before your bleed - it's just that if one was about to start then you might get out of sync with your natural cycle. You may well be fine with 2 mg and depends how you absorb it - probably if you can half the pills to start with and give your body time to acclimatise that might be an idea - but otherwise just go for it. If you do start the tablet then best to keep on with the regime for a few weeks to allow any initial side effects to settle.
Glad your holiday was good despite feeling a bit rough some of the time - nothing like a holiday is there! :)
Hope you manage to sort it and do let us know how you get on.
Hurdity x
Hi Huridy
Thanks for getting back so quick.
On looking at the elleste pack, it has days on each pill like BCP and they're pretty small so cutting in half and managing the days could be tricky so
like you say I might just have to go with the 2mg whenever AF arrives.
However what do you mean when you say taking the 2mg “depends how you absorb it†can it go wrong?
I really do want to stay in synch with my natural cycle. I've messed with BCP
in my younger days to help time AF and side effects have not always been great, however good point that I won't bleed until after the progesterone, fingers crossed!
I'll wait a few more days then take a check point. My mental health is really deteriorating, no doubt it's the lack of good sleep while daily life is full on is not helping, I really feel deflated, I feel anxious and I'm sweating just writing this now, it's crazy! I think I need to weigh up the benefits of starting v's how I am now, but I know the good effects won't be immediate and it's a ? with the side effects of progesterone, but hoping the oestrogen will balance things out as the mini pill when I took it (reacted badly) was only progesterone and was taken orally. Ok will see will see.
Thanks again lovely x
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Hi DR
I am in the same situation just about to start the Utrogestan. Posted questions on this earlier. I am 51 and perimenopausal and probably over thinking it!.
I was planning to do 100mg vaginally days 15 - 26. I thought the idea with doing it vaginally was you could reduced the dose?
Thanks
Macjac
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That dosage sounds perfect Macjac