Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: AJacynM on November 11, 2019, 11:14:18 PM
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Hi there,
I’m having terrible issues with the progesterone side of HRT... I’ve tried a combined patch, caps and now pessaries but they give such bad side effects. I only use the pessaries for 7 days each month now but my breasts hurt so bad and get really hard, I get really bad vaginal irritation and feel a bit sick... then my period won’t come for another 7 days after I stop using the pessaries! So I’m feeling awful for nearly 2 to 3 weeks each month as it drags on!
Does anyone else suffer like this, any help/advice would be gratefully received? The oestrogen side of things seems ok!
Thanks in advance. xx
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Hi there. So sorry to hear you are feeling like this. If you search this board you'll see many of us cannot take one form of progesterone or another. I'd say, and others will come along and say more specific advise, that it really is trial and error as to the type of progesterone. I could not cope with femoston or elleste tablets as it made my migraines far worse. I then switched to Oestrogel which was phenomenal but as soon as I started taking utrogestan it knocked me for six- zombie like with migraines from hell. I'm meno and am now on 2.5mg of continuous Provera and all is great. So it may be worth a different combination? Let's see what others say xxx
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Hi,
I'm afraid I don't have any helpful advice just writing with sympathy as I am also pondering progesterone problems. I had the mirena fitted 8 weeks ago for the progesterone to balance my oestrogen only evorel 50 patch. I am horribly fatigued with daily headaches, and stomach issues exacerbated by the painkillers for headaches ( I am a many years migraine sufferer and have occipital nerve blocks which were working but the progesterone has upset the Apple cart) I had horrible mood swings and depression also but that has been helped by increasing my oestrogen dose. Although I am still more anxious and low than prior to insertion. I am considering removing the mirena and trying different progesterone but scared things could get worse not better.
I had a much happier few months on oestrogen only patches which I was allowed to try due to migraine, but the appearance and removal of an endometrial polyp means my no progesterone days are sadly over.
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Hi AJacyjM
Sorry to hear you are struggling. As you can see this is a very common problem, if not the most common problem which affects many of us (including me), so please don't think you're on your own.
I have tried every progesterone going, including the mirena which I had to have removed after 6 months (as it didn't get any better). I currently use utrogestan vaginally, which I would say is the best of a bad bunch. Even so I really suffer from day 5 onwards with mood swings, lethargy, foggy thinking, headache, tearfullness and thrush to name just a few of the issues it gives me.
I am on a quest to find a solution and constantly on the lookout for an alternative. In fact we have a thread on here discussing this very subject - that we need more options when it comes to progesterone.
Which progesterone are you using, it sounds like utrogestan? Have you tried typing progesterone into the search bar to look for alternative options? Wishing you well x
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Ohhhhh yes,
Progesterone- almost a swear word to me !
The one and only one I can tolerate is dydrogestone- it doesn't come alone, hence why I am on a very weird regime.
Norethesterone- was not bad, but I did feel very sick on it so changed to
Utrogestan- OMG- what a disaster. I was like a raving lunatic on it and that was only after 5 days of 100mgs- never, ever again. Some ladies swear by it though, but my experience was not good.
I have always struggled with progesterone- in combined pill days I could only tolerate marvalon- dydrogestone again , I think. Tried the mini pill once- again did not go well.....
You sound completely normal - it is just trial and error.
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Hi all,
I'm sorry you're all going through this too. It's just horrible I know.
I've tried Evorel Sequi... was fine with the oestrogen but not the progesterone, moved on to Femseven sequi which would not stick but then the progesterone started again to give me bad side effects also... then tried utrogestan tablets and honestly felt like I was dying, zombified and just horrific!! Lastly and currently, I'm now using utrogestan pessaries which I've decreased from 12 days to 10 and now to 7 days each month but still the side effects are awful after day 4 or 5...
The menopause has totally thrown me, up until 41-ish I was just a normal happy go lucky girl... now I feel totally alien to my previous self - I have a bad memory, I ache so bad, can't think straight, worry a lot, debilitating exhaustion, no stamina and eye sight going downhill fast to name but a few of the issues. My friends can't believe the change in me and neither can I! I just want to feel like the old me, or somewhere near at least?!?
I haven't yet tried dydrogestone, oestrogel or provera options so I will look into these as suggested and also look at the progesterone threads on here to see if anything else is worth trying?
Thank you so much again for taking the time to reply.
Hope today is a good one for you all.
AJ. xx
Ps do any of you use testosterone?? That was another thing that flashes up when I research my issues?!
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Sorry, no brain, meant to also say that I'm using evorel 50 patches too currently... they were up'd to 75mcg for a while but made no difference!!
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AJacynM
You're experience with utrogestan is identical to mine. Yes, I use testosterone and it really helps with memory, energy, stamina and libido. Once again research on this forum using the search box.
Don't give up, and keep us posted how you get on x
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Hi AJacynM - I can truly empathise with your prog problems too, tried them all and had similar issues. I eventually found a workable solution in fem7 conti but they're no longer available so.... I'm back on Utro but alternate day, actually every 2 days for me as my E dose is quite low. I'm almost 2 weeks in so very early days but I'd know by now if I couldn't tolerate it.
I use just under a 1mg sachet of Sandrena every day which is roughly 37.5 patch, Utro every 2nd day and a small blob of testim twice a week. I feel really good, no sweats, brain fog, low energy or low mood, I'm sleeping well and libido seems normal. Overall I'm really happy with this. There's lots of studies on alternate day Utro and I've posted one below but if you do a search on here you'll find info in the threads. It's a conti regime, so the theory is no bleeds but if you're switching from a sequi you might get spotting for a while, you might not, depending on your age and stage of meno.
Most of the alt day regimes have a max E dose of around 2 pumps gel, 50 patch or, as this study shows, 1.5mg Sandrena. If you're ok on that dose, it might be worth considering? I never thought I'd get on with Utro as it used to cause me terrible problems but spreading it out like this seems to work. Hope it continues and good luck in your search, it's not easy and akways a good idea to clear it with your doc first.
https://www.fertstert.org/article/S0015-0282(05)00403-6/fulltext
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Apologies, I should have mentioned, I use the Utro vaginally.
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Hi AJacynM
Yes it's a common problem.
Can you tell us how old you are and where in menopause? Are you peri-menopausal or post-meno? Also when you say pessaries - I presume you mean the 200 mg utrogestan now only "licensed" for fertility. Well the good news is that there are alternative regimes especially as you are on a medium dose of oestrogen and easier if you are post-menopausal. The 100 mg and the 200 mg utrogestan can all be used orally or vaibnally - they are exactly the same. Also there is research to show that lower doses of progesterone can be used when taken vaginally (off-licence of course). Also some women ( if post-menopausal) stretch the cycle to make it longer without progesterone - cutting the duration too much eg to 7 days is not usually recommended especially without medical supervision. In fact any variation from the licensed regime should be checked out with your doc to ensure protection (and hopefully monitoring) of the womb lining.
I did a whole thread on some of the studies looking at vaginal progesterone including a review (which include the one kilted cupid linked to).
Just by way of example - I have a 5-8 weeks cycle during which I take 100-200 mg utrogestan vaginally ( 100 mg on the short cycles) along with an oestrogen patch 62.5 mcg ( cut down from 75 mcg) together with a small blob of testogel per day. I'm mid 60's and been on HRT for 12 + years.
You might be OK with 10-11 days of 100 mg utrogestan used vaginally (I must stress, with OK from your doc as this departs from licenced regime ie using less prog) per month.
There is a thread in private lives "Testosterone Here We Go" which you might like to rread. Also one on this board about the various doses and products and links to BMS etc - I will bump this one and the one with the vaginal prog studies. https://www.menopausematters.co.uk/forum/index.php/topic,27959.0.html
Just to quickly say that Testim is no longer available but Testogel sachets (1%) are - and these are recommended as the strength is lower than Testogel pump pack. There is also Tostran but this is twice the strength so you have to use it less often - and some women find it too much of a "hit" eg blobbing twice a week - also more difficult to be consistent with the blob size when it's more concentrated. Androfeme cream made in Oz is only available privately and v expensive.
Hope this helps :)
Hurdity x
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Hi again,
Wow, thank you so much for all this info...
Some details about me... I'm 47 and started having issues in my very early 40's. Both my mum and my grandma went through menopause at 40 and 37. I tried to manage for a few years but felt like I was losing the plot plus I went nearly a year without periods so went to my GP. Now - my GP surgery we're very hit and miss with hormonal bloods etc but finally they did a set and said I needed to go on HRT to try and ease my symptoms and also protect my bones as I was too young to go through the change etc...
I started on Evorel Sequi around 2 years ago and at first all was ok... then the progesterone started to give me issues after around 3 months, I carried on for a further 3 months until it became unbearable... after that we started trying other HRT's as listed in my previous post.
I've been back quite a few times to my GP surgery who refuse to do any more bloods to check my levels as they say the levels change throughout the day anyway so no point and they go off symptoms rather than blood work, they also won't discuss testosterone even though I tell them it seems to help so many with my symptoms, no libido AT ALL! Exhaustion through the roof...
(I've just started to cry as I just feel so upset at the way I am now when up to 6 years ago I was so happy with no issues.. and I'm not a cryer).
Ok, so the last time I went to see them my GP said she would contact a consultant to see if I could use the progesterone for 7 days each month, he agreed (it is utrogestan pessaries), so I have done that this month to try it and after day 4 my breasts are so painful and thrush so bad and my period never comes until 7 days after stopping the progesterone but when it does come it's a very healthy period lasting 3 to 5 days...
I just don't feel well at all these days but any blood work they do (routine, not hormonal as they won't do that) is always normal and so I feel as if they just think I'm mad, my friends don't really understand how bad it is so I just always put a happy face on and try to be upbeat but it's so hard when I just feel so crap all the time!
I live in the UK and so I think if I get testosterone gel I'll have to order it myself to try... Out of those you mention, which one would you recommend and I guess I'll have to mention this to my GP too... surely I should be tested for testosterone levels first?
So at present I use evorel 60 oestrogen only patches adding in the progesterone for 7 days each month... do I get bad side effects as the progesterone is too strong as when I read up it does say that bodily overload of this can lead to these symptoms? I'm scared of putting too much into my body I guess... as you've all said up there, it's so trial and error.
Gosh, I'm so sorry for all this info and so many questions! Can you tell how desperate I am to feel well?! I have two children, one still at primary, and just want to be the mother I once was.
Thank you all so much, I promise you I am a normal girl. I feel you may all think I'm mad too now!
xxx
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That should read Evorel 50, not 60. 😖
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AJacynM - I am on Tostran testosterone and I am in Northern Ireland which is the UK. A lot of GP's wont prescribe testosterone themselves but will do it on the NHS if a meno consultant recommends it but it very much depends on the area of the country you live in as to whether T is on the prescribing list. I use 2 pumps a week and have been on it 9 months.
I have been on the gel/utro regime for 14 months now with terrible terrible problems before. I found the first 3 months of starting the regime with the utro were not good. I have always used it vaginally because it has less side effects and never swallowed it so couldn't comment on that side of taking it. I got cramps, sore boobs, itchiness, not thrush exactly but I was uncomfortable down below, quite obvious mood swings, crying and my lethargy was horrendous (but that was more sorted by the Testosterone) What I would say is that after the first 3 times of using the Utro (I use it on a cycle 12 days 200mg) it all settled down to something I could deal with. I need to clarify the "12 days 200mg". That was what I was supposed to take but in the first 3 months I couldn't. First month I only got to day 8 and stopped but I did bleed, 2nd month day 9 and then 3rd month day 10 and then after that it has been 12 days all the way. My bleeds start 5 days after stopping the utro and then last 3 days and on the 4th just specks mucky discharge. My utro makes me down from day 8 but nowhere near as bad as when I started and I can cope with it because I know it will end soon and I will have 28 days of "ok-ness"!
I also string out my cycle like Hurdity. I count 28 days of gel then start 12 days of utrogestan. I am 57 and post meno but been on hrt since age 45 (up until the utro and gel, nearly all of them didn't work or had some problem or other).
It is always difficult at the start when you change a regime and have been on other HRT. Your body has adjust to the new drugs and then settle into a pattern it can seem worse before it gets better. I'm not fixed but I know from experience this is as good as it is going to get. I can have a life now (other post will show what it was like before and I am pretty angry about that - but that's another story!). I don't think we ever go back to how we were before, we need to work out through trial and error what works for our bodies. GP's and the like cant really advise too much because they are not living inside our bodies, only we can work that out but it is difficult and distressing and painful and tortuous - basically downright horrible >:(
As you are on a 7 day - see if you can persevere for at least 4 months straight and see how you go. I treated all the other symptoms like the cramps with paracetamol and the soreness/irritation with general vaginal cream and any itchiness with anti-histimine. It helped to tide me over whilst it settled which it did but it would have been easy to give up. I always post I'm glad I didnt. Things just have to balance and it takes quite a long time with hrt up to 3 months or more. I wasnt able to say I felt "ok, this working" until I was 7 months in. Everyone's different.
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Hi Ladybt28,
I have been using the utrogestan pessaries for 4 months now... it's just this last month that I've gone from 10 days down to 7. In truth I will try another month as I've dropped the evorel back to 50mcg so wondering if upping it to 75mcg lady month caused it to be much worse this month with the utro..? As you say, it's all so frustrating and trial and error.
One thing I didn't realise until Hurdity mentioned it is that I can use utro oral caps vaginally? If I read it right that may help as I could poss try 10 days at the 100mg strength... and stretch out my cycle a bit as you both are doing?
I do think I'm going to push for testosterone gel after reading all replies as it seems it would defo be worth a try... anything to feel more lively and to lose this awful lethargy that I have day in, day out as it's just debilitating.
I'm on a mission now to feel better and what I've learnt from you all these last few days is invaluable in the fact that I know now I kind of need to take a bit of control myself and maybe work out what's best for me rather than just going with what is ‘the norm'. We are all unique and need to be treated so. There is such a lack of knowledge in my area around this, my GP surgery just prescribe what they think and don't seem to listen to me... but I'll try to talk about it with them again now I have more info.
I will look into the testosterone - May suggest to GP to try testogel sachets as Hurdity suggested at first as it's a lower strength. 🤔
Thank you all again!
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Yes you can use the oral caps vaginally just push them up as far as you can go. I don't have to do it, because I use 4 pumps of oestrogel everyday but I have read that some women up their oestrogen during the progesterone phase. I would say that dropping oestrogen rather than upping can make the progesterone phase worse in some ladies.
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I've been on Utrogestan for a week now so early days but so far, so good. I had been on Oestrogel for a few weeks prior to starting the Utro and only use 1 - 1.5 pumps a day.
The regime I've been given is 100mg every day and so far it's working well. My flushes and night sweats had totally stopped a day or so prior to starting the Utro so I know the gel is working at that amount - and since starting the Utro - I'm sleeping MUCH better. I've had a few nights of about 6 hours solid sleep which is a million times better than even a week or so ago. I could literally cry - I'm so happy about that. I'd forgotten what sleep was.
I'm drinking loads of water to flush out any water retention and I've not any reactions to the Utro like headaches etc. I'm soooo hoping I've got it right finally. IF ANYTHING my temperature has returned to what it should be for this time of year and for the first time in years (honestly!) I've been putting a thermal vest on or a wooly jumper.
I'm feeling great actually!!! :) By the way. I was told by my Dr weeks ago that Utrogestan wasn't available which when I asked the consultant she said that's not true. Fortunately she's written a letter to the Dr saying that Utrogestan is "now Green on the Buckinghamshire Formulary" so please would they continue with my presciption. I'm so pleased she wrote that in my letter otherwise I might have issues next time I want some more.
KiltedCupid....Is there any way to message you privately as you're obviously new to Utro too and I'm interested to hear about your alternate day regime? (especially as you dont take much O, like me) Thanks x
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Graciemouse - you can send me a pm on here, I think you just click on my name and then send message.
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Graciemouse it's really good to hear a success story... hoping I can get it right soon too! Glad you're feeling so great.. hope it continues now.
Kiltedcupid, thank you for your advice... hope you don't mind me asking but do you use Utrogestan alternate days continually or just for a set time? Also is it a 200mg pessary you use or 100mg capsule vaginally?
I'm trying to work out the best regime... I really think the testosterone gel may help me too so looking into this.
Thanks again. x
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AJacynM - no probs at all with asking, that's what we're here for - to share our experiences. I use my Utro every 2nd day, vaginally on a conti basis, 100 capsule, but I'm 57 and well post meno. I've just increased my Sandrena gel to 1mg which is roughly equivalent to a 50 patch and I use a small blob of testim gel 2/3 times a week. I'm doing really well on this and really surprised I can tolerate the Utro as it used to make me very depressed, bloated, tired etc etc. You know the deal.
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Hi AJacynM - thing is if you are peri-menopausal still then a cycle is the recommended regime otherwise you can get random bleeding at odd times - although the fact that you haven't so far indicates maybe you are getting near menopause or beyond it? Also how are you feeling generally on that dose of oestrogen? That is a standard medium dose of oestrogen for post-menopause but at your young age I would want to make sure I had more than this. In your position i would actually push for estradiol blood tests if you can - even though they are not accurate ( aim for half-way through the patch time eg on the second day or something) - it might give an indication of how well you absorb the oestrogen from them. If you are peri-menopausal though it won't show anything really - just if you are post-meno you want to make sure your oestrogen levels are at least 200 pmol/l to be over the amount recommended for best protection against osteoporosis.
If you doc has approved 7 day progesterone through writing to a consultant then that's brilliant but you should also ask if they are prepared to givre you asn ultra-sound scan ag annually to check that the prog is doing its job. Again if you are still peri and ovulating fairly rregaulraly then your own progesterone will be helping to do the job but if you are very late peri or post-meno you just want to keep an eye on this - and the fact that they've agreed to 7 days - less than the licensed amount - means they should allow and recommend this ( scan).
Hurdity x
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Thanks so much Hurdity... the info you've all given me is invaluable...
Like I said, I didn't have a period for just over 11 months when I started HRT, my docs said when a person doesn't have a period for a year they are classed as in full menopause... but still put me on a sequential regime because of my age. I don't have any breakthrough bleeding at all during the month but do get a bleed after 7 days on stopping the progesterone and when I skipped a month once (no progesterone) I didn't have a period so I think I'm defo not peri anymore?
I don't feel great at all anymore, I'm not sure how I'd feel if I came off all HRT though? I do think the oestrogen helps with the aches but my mood is generally a bit low these days although I try not to show it, but I have a huge lack of energy and really feel exhausted most of the time. The hot flushes have stopped too on HRT so that's a plus!
I will push for blood work and try to determine the results of where I go from here as I feel much more informed now because of this forum. I will also mention annual scans. Thank you again.
Kiltedcupid - thanks to you too for your info... I'm defo going to look into the testosterone. Did you ever use patches and if so do you find the Sandrena a better option?
Thank youuuuu!!! I promise I'll stop asking questions soon and go to the docs armed with all I know and want to say! :)
xx
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AJacynM - I have used patches and I got on really well with Fem7 conti but unfortunately they're not available at the moment. I tried various different patches and preferred that brand. Some women prefer one brand over another and some don't notice any difference between them - it's just trial and error, I'm afraid. I personally prefer the gel as it's a daily dose and I really don't like having a patch stuck to me as I'm always aware of it. Hope that helps and good luck at the doc.
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Ah yes I forgot you said that. Re no period for 11 months. You may well be post-meno then and your lack of bleeding at other times bears this out. If you are not yet feeling well even though flushes have stopped then sounds like and increase in dose would be good. That being the case though off-licence alt day Utro probably wouldn't be sufficient as only for low or medium doses oestrogen ( depending on absorption). Personally in your position I would stay with a cycle, increase the oestrogen dose, especially if your doc has permitted a shorter duration - as long as its monitored. You might find that continuous prog continues to dampen your mood - it has a sedative effect - though a few women thrive on it even with higher oestrogen doses! I would get your oestrogen dose up and see how you feel and the explore testosterone which may well also be contributing. The sign that this is low is lack of libido and especially response, although other things can depress this eg some ADs.
re changing from patch to Sandrean - I tried this for a short while and didn;t get on with it. Not to say you won't - my flushes came back on the supposed equivalent dose to patches - although it wasn;t the same amount of gel as with estrogel which was 1.5 mg ( with Sandrena it was given as 1 mg - maybe because it is more concentrated). personally I would try a higher dose patch rather than change at this point especially if it has worked on flushes and sweats - which shows that you're absorbing it!
In haste (apols for typos) and good luck!
Hurdity x