Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: Kathleen on January 31, 2021, 10:26:21 AM
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Hello ladies
I was wondering if there are well known symptoms of progesterone intolerance so that I could work out if this is what I am experiencing at the moment.
I resumed HRT recently after a long break because my mood swings and tearfulness were becoming more intense. I am ten years post meno and don't really have physical symptoms anymore although I had many in the past. My problems now are emotional/psychological.
I have been using four pumps of gel daily plus Utrogestan orally at bedtime for four weeks and although I am less tearful my other symptoms of anxiety, irritability, mood swings etc haven't improved.
I have probably asked about progesterone intolerance before and I know lots of ladies use Utrogestan vaginally to reduce side effects but I would like to know what those side effects actually are. For example is increased irritability one of them or would that be due to low oestrogen?
Any insights and experiences would be great ladies and thank you for reading this.
Take care.
K.
I would love to get a clearer idea
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I abandoned Utrogestan because the side effects for me were fatigue, muscle aches and pains, low mood and pelvic discomfort. I was taking it on days 15-26 but struggled to take it for the full 12 days.
I've switched to Evorel sequi patches but I'm yet to get to the combined patch.
Have you thought of trying to take it vaginally? Newson Health have a leaflet on progesterone intolerance and they suggest taking it on alternate nights vaginally on a conti regime.
https://d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/559/Progesterone%20Intolerance.pdf
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Perhaps try it as sequi on a long cycle until you know what's going on? If you use a 6 week cycle you'll have a month without utro so you can tell if it's utro that's causing the problem. I just get fatigue on it. The emotional problems do seem to take longer than the physical ones, it was a good 3 months before I felt anything like stable. If you've gone from nothing to 4 pumps that's a big change, possibly better to build up gradually. The symptoms for too much or too little oestrogen can be similar. I'm not suggesting you're on too much long term but perhaps the big increase is confusing things.
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Hi I think you need to give it time. You have noticed an improvement in crying, so that’s a positive. I started on 3 pumps and quickly increased to 4, but it took a long time for improvements to show. Keep going 😊 .
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Hello ladies
Thank you all for your responses.
Jasmine 20 - I will check out the link you posted so thanks for that. I find it hard to know what is causing what which is very frustrating.
Sheila99 - I did ease in a little to four pumps and have been using that amount for a month though I accept that it is still early days really. Actually I tried a long cycle ages ago but didn't get on with it for reasons I can remember unfortunately. It's heartening to hear that you did see results after three months and I suppose I just need to be patient!
Dotty - Yep my tearfulness has improved a little so that gives me hope. As with Sheila I see that it took all of three months before you felt better so I will keep going.
Thanks again ladies for taking the time to comment, very much appreciated.
Wishing you all well.
K.
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Kathleen I’ve followed your struggles and really feel for you, it’s not easy is it? I feel your side effects are definitely caused by continuous progesterone. For me (I’m taking it currently) issues are sedative effect which tips into low mood the longer I take it. For instance I can manage 4 days then go offside (poor hubby) I’m not like this any other time. It manifests itself in negative thoughts and bad dreams, all of which cease once I stop taking it. I also get burning itchy skin and bloating.
Lovely isn’t it. I manage it by taking it vaginally and for the minimum time possible, so that I get the maximum benefits of oestrogen (which my body loves).
Don’t give in, keep tweaking your regime and I’m sure you’ll get there. Hope this helps xx
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Yes I do Avalon. I also swell right up around my abdomen which I hate, it goes as soon as I stop taking it though so is only water retention x
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Hello again ladies.
Perinowpost - thank you so much for your response. I have never been able to figure out if my mood issues are due to low oestrogen or continous progesterone, all I know is that I didn't have mood problems before the menopause which is true for many of us I suspect!
I am interested in your experience of mood changes after four days of prog. At the moment I am taking the capsule at night and usually sleep okay but about lunchtime the next day I feel my mood lower and then I am tearful until early evening when my mood begins to lift. Sometimes by about 8/9pm I am feeling a lot more normal. Does this sound like the effects of progesterone to you?
At 64 I don't really want to have regular bleeds on a long cycle but I need to do something so I suspect using Utrogestan vaginally is my only option.
Thanks again for your help and wishing you well.
K.
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Hi Kathleen
I think it’s very possible. As you say you didn’t have mood problems before menopause (like many of us) and which is a different issue entirely. Hormones are the precursors to mood and when they are out of balance cause all sorts of problems. I think your issue (like mine) is finding the right balance, but the regime has to be safe as well, and that’s the hard part.
The only way you’ll know really is to try (as others have suggested) oestrogen only for a while and see how you feel. By eliminating prog you can see what’s working. Trying this for one cycle can’t hurt.
Taking prog vaginally isn’t perfect but does minimise side effects. Taking it for the minimum time allowed also (although do this safely).
I totally get it about not wanting a period at 64 but it’s not like a traditional period, it’s lighter and doesn’t last as long. What’s the alternative - hysterectomy - it’s something I’ve thought about but it scares me.
The other option is to swap gel for patches. It’s the same thing (oestrodial) but a much more consistent method of delivery (I have found) so might help with mood, it would be a simple thing to switch.
Hope all the above makes sense. Keep talking xx
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Hello again Perinowpost.
Many thanks for your reply, much appreciated as you make some interesting points. Food for thought indeed.
Wishing you well.
K.
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When you take progesterone vaginally, do you decrease dosage? I have heard it is decreased by half. Anyone know?
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Yes I take the 100 mg capsules x
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AGH. I tried vaginal progesterone and it was awful. I had worse symptoms (lethargic, tired, bad dreams, etc!) than when I take it orally.
What is standard dosage of progesterone? I've been told by many women that they take either 100mg daily or 200 mg cyclic and even with estrogen dosage increase, the progesterone doesn't increase. Is this true? My doctor has been increasing my progesterone dosage when estrogen dosage is increased. :-\
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When you take progesterone vaginally, do you decrease dosage? I have heard it is decreased by half. Anyone know?
Are you talking about utrogeston?
The manufacturer says it's same dose if you use it vaginally or orally. Some people who are intolerant or on low dose oestrogen do use less but this should be with medical supervision.
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Yes, sorry - in Canada it's Prometrium (micronized progesterone).
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I am on two oestradot patches, allowed, and took 100mg progesterone but had a heavy bleed after 30 days. I then had continuous spotting. I asked my consultant and she said take two progesterone if another bleed happened. It did and I have been on two since 22nd Jan. I had a bleed for 8-10 days recently but still spotting and have daily period-like pains.
I am talking to my GP on Monday but am concerned as I have had to use pads or panty liners since 28th December!! :(
I’m hoping I don’t have to have regular bleeds, as I have never heard any women on HRT have this issue. My flushes were so debilitating I would not consider stopping oestrogen EVER! As I still have a womb I know I need progesterone.
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What dosage of patches are you on? And you are taking 200mg Prometrium (Utrogestan in UK) daily?
I am super confused about how much progesterone I should be taking, daily. My GP says 100mg daily. My OB/gyne says 200mg daily. I am on 100mcg Estradot. I feel better on just 100mg daily but of course don't want to risk endometrium becoming too thickened.
What to do?
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CandaceJ - The licensed dose is 100 mg daily (or 25 days out of 28) or 200 mg for 12 days per 28 day cycle, taken orally. This is the same irrespective of the oestrogen dose which is clearly not sensible since the amount of progesterone needed to protect the womb is dependent on the oestrogen dose. This dose may seem to be too much for women on very low oestrogen doses and insufficient on very high doses.
The dose is right if it is sufficient to prevent breakthrough bleeding in post-menopausal women on a continuous dose ( provided no womb pathology etc) ie keeps the lining thin but not overthin.
Only scans will tell you what is right for you if you are having unscheduled bleeding. You doc must have a reason for suggesting a higher dose. Maybe because you are on a higher oestrogen dose and have experienced breakthrough bleeding? Maybe a scan has shown thickened lining?
Taken vaginally it is more effective in protecting the endometrium, so some docs prescribe a lower dose if taken this way although unfortunately this is off-licence.
Hurdity x
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From what I understand Dr Newson recommends 100 ustrogestan/Prometrium orally per day, OR
100 ustr/prom vaginally every second day (although I have heard in Australia some have been lowered to Monday, Wednesday and Fridays of each week)
OR 200 on day 15 to 28 of each month orally. or half that vaginally.
Vaginally required half the amount taken orally.
When I enquired about the amount of progesterone for the different amounts of estrogen, I was old this amount is suitable for all amount of Estrogen being used. 50/75/100 etc.
But I have yet to find a perfect level and feel confused most of the time about returning symptoms