Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: pepperminty on August 01, 2021, 09:51:58 AM
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https://www.podbean.com/media/share/pb-hp6rr-e00017?utm_campaign=embed_player_stop&utm_medium=dlink&utm_source=embed_player
Hi ladies , pod cast about progesterone link above -
In this podcast, Dr Louise Newson is speaking to Professor Jim Simon, a Clinical Professor of Obstetrics and Gynaecology and Reproductive Endocrinology at George Washington University in Washington DC.
Dr Newson and Professor Simon talk about the Women’s Health Initiative (WHI) study and more specifically about the different types of progestogens and progesterone. He clearly describes and explains how body identical progesterone is the safest to take as well as the benefits women often experience when taking body identical progesterone. Jim also explores and explains the evidence regarding the reported risks of breast cancer with HRT and he and Dr Newson also talk about how important it is that women receive the best care and treatment during their menopausal years.
Professor Jim Simon's Three Take Home Tips:
Listen to your own body - it will tell you the truth! Address each of your symptoms with a healthcare profession and know your treatment options. Your symptoms are not 'a right of passage' that you have to put up with.
You are likely to live a very long life, take the big picture into account and try to practice preventive medicine.
Remember that whatever you decide on with your healthcare professional, doesn't have to be for the rest of your life. Make the best choice for you today and live it out until things change - you can always make a different choice if it's warranted tomorrow.
PMxx
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Thank you Pepperminty. Another interesting & useful medical expert podcast in the Newson Health series.
Even for women like me, who unfortunately can't tolerate the micronised progesterone now so widely advocated as the gold standard, this is well worth a listen for the broader messages Prof Simon has about women's post-reproductive health & HRT in general. His clear, explanatory style & his perspective from a background in reproductive endocrinology help make reassuring sense of the terminology & some of the biological processes associated with HRT, as well as making a persuasive case for its benefits in safeguarding against the long term consequences of hormone deficiency.
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Thanks Wrensong,
couldn't have put it better! Cannot remember what regime if any you are on? Have you found anything you can manage ?
I do not think I am intolerant of progesterone- as I fair ok on dygesterone ( I so wish they would bring Duphaston back as it has a really good safety record).
PMxx
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Currently trialling FemSeven Conti, Pepperminty, but have worked my way through all forms of progesterone inc the Levonorgestrel in this current preparation, but at the higher dose they put in FemSeven Sequi & years ago. Seemed worth a retrial as all out of options otherwise & now way postmenopause the lower proportion of progestogen taken daily might just work out to be OK.
Glad to know you are OK on Dydrogesterone :). Agree that if it were available separately it would be so helpful in providing another option to try with the various oestrogen-only preps. Fingers crossed efforts to reinstate it come to fruition.
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Hi Wrensong,
yes even though it says unavaiable , it is available. Are you getting on ok with it so far? Have you been on it long? I do hope it works out for you. I think it is in the mirena coil also.
When I had the mirena- I had no side effects except my legs swelled up , like tree trunks, so they took it out. I had no explanation or indeed was not told that my heavy bleeding was peimenopause and no offer of HRT. ( didn't know what it was really or that the mirena was a progesterone! ). That was after 4 months and they never mentioned that it may settle. It was a mare getting it in though- even under a general A. ::)
Our tolerance does change and what once did not work may now for you.
I am considering going to my MP and asking that he campaigns to get Duphaston back. Lets face it one more safe option would mean more ladies able to carry on a decent quality of life.
Personally it would mean that i could go transdermal without worrying that I have to get through trialling another progetserone. Goodness knows how us ladies manage to work, run a home and try to get the HRT sorted.
Louise Newson's mum , said that she was given a tablet and it made her feel better and she had no idea it was HRT! Then the scare came and she refused to come off as it was quality of life.
And then they realised that it is safe to use etc.
I suspect that the incidents of osteoporosis and I know alzhemiers has increased since the HRT scare- coincidence?
I try and remeber that there are lots of ladies out there doing really well and that helps.
PMXX
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Yes, Levonorgestrel is in Mirena too, but have always avoided that as can't contemplate having a device fitted I can't remove myself. Given my body goes nuts with prog :o., especially Utrogestan, I need to be able to control what I'm taking. Also, smears are an absolute b*gger at this age - they can never find my cervix :o, so anyone brandishing an IUD in my direction is likely to leave quicker than they expected & with my teeth marks in their arm ;D
The leg swelling sounds scary & very uncomfortable.
I am considering going to my MP and asking that he campaigns to get Duphaston back.
Didn't someone post on here a little while back that's being pursued already? I had in mind it was you?!
I suspect that the incidents of osteoporosis and I know alzhemiers has increased since the HRT scare- coincidence?
Unlikely to be coincidence with osteoporosis, but Alzheimers they seem less sure about. That said, it's a fear I have for the future if I have to stop HRT as my memory is better on it & frankly it scared me how bad it was at times before HRT.
Do you feel you need to come off Femoston because it's oral then?
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You did make me laugh ;D
Yes I had tried previously with calls and letters , but it got no where. And others here were very proactive too!
I am aiming to scare my MP into doing something, when I feel more up to it. ;D
I have never been great on femosten. It is the joints and muscles that siezed up, but the brain fog and anxiety went. So I decided that I would put up with the aches. But now they have ramped up. I do not seem to be able to get to the 2/10 dose without uncontrolable anxiety and poor mood.
I feel that I probably need testosterone, to help with my meno symptoms also but as my SHBG is sky high - caused by the oral HRT I think - and T is not recomended to take it whilst using the tablets.
I would have tried another regime earlier, but I can't afford to be off work- when I started Femosten I was in a right 2 and 8 - took months to get stable.
I know I need a higher dose.
When I started my HRT journey , I was clueless and I was put on premapac and the premarin was a miracle drug for me - I stopped limping overnight and was as bright as a button. But the progesterone part drove me insane.
PMXX
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Yes I had tried previously with calls and letters , but it got no where. And others here were very proactive too!
Oh, how frustrating is that? The powerlessness we can feel regarding all things menopause can be such a downer. Shouldn't be this way. Good luck with the MP.
What's left for you to try that's transdermal? I hear you on the work situation. What a dilemma, but you need to be well.
Yes, I've heard some women feel so much better on Premarin, but must be a difficult choice in that case, given its origins.
Wx
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Hi, I haven't tried utro yet , or provera.
The majority of women before the scare were given Premarin and just took it, knowing that they felt better. It was the go to HRT . But then we all just tended to do exactly what the doctors recomended without research or questions.
My philosophy is to try not to judge, I suspect that there are women out there on it who are afraid to say for fear of condemnation.
PMXX
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My philosophy is to try not to judge, I suspect that there are women out there on it who are afraid to say for fear of condemnation.
I agree.
You have a couple of options for prog then, plus the range of oestrogen alternatives. Hope you find a way of progressing without it causing work probs for you.
Wx
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Thank you,
it is a long journey, infact life long! ::). Yes options are there - along with the hormonal anxiety around change! ;D
But I for one loke yourself would like to be as healthy as possible as we are all living longer.
PMxx
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I am considering going to my MP and asking that he campaigns to get Duphaston back.
Didn't someone post on here a little while back that's being pursued already? I had in mind it was you?!
Hi, apparently we can get Duphaston in the UK again now. ChelWest have just prescribed it for me after my Utrogestan nightmare. My hospital prescription was filled by the local chemist, who didn't seem to have any problems ordering it.
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Hi rae123, that's very interesting, thanks for posting :). I had a quick google & came up with the following from Chelwest's MENOPAUSE AND PREMENSTRUAL SYNDROME SERVICE GUIDELINES (2018-June 2021)
https://www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/links/CWMENOPAUSEPMSguidelines2014v3.2.pdf
"Duphaston
(Dydrogesterone)
Unlicensed drug
Biologically similar in action to naturel progesterone
Not available in the UK but licensed in Europe and safety data still
justifies continued use
Available on a named patient basis only via pharmacy, for women with
severe progestogen intolerance"
I hope you get on well with it. Please let us know how it goes.
Wx
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Thank you for posting rae123 :)
Well that is interesting- so you can get it if presecribed by a specialist if you are progesterone intolerant. - If I am reading it correctly?
It is a cheap drug - so they can't use the excuse of it is too expensive, and considering tat it has a good safety data and widely available elsewhere.
I wonder if other specialists are aware that they can prescribe it? Thanks for copying the relevant bit wrensong.
This bit of info could be very useful for some ladies.
Perhaps we should do a seperate titled post with this information on also- as it gives one more option for those on here to try?
PMXX
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Thank you for posting this, Pepperminty! It's made me feel a lot more comfortable with taking HRT long term. :)
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rae123 would you mind giving details of your regimen please? Would be really helpful to know what dose of Duphaston you've been prescribed, whether continuous or sequential & if sequi, for how many days, standard/short cycle, how much oestrogen with it, whether you take testosterone, where you are in menopause etc. Also what side effects you had from Utrogestan. Blimey - Spanish Inquisition. Sorry ;D. If you prefer not to say, that's absolutely fine :)
I see the guidelines published in the link were due to expire in June this year, so wonder whether Duphaston is included in those that replaced them. Can I ask how long ago were you prescribed it rae123?
Agree with Pepperminty's suggestion of a new thread too.
Wx
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Hi Pepperminty, attached link/extract from MHRA document dated 2014 refers to "named patient" prescribing. I haven't read it all & don't know whether there is anything more up to date.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/373505/The_supply_of_unlicensed_medicinal_products__specials_.pdf
"The supply of unlicensed medicinal products (“specials”) MHRA Guidance Note 14
2.2 An unlicensed medicinal product may only be supplied in order to meet the special
needs of an individual patient. An unlicensed medicinal product should not be supplied
where an equivalent licensed medicinal product can meet the special needs of the
patient. Responsibility for deciding whether an individual patient has “special needs”
which a licensed product cannot meet should be a matter for the doctor, dentist, nurse
independent prescriber, pharmacist independent prescriber or supplementary prescriber
responsible for the patient’s care. Examples of “special needs” include an intolerance
or allergy to a particular ingredient, or an inability to ingest solid oral dosage forms.
These examples are not exhaustive."
Off at a tangent from your original post but hopefully relevant to your question as to conditions under which "specials" can be prescribed.
Wx
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Hi Wrensong, thank you that is very helpful. I think that in the light that Duphaston is not a contentious drug - untested etc and the fact that it is already contained in Femosten ( all types) it seems ludicrous that you have to jump through hoops to get it. But maybe one still can via the NHS using the information from the C &W clinic ?
In fact I think it has a really good safety record.
I suspect the rae123's progesterone may be the standard 10mg ? But it would be very interesting to here the actual regime that was prescribed if possible.
Knowledge is power!
PMXX
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Hi Pepperminty, agree with what you say here . . .
I think that in the light that Duphaston is not a contentious drug - untested etc and the fact that it is already contained in Femosten ( all types) it seems ludicrous that you have to jump through hoops to get it.
but was very surprised to find it documented in the Chelwest guidelines that dydrogesterone can be prescribed on it's own for HRT use in combination with the various oestradiol preparations, given how many times it's been understandably lamented on here that it's only available in the UK in the Femoston combi products.
But maybe one still can via the NHS using the information from the C &W clinic ?
No idea whether some Health Authorities may decline to allow it though. I printed the guidelines off to show to my Cons as soon as I found them, so great minds think alike!
But yes, knowing the full details of the regimen would be so helpful, so anyone who feels the need to try it can take along to their doctor evidence of how it's been prescribed by one of the most respected menopause authorities. That should hopefully give confidence to prescribe if hands are not tied by individual HA regs & open up another option for those of us who really struggle to get around progesterone intolerance.
Wx
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AWESOME Peppermint! Will definitely have a listen over brunch. ;D
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Fab, we need more choices!
PMXX
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I live in Ireland and Duphaston is available here. I have just started it.
I am a year without periods and I am taking estrogen in patch form and Dupaston 10mg for the last 14 days of the cycle.
I guess I will have a bleed with this regime but I am going to see how it goes and if it is unbearable then I will see if I can take it continously but I would need to ask my gp.
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Oh IrishWendy - good that you've posted here as well as on your other thread :). Everything crossed for you.
Wx
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Hi irishwendy,
I've just started duphaston 10mg for breakthrough bleeding after 14 months on utrogestan 100mg continuous.im finding the mornings the worst with a sick tummy and hardly able to get up with tiredness. Did you have these side effects and if so how long did they last. Were you on 10 or 20 mg, I must begin on 10mg and change up to 20mg at some point. Just worried at how strong the side effects are on the 10mg not to mind going upto 20mg.
Any advice would be really appreciated.
Thanks
Jo.x
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Hi Jo journey
:welcomemm:
This is a very old thread (which I started reading until I realised!) and perhaps best to start a new thread so your message can be seen and answered by more women?
Especially interesting that you mention Duphaston and others would be interested too if you put that in the title! eg WHERE do you get it from?!!!! Here in UK it is not available and lots of us would love to try it!!!
Few women on here take this although some do as part of Femoston - the only HRT that it is licensed to be supplied as part of....
Hurdity x
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Hi Jo Journey,
as Hurdity says. It would be great to know how you got it prescribed? Are you in the UK?
Many thanks PM X