Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Cassie on July 28, 2023, 09:52:38 AM
-
Are there ladies on this lovely forum still taking HRT into their 70s and possibly even older? I was just wondering if theres a cut off point and how does one address getting withdrawal bleeds at that age? Not sure if its even possible or safe or does one have to go onto a conti regime from a certain age? The thought of taking a progestegin daily worries me, its bad enough using Utrogestan every 2nd month for 12 days but to use it continually would not work for me.
-
I'm 76 this year, I've only just started ovestin cream due to VA I did some research the other day on this and there's no age cut off point. I also looked at the benefits of using the cream against the risks and the benefits far outweigh the risks. I've a few more days left for the 2 weeks every day then it's down to twice a week. Yes it's a pain having to go through the rigmarole of using the cream but it's better than the awful effects of VA. Thankfully I don't need progestegin.
-
Yeah Ovestin though does not require a protective progestegin/progesterone, I am not sure about the safety of HRT and getting monthly bleeds nor the convenience of it when older, would love some feedback on that from ladies over 70 in this forum and how you are finding it and if not getting bleeds what conti HRT works for you as I am currently on the gel and utrogestan but not sure if this will work in years to come as I age.... :-\
-
Hi
I don't know if it helps, as l don't understand all the different hurts, but my mum is 73 this year and still taking hrt, she's tried to come off it but she got bad sweats so didn't.
She's taking just estrogen tablets as she's had a hysterectomy.
She's also now said she's never going to come off it.
-
Thank you for that. I would love to be able to just take the estrogen part but without a hysterectomy, its not possible and really hoping to get some responses from those ladies who still take the combined HRT as to how they handle the bleeds? I seem to think Hurdity may have some input but may be mistaken....anyone else? :-\
-
Morning,
I’m 69 years old and have been on HRT since I was 42. I was recently advised to take utrogestan continuously due to my age. After 8 months I started to bleed and had a hysteroscopy privately. Thankfully it came back all clear and the consultant suggested I go back to a sequi regime. I have absolutely no intention of coming off HRT.
-
Cassie, I think the problem is Utrogestan which is not well tolerated judging by the posts on here and my own experience with it.
You don't have to be progesterone intolerant to have problems with Utrogestan.
I couldn't stand bleeding in my late 50s (I'm now 62) let alone 70! The bleeding literally made me ill and I hated it.
I now use one pump of Oestrogel, testosterone and 50mg of progesterone gel every day and I'm l completely free of any side effects. Have you thought about trying a different progesterone? Having used Utrogestan and switched to different progesterones (compounded then gel) myself, I honestly think the problem is Utrogestan.
-
Hi Mary G, what make is your progesterone gel please? I haven't heard of that before? Thanks.
Cassie I'm still on at combi HRT at almost 67, I may have a trial off it in a while to see how I go, have been on it for nearly 4 years. If flushes return then I would go back on it. It is all very much trial and error :-\!
-
Julia, I use progesterone gel which I buy in Spain but the progesterone cream from Biovea is just as good. 50mg is the perfect dose for me with no side effects and good womb protection - backed up with scans of course.
I really liked the progesterone lozenges but it was no longer viable for the UK pharmacy to post to Spain post Brexit.
-
Thank you ladies, I have not heard of the gel, I would love to try anything other than the Utrogestan.
Jaydee & Julia Dizzy how do you feel about still getting bleeds regularly?
-
Cassie might it be worth trying cyclogest?
-
HRT can be prescribed for life. Age shouldn't be a barrier.
Vaginal atrophy threatment the same. Some require nightly applications which is completely safe, regardless of what it 'says' in the leaflet. Other cope with several times a week, i.e. every 3rd and 6th/7th night.
-
Hi Cassie
Never fear - you're not alone! yes I am here, 70 and still bleeding :( - ie cyclical HRT. I remember posting a similar thread about women in their 60's and bleeding! How time flies!!
There is no cut off date. The artificial cut-off date used to be post-menopause (or after a year of being on HRT or after age 54 when on cyclical HRT) but we're long past that. I can't remember how old you are but I know we've been chatting on here for some years.....
What is the alternative?
1 Give up HRT. I used to think when I got to 70 I would think about it but now I am here - NO WAY! As long as no medical reason means that I have to stop, then I'm not.
2 Have a hyserectomy - also out of the question. You can't just have surgery for no reason and discomfort with using progesterone would not be considered enough at our age I doubt.
3 Change progestogen. I've only ever used bio-identical products save for initial 3 months on evorel sequi 15 years ago and the occasional norethisterone cycle to clear my womb lining build-up. For me it has to be utrogestan with all its failings. The only exception I would make is if dydrogesterone was available on its own in UK and I would try that. As an aside does anyone know if it is available in Eire (as Duphaston or similar) because I think it is still available in some EU countries?
4 Take Utrogestan continuously. Like you Cassie this is a complete no-no. A don't want to end up like a fatigued brain-fogged migraine-ridden zombie. There is also the question mark of its association with breast cancer so taking it continuously for a long time into old age is untested and maybe taking unnecessary risks - not enough is known.
Which leaves what we are doing which is - taking it cyclically into our 70s and beyond. This is new territory and I'm not sure if anyone is studying it - I do hope they are!
How do I manage? Well unfortunately I did have some abnormal spotting and a thickened lining recrently though hysteroscopy and biopsy revealed nothing abnormal but I can't understand why this occurs because my bleeds are minimal. Maybe the utrogestan is not working as well as it used to. Maybe my uterus is not as responsive as it used to be? I have recently changed from 2 x 100 mg to 1 x 200 mg (the vaginal utrogestan) and I am hoping this might work better.
Becuase of the thickened lining I have reduced to 5-6 weeks, though post-scan/biopsy the consultant wanted me to take 200 mg for 14 days per 28 day cycle :o . No way!
There we are.
And no, it is not recommended for anyone to use OTC progesterone cream for endometrial protection as part of HRT in case anyone is thinking of experimenting. It is important to use proprietary products at the correct dose and be under medical supervision, and especially when you get older.
There is Crinone progesterone gel used for fertility as well as Lutigest and Cyclogest but I haven't really come across anyone using it on here - there was someone a while back I think. It used to come in lower concentration but now only as 8% and looks like 90 mg per dose. There is some research into its efficacy for endometrial protection but I think this was using the 4 % gel - the BMS paper on progestogens refers to it. That might be a possibilty if you can persuade a doc to prescribe it?
I can't remember if you take utrogestan vaginally? Even though I have never taken it orally I still get the unpleasant side effects from vaginal intake, because of course there is systemic absorption.
The first progestogen I used was Cyclogest but it was quite messy. Also the efficacy in protecting the endometrium hasn't been properly studied I don't think? I was given a very high dose (400 mg for 11 days per cycle) by my GP, so lower quantities comparable with utrogestan, I think would be experimental?
Do let us know if you try something different and good luck with your choices!
I wonder if there is anyone of 80 still on HRT and having to bleed!!!!
Hurdity x
-
Hurdity do you have any comments on taking utrogeston rectally?
-
Cassie might it be worth trying cyclogest?
Good idea, I meant to suggest Cyclogest as well. I bought a box to have on standby and it seems very dose flexible (wax pessaries you can cut) and it can be used vaginally or anally.
I doubt it would be any worse than Utrogestan.
-
Hi cassie, I don't have bleeds on my regime of Estradot 50 patch and Utrogestan 100mg every night.
Although reading what Hurdity says about Utrogestan has got me worried now!! I don't seem to have many side effects on it, although feel pretty rubbish in general these days with joint ache and fatigue so it's hard to know!!
I don't fancy Cyclogest, they sound very messy... :-\
-
Thank you laidies @ to you in particular, Hurdity, for your very helpful response. I take Utro 100mg vag x 12 days per every other month but have tried to come down to every 6 weeks. I am interested to hear about Duphaston and why you would consider that, if available. Is it a more"user friendly" progesterone than Utrogestan? Is it also bio identical? I would love to know if there are any ladies still in their 80s doing the cyclical routine, you will have to be our "guinea pig" Hurdity & keep us updated ;D
-
Hurdity do you have any comments on taking utrogeston rectally?
I read this as Cyclogest first....
Yes my comments are that it is not designed to be taken rectally and has not been tested in this way, and not even structured to facilitate this so I wouldn't do so. You have no idea how it is going to be absorbed or how much or how the coating etc reacts with the contents of the rectum etc. It would be trial and error and how long do you give it before deciding it is not protecting the uterus.
Anyone who wants to go down the rectal route (and having tried it for some months or maybe even a year - can't remember - I never want to again!) should go for Cyclogest which is designed for this, even though unlicensed for menopause.
Also for it to work rectally- it has to be absorbed systemically through the wall of the bowel before being transported to the uterus, whereas inserted vaginally - much of it goes straight to the uterus where it is needed.
Hurdity x
-
Hi cassie, I don't have bleeds on my regime of Estradot 50 patch and Utrogestan 100mg every night.
Although reading what Hurdity says about Utrogestan has got me worried now!! I don't seem to have many side effects on it, although feel pretty rubbish in general these days with joint ache and fatigue so it's hard to know!!
I don't fancy Cyclogest, they sound very messy... :-\
Apologies Julia Dizzy - I didn't intend to be alarmist.
I have never taken any HRT orally (apart from very occasional norethisterone cycles) so I have no idea how taking it orally would affect me. Research has shown that the metabolic breakdown products of progesterone (Utrogestan) when taken orally can cause unpleasant side effects and the (French) manufacturer recommends it to be taken vaginally if side effects from oral use.
All I am saying is that because there is some systemic absorption of progesterone even when taken vaginally, I can feel the effects and as such I don't like them. This is not the case for everyone and you may well feel perfectly OK or only mildly sedated etc? If you don't have many side effects on it then that's great - but as you say, your fatigue could be down to continuous progesterone, if other causes have been ruled out.
Hurdity x
-
Thank you laidies @ to you in particular, Hurdity, for your very helpful response. I take Utro 100mg vag x 12 days per every other month but have tried to come down to every 6 weeks. I am interested to hear about Duphaston and why you would consider that, if available. Is it a more"user friendly" progesterone than Utrogestan? Is it also bio identical? I would love to know if there are any ladies still in their 80s doing the cyclical routine, you will have to be our "guinea pig" Hurdity & keep us updated ;D
You're very welcome.
Duphaston used to be available in UK but was discontinued before I was aware of any of this. Dydrogesterone is definitely a "better" progestogen of all the synthetic ones. Not bio-identical but very close in structure to our own progesterone. Because it is more stable in the body (unlike progesterone) it can be take in much smaller quantities than progesterone which needs to be taken in very large quantities because it breaks down in the body so quickly. Now it is only available as part of the Femoston combi range.
There was also some research done (not trials I don't think but observational study? Sorry can't remember off hand) showing that of all the synthetic progestogens, dydrogesterone was the most "breast-friendly" ie associated with the lowest breast cancer risk. Don't quote me on that - I can't remember the details....
re HRT guinea pig - Haha ;D! if I live that long and stay healthy!
Hurdity x