Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: bubble tea on October 04, 2023, 03:18:35 PM
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Hi, I am 58 and still having horrendous menopause symptoms. I can't take the HRT at the moment as I cannot tolerate the progesterone part of it. It makes me anxious and severely depressed.
Can anyone recommend where I might be able to find a HRT health professional who is knowledgeable about progesterone intolerance? My GP was unhelpful so I am happy to see someone privately. Many thanks x
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Hi. U shouldn't need to pay for advice though many do so as GPs don't always have a handle on peri-menopause etc.. :welcomemm:
There are dedicated NHS and private menopause Clinics. Many cannot tolerate progesterone and the extreme route out is hysterectomy. However, if 1 can get proper advice about a longer HRT regime you may feel a lot better. Several ladies here should be able to give advice.
Some find that keeping a mood/food/symptom diary useful to chart progress. Is there a GP or Nurse Practitioner within your Surgery with an interest in womens health?
Which symptom would you like to ease first?
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Sorry to hear you are progesterone intolerant. If you are severely intolerant to the extent that you literally can't touch it, your only option is a hysterectomy. Perinowpost on here was extremely progesterone intolerant and her life has been transformed by having a hysterectomy and taking oestrogen only HRT.
If you are progesterone intolerant but can just about stand a few days of it then you need to take 100mg Utrogestan vaginally for 7 days each month but you need to have regular scans to check the womb lining. Most women are fine on that dose (I was fine on even less than that) but there will always be some women who don't get adequate womb lining clearance on a low dose of progesterone. You would have a monthly bleed on this regime.
If you are post menopause and/or don't want a monthly bleed, you can take 50mg progesterone every day or 100mg every other day but again, you will need scans to make sure your lining is thin.
You need a doctor who specialises in progesterone intolerance and I would try Professor Studd's old practice in London which I believe is now run by Mr Michael Savvas, Mr Neale Watson and Ms Beverly Benster. They specialise in progesterone intolerant and reproductive depression. I'm pretty sure the Newson clinic have specific doctors who specialise in progesterone intolerance too.
NHS menopause clinics are over subscribed with massive waiting lists so I would definitely seek help privately. Private clinics are more flexible on doses too.
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Sorry to hear you are progesterone intolerant. If you are severely intolerant to the extent that you literally can't touch it, your only option is a hysterectomy. Perinowpost on here was extremely progesterone intolerant and her life has been transformed by having a hysterectomy and taking oestrogen only HRT.
If you are progesterone intolerant but can just about stand a few days of it then you need to take 100mg Utrogestan vaginally for 7 days each month but you need to have regular scans to check the womb lining. Most women are fine on that dose (I was fine on even less than that) but there will always be some women who don't get adequate womb lining clearance on a low dose of progesterone. You would have a monthly bleed on this regime.
If you are post menopause and/or don't want a monthly bleed, you can take 50mg progesterone every day or 100mg every other day but again, you will need scans to make sure your lining is thin.
You need a doctor who specialises in progesterone intolerance and I would try Professor Studd's old practice in London which I believe is now run by Mr Michael Savvas, Mr Neale Watson and Ms Beverly Benster. They specialise in progesterone intolerant and reproductive depression. I'm pretty sure the Newson clinic have specific doctors who specialise in progesterone intolerance too.
NHS menopause clinics are over subscribed with massive waiting lists so I would definitely seek help privately. Private clinics are more flexible on doses too.
Hi just wondering how often you would need scans if doing the 7 days of utrogestan route? Thanks
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Penguin, a scan once a year would be enough unless you had a problem like suddenly bleeding very heavily.
Personally, I think it's pointless to overload with progesterone and suffer the side effects when you can so easily find out how much you need by having annual scans.
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Mary G, do you know where scans can be done? Is it private clinics?
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Tribbins, I've never had a TVS in the UK but all the private clinics like Bupa and Spires offer them and there are various other places I believe - Mothercare used to do them. If do a Google search in your area, they will come up and I think they cost about £100.
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Many thanks for all your advice I really appreciate it. I have been trying to handle the menopause symptoms without hrt because of the progesterone. But the hot flushes, mood swings and sleepless nights are ruining my quality of life!
Has anyone been to a clinic called "Menopause Care"? Their website mentions "progesterone intolerance". I have seen a few doctors though and nobody has offered a solution up to now sadly.
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Mary G, do you know where scans can be done? Is it private clinics?
I've heard ultrasound direct mentioned on here. They do a wellwoman pelvic scan which is transvaginal and it is £145. Seems you can get an appointment really quickly too. Their TrustPilot reviews are very good.
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Why don’t you get in touch with Newson clinic? As Mary has suggested, they will probably be able to help you find ways round the progesterone intolerance.
I’m guessing a coil would be out of the question? It releases a tiny amount of hormone directly into the womb; far less than utrogestan.
There are ways and means round this. You just need to find the right support to guide you. If you would only need a couple of scans a year to check on your womb lining, then that could be money well spent, to reclaim your life?
Keep researching; it can be done
Are you intolerant to all progesterone?
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Sorry to hear you are progesterone intolerant. If you are severely intolerant to the extent that you literally can't touch it, your only option is a hysterectomy. Perinowpost on here was extremely progesterone intolerant and her life has been transformed by having a hysterectomy and taking oestrogen only HRT.
If you are progesterone intolerant but can just about stand a few days of it then you need to take 100mg Utrogestan vaginally for 7 days each month but you need to have regular scans to check the womb lining. Most women are fine on that dose (I was fine on even less than that) but there will always be some women who don't get adequate womb lining clearance on a low dose of progesterone. You would have a monthly bleed on this regime.
If you are post menopause and/or don't want a monthly bleed, you can take 50mg progesterone every day or 100mg every other day but again, you will need scans to make sure your lining is thin.
You need a doctor who specialises in progesterone intolerance and I would try Professor Studd's old practice in London which I believe is now run by Mr Michael Savvas, Mr Neale Watson and Ms Beverly Benster. They specialise in progesterone intolerant and reproductive depression. I'm pretty sure the Newson clinic have specific doctors who specialise in progesterone intolerance too.
NHS menopause clinics are over subscribed with massive waiting lists so I would definitely seek help privately. Private clinics are more flexible on doses too.
Just called the clinic Mr Neale Watson and Mr Savvas are at and had a chat with a lovely lady there. She said that they no longer prescribe lower dose/ shorter duration of progesterone and now stick to BMS guidelines of 200mg x 12 days. Even patients who were previously prescribed on that basis are no longer apparently. Her suggested alternative would be the mirena coil. Wondering if you have any thoughts about that as an option, or if you know of any other clinics that may be more flexible please?
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I also called this clinic (Watson/savvas) and was given the same information.
I also called the Newsom clinic and was told any of their doctors could advise on progesterone intolerance.
I am a bit sceptical of booking an appointment because I have already seen other consultants who have had not really helped. I obviously understand the importance of progesterone but I felt very ill on the doses I have had previously.
I have done a lot of research but keep coming up against dead ends.
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I also called this clinic (Watson/savvas) and was given the same information.
I also called the Newsom clinic and was told any of their doctors could advise on progesterone intolerance.
I am a bit sceptical of booking an appointment because I have already seen other consultants who have had not really helped. I obviously understand the importance of progesterone but I felt very ill on the doses I have had previously.
I have done a lot of research but keep coming up against dead ends.
Did the person you spoke to at Newson give any idea of what sort of options were available? I found the lady at the Watson / Savvas clinic amazing and she spent about 15 minutes talking to me about it all and explaining things. I didn't end up booking an appointment yet as I am hoping to find out more on here re mirena etc. I can see what you mean about booking another expensive appointment only to find out they can't help you again!
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That is the issue exactly! Most people I know just start on the hrt and cannot understand why I can't so it's very hard to get advice from friends etc.
Newson were very nice but quite vague about my specific issue. I only spoke with the receptionist though.
I have been recommended the mirena coil also but because my reaction to Utrogestan was quite severe I am scared to try it.
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That is the issue exactly! Most people I know just start on the hrt and cannot understand why I can't so it's very hard to get advice from friends etc.
Newson were very nice but quite vague about my specific issue. I only spoke with the receptionist though.
I have been recommended the mirena coil also but because my reaction to Utrogestan was quite severe I am scared to try it.
I'm scared too. I can just about handle the physical symptoms, but the mental health ones are debilitating. Please update if you find something or get any good advice. Am hoping Mary G will come back on as she knows her stuff re progrsterone intolerance.
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Mary G, do you know where scans can be done? Is it private clinics?
I've heard ultrasound direct mentioned on here. They do a wellwoman pelvic scan which is transvaginal and it is £145. Seems you can get an appointment really quickly too. Their TrustPilot reviews are very good.
I've checked this out, there's one in my nearest town. I'm going to do oestrogen only until my next review in a couple of weeks then get a scan. I can't even cope with 50mcg progesterone every other day, just too crappy feeling. I tried to reduce oestrogen and migraines come back, feel between a rock and a hard place at the minute. There's got to be some solution.
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It sounds like Watson/Savvas have bowed to BMS pressure on progesterone doses so there is no point in going to them. If you are progesterone intolerant, you will never cope with that dose.
A Mirena coil is a definite maybe but again, if someone is diagnosed as progesterone intolerant, it's not going to fly. Although the progesterone from the coil is mostly confined to the womb, enough of it can reach your overall system and cause side effects like breast pain in my case.
A progesterone coil with a lower dose than the Mirena (Jaydess) is worth a try. It's not licensed for HRT use (only contraception) but there is no reason why you can't try it as long as you have regular scans. I found the Mirena caused too much thinning of the womb lining so if you can swing the Jaydess, it could be a good option.
Once you have tried all the conventional progesterone routes, the final port of call prior to the last resort (hysterectomy) is compounded progesterone. The Specialist Pharmacy in London who produce it can provide a list of all the practitioners who prescribe their products. I got on well with progesterone lozenges @50mg but they now have drops and creams that are also very good and very effective on the endometrium.
For the record, I'm not progesterone intolerant! I did think I had suddenly become so post menopause because the Mirena coil, Utrogestan and all other forms of synthetic progesterone triggered my silent migraines but it turned out that the dose was just too high and I how happily take 50mg progesterone every day with zero side effects.
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Hello ladies. Thank you so much for sharing your experiences on progesterone. I am on vaginal Utrogestan 200mg for 12 days of the month. The 1st month was ok but now on day 5 of the second month and I am experiencing anxiety and low moods. I’m also on AD which has been helpful but does not seem to be helping with my progesterone anxiety. Please can anyone suggest any herbal remedies which can help with anxiety? It’s all very debilitating and I really don’t know what to do. I would appreciate your responses, please. Many thanks.
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I think you will struggle to find sonething you can take alongside AD'S. Definitely not st johns wort or rhodiola. Maybe try a magnesium supplement?
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It sounds like Watson/Savvas have bowed to BMS pressure on progesterone doses so there is no point in going to them. If you are progesterone intolerant, you will never cope with that dose.
A Mirena coil is a definite maybe but again, if someone is diagnosed as progesterone intolerant, it's not going to fly. Although the progesterone from the coil is mostly confined to the womb, enough of it can reach your overall system and cause side effects like breast pain in my case.
A progesterone coil with a lower dose than the Mirena (Jaydess) is worth a try. It's not licensed for HRT use (only contraception) but there is no reason why you can't try it as long as you have regular scans. I found the Mirena caused too much thinning of the womb lining so if you can swing the Jaydess, it could be a good option.
Once you have tried all the conventional progesterone routes, the final port of call prior to the last resort (hysterectomy) is compounded progesterone. The Specialist Pharmacy in London who produce it can provide a list of all the practitioners who prescribe their products. I got on well with progesterone lozenges @50mg but they now have drops and creams that are also very good and very effective on the endometrium.
For the record, I'm not progesterone intolerant! I did think I had suddenly become so post menopause because the Mirena coil, Utrogestan and all other forms of synthetic progesterone triggered my silent migraines but it turned out that the dose was just too high and I how happily take 50mg progesterone every day with zero side effects.
Thanks Mary G that is really really helpful. I will try and find out more about the Jaydess and where I might be able to get it. Do you think I'd still need scans if I went down that route?
I have not heard about compounded progesterone before. I will look into that too. At the moment I am feeling the usual horrible drop that always happens when I stop taking the utrogestan, even though I only took 100mg on the last night - feeling very down, anxious and full of rage all at the same time 🙄
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Penguin, I found a fact sheet from the Chelsea and Westminster menopause clinic and there is a third coil (Kyleena) which is also low dose. They recommend the Jaydess and the Kyleena off licence for progesterone intolerant women with annual/biannual scans.
https://www.chelwest.nhs.uk/your-visit/patient-leaflets/medicine-services/levonorgestrel-intrauterine-system-with-hormone-replacement-therapy
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Have you tried different types of progesterone? Just that sometimes it can be intolerance to a formulation so it's possible you might find something you tolerate better. I know it isn't the same but I'm wiped out on utrogeston but fine on norethisterone (which I can't have now because of of allergy to something else in it).
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I have only tried utrogestan. I thought itd be the same on all types unless I had a lower dose. I really liked the sound of Dydrogesterone but don't really want to stop the estrogel as I really like it.
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Thank you @ jorainbow. I will try magnesia supplements. I hope I get some relief. Many thanks for replying.
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thank you everyone for the advice - I feel as if I have a lot more options and places to look now
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I can' t take Utrogestan either but am fine on Crinone (another progesterone that is bio identical to the natural one), which comes as a vaginal gel. Different formulations of the same compound definitely affect us differently.
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I have been recommended the mirena coil also but because my reaction to Utrogestan was quite severe I am scared to try it.
I am perfectly fine with mirena coil, but can’t tolerate utrogestan. Those two products are different types of progesterone and for some reason my body prefers synthetic one.