Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Mahoomie on October 24, 2023, 02:20:17 PM
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This year at 49 after suffering with what I thought was long covid I was sent for many blood test by GP and they all came back normal, yet no one ever suggested menopause or peri menopause! Anyway, after researching and watching Davina’s programme and reading her book I decided to ask GP for HRT.
I was seen by a lovely nurse who was the surgery menopause expert and seemed knowledgeable and empathetic on menopause and prescribed me Estrogel (eventually I found 3 pumps was just right for me) and Utrogestan 100 once a night continuously (even though I was still having periods, which I thought odd but she said it was fine). I read on the balance app that if taking Utrogestan vaginally it was was possible to half the dose and take every other night, so this is what I decided to do (I had read conflicting advice but went along with this as advised on there) My testosterone was found to be low, but on the low end of normal so I was able to get some privately online, and have been taking a pea sized blob of Testogel every day. This 3-way combination seemed to be perfect and I was feeling great! Right up until I moved on to the new shaped Estrogel bottles! Aaaggh symptoms seemed to come back.
Spoke to the nurse again and asked if I could try patches, she agreed and put me on Everol 75, and Utrogestan pessary 200 every night for 14 nights out of 28 cycle. I’ve used about 5 patches so far and right now I feel awful, sleep up the spout, am absolutely knackered all the time, no motivation, anxiety and mood is terrible, and confidence at all-time low - I’ve not even started on the 200 Utrogestan pessaries part yet. What the hell is going on?
Can anyone help or shed some light, could 75 be too much, too little? Should I try something else. At this stage I feel like giving the gel another try again - is it back to normal now? Any advice or recommendations would be so gratefully received as I feel at a complete loss right now.
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I can't comment on the change of oestrogel as I use sandrena but it could be that you don't absorb via the patch as well as you absorb the gel.
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I've always been a poor absorber of hrt but my E2 levels plummeted when I briefly swapped to patches from oestrogel so I went back to the gel post-haste. Sounds like that this is the case with you so I would in your position go back to the gel - I have the new smaller bottles but can't say I've noticed a difference from the old bottles...
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Oh thank you both @peach8 and @laszia - sounds like I could be the same as you laszia, I thought something seemed so odd. So do you find that the new bottles are ok for you? (the cylindrical tube-like ones?), and @peach8 how do you find Sandrena, do you get relief from your symptoms on this gel?
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I actually am spooked out by this post!!!!!!!!!
I was just about to post my story which is sooooooooooo similar.
I have been using gel and utrogestan since May after all the patch hoo ha. Have been pretty stable on it. About 6 weeks ago I started upping to 4 pumps from 3 just to see what would happen, As per previous attempts it appears I dont tolerate higher doses of oestrogen with sore boobs and ongoing cramps. So on last Monday I went back to 3 pumps. After a few days of desperately trying to source the old style bottle and getting nowhere even at my last resort private pharmacy I decided my only real option was to go back to patches as the new oestrogen is just not an option for me.
I have been on a patch since last Thursday and oh my god I feel terrible. Almost like I am pregnant. Tired. Exhausted actually. Flat mood. Bloated. Cramps and nausea like you would not believe. I am actually scared with how bad I feel.
The reality is it seems the new bottles are all thats available and Im not willing to use them. I was using patches quite successfully before until there was issues with patch supply - and I had a couple of issues with them sticking on my left side - weird but true. I am going to stick it out for a few more weeks but it aint fun and I am really struggling. @mahoomie I feel your pain. I think switching up can definitely affect you.
Edit - I am 46 and on Utrogestan vaginally days 14 - 26 of my cycle.
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I haven't noticed any difference with the new cylindrical bottles - I doubt they would have changed the actual formula of the gel ?
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there are far too many woman noticing issues. At Boots today the pharmacist said she has had a number of woman asking for the old style bottles back - which is interesting because I raised it with them back in July and they looked at me like I was losing the plot. Same with a local pharmacy - too many people complaining for it not to be an issue. Some of us may be more sensitive than others. It is clear that the dose coming out of each pump in the new style bottles is less than it should be and wholly inconsistent.
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Oh Moog sounds like we are going through similar - I'm so sorry to hear things are up and down for you too. Seems to really be a lot of women noticing the same regarding the new style bottles. Too many not to be something in it, whether its the formula or the way the pump is delivering the dosage, something is definitely up. I do hope they get to the bottom of it for all our sakes! Laszia so glad it's not causing you problems, that's so lucky.
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Oh Moog sounds like we are going through similar - I'm so sorry to hear things are up and down for you too. Seems to really be a lot of women noticing the same regarding the new style bottles. Too many not to be something in it, whether its the formula or the way the pump is delivering the dosage, something is definitely up. I do hope they get to the bottom of it for all our sakes! Laszia so glad it's not causing you problems, that's so lucky.
I think waiting at least 6 weeks to see if things have settled just a little is a good rule of thumb - thats only my experience though - when I first started HRT i remember almost bailing out because I didnt feel any benefits until one morning i woke up at the end of the 3rd week and I knew right away something was different.
The situation with the gel really is a pain. My pharmacist said there is 'intermittent' issues with estradot patches as well. What are we meant to do? Its simply not good enough.
Hope things settle soon - hang in there!
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HI
I am having problems with the new gel bottle as well. So something is definitely up. I have noticed the consistency is different as well as the dosing amount. I am wondering if that means that our bodies need to readjust to take up the new style gel. Luckily I have an appointment with a menopause specialist tomorrow (good timing) so I will quiz her on this, but it is a nightmare for some of us.
I am expecting to either have to go onto a patch and see what happens or try the Sandrena Gel.
I will keep you updated. x
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Hi Mahoomie, All I can do is tell you my experience with gels and patches and if I moved from my three pumps to an Evorel75, I'd be feeling exactly as bad as you are.
Evorel Conti is the cheapest HRT that many women are given at 12 months into menopause in the hope it works enough and they accept it and don't come back.
It was my first HRT at the 12 month mark, made me feel a little better at first (fewer night sweats) but by ten weeks I felt awful and stopped using it, I was very depressed all of a sudden and tired and grumpy. I didn't like myself on Evorel Conti at all and tbh if I was told I'd feel that way forever, I'd end it so they'd remember me as I am normally!
I kept asking for oestrogel, but my GP's practice doesn't give out separate items.
I had to wait over a year to get an alternative which was Evorel50 and provera.
Provera is the strongest tranquiliser I've ever had in my life, but it doesn't do it in a good way.
Evorel50 didn't work at all. I thought it might give the initial mildly good effect that Evorel Conti had done over a year earlier, but it did nothing. I have read so much here about women not absorbing these things and I'm sure I simply got nothing in my bloodstream from those patches in the three months of trying.
By this stage I was two years post menopausal and still fighting to get HRT.
This is getting long sorry,
Estradot 50 was next. It worked better than anything I'd had before, but still didn't take the physical symptoms away, just helped in a subtle way.
Then I saw the specialist doctor in person for the first time and I asked why I hadn't been allowed Oestrogel so far (I asked my GP a lot)
so she let me try oestrogel two pumps.
OMG What a difference!
For a whole two weeks I felt better than I had in a decade.
Then flushing started again and they said have three pumps!
So I'm now on three pumps of the new shaped bottle instead of two pumps from the old shaped bottle, that is probably why I haven't suffered from the issues around the change in bottle.
I'm two and a bit months into taking oestrogel now and I'd say that the patches aren't even similar. I think they forgot to put the medicine in the patches and sold me sticking plasters instead ;D
My advice is ditch the patches and get either Sandrena gel or an increased dose of Oestrogel.
Maybe after being deprived of oestrogen on Evorel your body would respond more favourably to your old dose than it did at the time the bottle shape changed?
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Thank you so much! This is exactly how I feel Pastie Supper! This has really helped me and especially to know that I'm not going mad! I do have some gel left so I'm pulling off this stupid patch now and going to apply the gel - will report back. Thank you again!
Kirsti, sorry to hear you are having problems with the gel - what a pain this is! I do hope you have joy with the alternative options. Do keep us posted. Good luck with your specialist today! x
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Evorel75 is supposed to be interchangeable with three pumps of oestrogel. That means on average they deliver the same dose, but women vary a lot in how much they absorb, so just pick what feels better and make sure you tell your GP.
Your doctor ought to be fine with it and tell you to take the utrogestan as was originally planned.
I hope you feel better soon.
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I think the gel is 'stronger' in that its almost an immediate hit whilst the patches are more of a slow release. I really want to stick to gel but the new bottle is next to useless for me and I simply cannot source any old style. I have about half a bottle of old stuff left and I am keeping that for emergency use only.
Im so tired of faffing around with it all I really am. It didnt help I had an interview for a promotion today and I was wittering absolute shite to a panel of people I know quite well at work. I wanted to caveat at the start - or end - of the interview by saying my hormones are a bloody mental mess just now I cant help it!!!
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Oh Moog, I totally understand how you are feeling, I wish it was easier, I too am fed up with messing about with all the different doses, options etc. Good luck for the results of your interview, fingers crossed they won't have noticed as much as you felt :)
Thanks Pastie, I have an appointment in a week's time so will run it by them x
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Mahoomie, you could either try a higher dose of patch or you could use more gel to compensate for the reduced dose effect of the new bottles. If you were fine on 3 pumps of green lid for eg, then you might need 4 pumps of the new crap cylindrical bottles....
Currently I'm on 5 pumps of the new crap cylindrical bottles. Even on 4 pumps of gel my estrogen was only 283pmol on day 16 of my cycle, in peri - and I've no idea how much of that is mine (some of it must be) - so I was hardly getting anything from the gel. I am running out of skin to apply gel to, what with my Testogel as well. I am pretty slick, of a morning ;D
I also wasn't getting much from the patches which is why I was switched to the gel in the first place.
One other option y'all might want to check out is the Sandrena gel, which comes in little sachets like Testogel does. There is also the Lenzetto spray, but that is quite low dose so you might need many sprays of it... I think I'd check out Sandrena next if I can't get high enough with oestrogel.
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Evorel Conti is the cheapest HRT that many women are given at 12 months into menopause in the hope it works enough and they accept it and don't come back.
Evorel conti is not cheap at all! Patches are way more expensive than tablets and estrogel is comparable.
There is nothing at all wrong with Evorel as a patch - I happen to think it is the best pacth that I have used and prefer patches to gel - it is all very individual and depends on each women's absorption - and presumably her skin and where on her body she applies it, temperature of her skin, what she puts on her skin, time of day etc etc.
Some women do have to try several types before finding one that suits.
Like you pastiesupper I was given Evorel sequi initially (15 or 16 years ago!) during late peri-menopause and it worked perfectly for the flushes, sweats and general well-being - but I didnt like the progestogen. Then for many years was on Estradot 50 mcg which again I was perfectly happy withm and then when the shortages hit, tried a couple of others until I was given Evorel and have stayed with it, even though Estrasdot is now available again....
Joziel have you tried higher dose patches?
Hurdity x
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Quick update- I took my patch off, and used the remainder of the gel that I have left, and I feel loads better. Not 100% yet but a lot better. Those patches are clearly not for me! How weird!
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Quick update - I feel much more settled now and noticed the difference the end of last week which was about 8 days after swapping to a patch. I also very luckily managed to get my hands on 3 months of Estradot 75 patches - apparently every other strength is out of stock.
The difference in how I feel is quick remarkable so its always worth giving any changes time.
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Just goes to show how important it is to have a cooperative and available GP who is up to date and knows these products have wildly different effects in different women!
I hope you both settle into your new regimens and feel better soon :)
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Hi
Am new here
I want to go the other way I have been on the patch now for nearly 5 weeks evorel 25 but am having the worst headache/migraines.
I was feeing better with my mood and other symptoms but because my headaches are bad am not sleeping can’t concentrate properly that it’s making me very irritable and emotional and moody.
Am only 44 but had a hysterectomy last year so just on oestrogen .
I want to take the patch off and ask the Gp if I can try the gel do u think that would be a good option for me ?
I have tried my hardest to persevere but the headaches are getting too much, I thought they would get better but they are not.
Please advise
Thanks
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Hi
Am new here
I want to go the other way I have been on the patch now for nearly 5 weeks evorel 25 but am having the worst headache/migraines.
I was feeing better with my mood and other symptoms but because my headaches are bad am not sleeping can’t concentrate properly that it’s making me very irritable and emotional and moody.
Am only 44 but had a hysterectomy last year so just on oestrogen .
I want to take the patch off and ask the Gp if I can try the gel do u think that would be a good option for me ?
I have tried my hardest to persevere but the headaches are getting too much, I thought they would get better but they are not.
Please advise
Thanks
Yes to switching to gel. The sooner you do, the sooner you'll find your HRT whether it's gel or the HRT you try after that. You need it more than an older woman according to the doctors, so you need to persevere, yes, but you don't need to persevere with Evorel if it's giving you migraines as a side effect.
I had my first migraine during my second pregnancy, then occasionally until menopause when they stopped, so I knew they were hormonal. Sounds like you can be pretty sure as well it's the hormones.
I've seen a lot of women being helped by HRT for their migraines, but for me it was one of the worst symptoms that Evorel Conti brought back.
I was already post meno so I was started on the 50 strength and the migraines started up again a few weeks later.
My advice is to ask for a different brand or type of oestrogen, you have more choice than women with wombs do, so that is a good starting point. Go to your GP and ask for oestrogel, it's very popular around here, I don't get migraines or any headaches on it and the weird feeling that comes with a migraine, visual disturbances and so on, doesn't happen now either.
On Evorel I sometimes would get aura with no pain, as well as the full blown migraines.
It can be the non active ingredients that mess things up, or a different oestrogen might be the answer.
GPs normally take migraines seriously enough to switch you before you've completed your three month trial of Evorel Conti.
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Bass1979, I'm surprised you are using such a low dose patch at such a young age. Basically, it's not enough and you need a higher dose of oestrogen.
I agree with pastie, definitely try Oestrogel and I would start with two pumps and work up to three because as pastie says, you need more at your age. I found patches too weak and too inflexible.
My silent migraines (aura without headache) started at the onset of the menopause and they are mostly caused by low oestrogen and low seratonin levels. Too much progesterone, bleeds and generic hormone instability also triggers an aura. This type of migraine does not improve post menopause.
Did you suffer with migraines before the hysterectomy?
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Goodness, if you've had a hysterectomy and you're only 44, you need a much higher amount of estrogen than that. You could be on 100-200mgs of estrogen, really....
This is not (just) about symptom management, it's about decreasing the risk of osteoporosis and heart disease. Why are you on such a low dose?
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Hi all, I realise this thread has been quiet for a while, but it was the first search result when I googled "symptoms returning at end of oestrogel bottle"!
I too thought I had long COVID until I noticed a pattern appearing in my symptoms - I'd developed PMDD in my late 40s and began HRT in march 2022 (on my 49th birthday !) Long story short- lots of trial and error - I don't tolerate progesterone so went for the lesser of the evils and had the mirena coil placed (but would still rather be without 🫤) and I can just about manage on 4 doses of oestrogel per day (am not "allowed" to take more despite my levels being well within "normal" range) I also use testosterone. Anyway, I've noticed in recent months that I'm generally overheating (not flashes), issues with motivation, cognitive function, mood, headaches and bladder urgency keep reappearing periodically. Again I thought it might be me- either my ovaries having a final hurrah or environmental factors. But my migraines which have been very well controlled by a low dose (25mg) of amitriptyline started up again. I still track all my symptoms over various apps, and don't always make a note of the more subtle symptoms, putting them down to the ups and downs of daily life, but my migraines are very specific and definitive, and they're coinciding with the last couple of days of each oestrogel bottle. A few months ago I had one of the old conical shaped dispensers amongst my prescription and remember feeling so much better, but again put it down to coincidence. Today, a friend whom I haven't really spoken to for some time got in touch and I asked her if she'd noticed a change since using the cylindrical shaped bottles, and she said she'd yellow carded it months ago (but it was rejected).
Now that I feel sure these new bottles are related to poorer control of symptoms, I've submitted a yellow card report AND sent an email outlining my concerns to Besins. I'm sure to be gaslit by the patriarchal minded medical mindset (if they even respond at all) but if there are more women noticing a change in symptom management with the new bottles and we all report it, at some point they may be forced to take note. 🙏 I feel there's definitely something going on with the new bottles - either the smaller nozzle is dispensing less or changing the properties of the gel.
Has anyone got any further with this issue, such as an acknowledgement that it's actually real? X
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Check out bloomingthroughthemenopause on instragram. She has been doing daily weighing of dosage and the new bottle dispenses upto 20% less! No wonder I've had a return of symptoms!!
I have emailed besin healthcard and reported my concers with yellow card scheme and I urge anyone else have the same problem to do the same.
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Hi all, I realise this thread has been quiet for a while, but it was the first search result when I googled "symptoms returning at end of oestrogel bottle"!
I too thought I had long COVID until I noticed a pattern appearing in my symptoms - I'd developed PMDD in my late 40s and began HRT in march 2022 (on my 49th birthday !) Long story short- lots of trial and error - I don't tolerate progesterone so went for the lesser of the evils and had the mirena coil placed (but would still rather be without 🫤) and I can just about manage on 4 doses of oestrogel per day (am not "allowed" to take more despite my levels being well within "normal" range) I also use testosterone. Anyway, I've noticed in recent months that I'm generally overheating (not flashes), issues with motivation, cognitive function, mood, headaches and bladder urgency keep reappearing periodically. Again I thought it might be me- either my ovaries having a final hurrah or environmental factors. But my migraines which have been very well controlled by a low dose (25mg) of amitriptyline started up again. I still track all my symptoms over various apps, and don't always make a note of the more subtle symptoms, putting them down to the ups and downs of daily life, but my migraines are very specific and definitive, and they're coinciding with the last couple of days of each oestrogel bottle. A few months ago I had one of the old conical shaped dispensers amongst my prescription and remember feeling so much better, but again put it down to coincidence. Today, a friend whom I haven't really spoken to for some time got in touch and I asked her if she'd noticed a change since using the cylindrical shaped bottles, and she said she'd yellow carded it months ago (but it was rejected).
Now that I feel sure these new bottles are related to poorer control of symptoms, I've submitted a yellow card report AND sent an email outlining my concerns to Besins. I'm sure to be gaslit by the patriarchal minded medical mindset (if they even respond at all) but if there are more women noticing a change in symptom management with the new bottles and we all report it, at some point they may be forced to take note. 🙏 I feel there's definitely something going on with the new bottles - either the smaller nozzle is dispensing less or changing the properties of the gel.
Has anyone got any further with this issue, such as an acknowledgement that it's actually real? X
Hi Missfitz
Many many people have reported to Bessins their issues, I'm not sure they are acting upon it.
I am also very sceptical about the '20 %' smaller dose' explanation as I increased from 3 pumps to 7 pumps (133% increase) and still didn't feel great. (BTW I believe the pump dispenses a smaller amount, I just don't believe the product is the same)
In my opinion, the only way Besins will listen is if they lose revenue. And I think they will, because Oestrogel simply is no longer working for many women.
I'm now happy on Sandrena. I have one ex-oestrogel fan who didn't get on with Sandrena but is very happy with Evorel.
There are other options out there worth trying x
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Thanks - I have asked my pharmacy if it's possible to only have the conical bottles in future - but with a certainty that I'll most likely switch to Sandrena at prescription renewal.
It's SO VERY frustrating that I've had a decline in recent months and blamed it on anything and everything else, too trusting that it couldn't possibly be the HRT preparation. When it became irrefutable in my mind and I googled it, finding many others experiencing the same 'phenomena' it was such a relief, so huge thanks to everyone for their confidence and sharing 🙏
I'll not let these gaslighting b'stards pull me down!! 💪💪💪
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I've had email responses from the MHRA and Besins, both confirming that they've had a lot of complaints and are looking in to it! 🤞🤞🤞
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I've had an email back from besin and they are wanting me to return a bottle for analysis and had a response email from the yellow card scheme to say they have contacted basin also.
I urge everyone that has had an issue with oestrogel and return of symptoms on same dose to do the same. We need voice in numbers.
I'm back to the gp next week to ask for a swap with patches or sandrena gel....I just can't decide what to ask for. I'm currently on 4 pumps of oestrogel.
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I’ve moved from 4 pumps Oestrogel per day to Estradot 100 and feel much better than I did. On the Oestrogel I was jittery, but if I reduced to 3 pumps I had hot flushes and joint pain. On Estradot 100 everything feels more even, I’m not jittery and the hot flushes and joint pain have gone. X
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I was just the same Oestrogel did not work for me at all despite having been on it for over 20 years ago originally but something in it changed after the shortages and for me personally it ceased to work at all and I was not absorbing it at all. I noticed the consistency had changed too. I find Estradot patches a lot better absorption wise although it took ages for me to get both the right dose and the right spacing day wise. They seem to be back in stock now too as my GP gave me 3 months's worth last week. They stick really well too I have never had one come off in over a year.
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I've had an email back from besin and they are wanting me to return a bottle for analysis and had a response email from the yellow card scheme to say they have contacted basin also.
I urge everyone that has had an issue with oestrogel and return of symptoms on same dose to do the same. We need voice in numbers.
I'm back to the gp next week to ask for a swap with patches or sandrena gel....I just can't decide what to ask for. I'm currently on 4 pumps of oestrogel.
It is quite the nightmare finding the right product! I'm going to give Sandrena or lenzetto a go, then failing that possibly estradot, but in the past theres been a lot of availability issues .
I've returned my oestrogel bottle and given consent for them to contact my GP - I'll update if there's any news