Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: TheMidnightSkulker on September 16, 2024, 06:35:47 PM
-
Hi, everyone. I'm back. I've just had a disappointing encounter with a specialist.
SOME BACKGROUND
Previously, I wrote this explanation of my symptoms:
https://www.menopausematters.co.uk/forum/index.php/topic,64256.msg889442.html#msg889442
tl;dr: I was on combined BCP (Yasmin) for decades, stopped three years ago at age 51, and got very puffy eyes overnight as a result of stopping. All other causes have been ruled out. I am definitely sure this is a hormonal problem.
The puffiness is enough to ruin my appearance, and I'm very upset about that. Because I'm a performer it has also ruined my ability to work.
Here is a very important point: After six months off Yasmin, as a test, my GP gave me one (1) more pack of Yasmin. Within five days all my symptoms disappeared, INCLUDING MY EYE PUFFINESS. I could literally see the skin of my eyelids puckering and tenting as it shrank back into my eye sockets. After I finished that one (1) pack of Yasmin, my eyes got puffy again.
Therefore, I know that an effective treatment exists. The problem is that that treatment isn't sustainable into post-menopause.
----
FIRST ATTEMPT: ELLESTE DUET CONTI
After one year, I qualified as post-menopausal. I consulted my GP, and was put on Elleste Duet Conti. I posted about that here:
https://www.menopausematters.co.uk/forum/index.php/topic,64943.msg896893.html#msg896893
tl;dr Elleste Duet Conti was no help whatsoever.
----
NEXT ATTEMPT: OESTROGEL + CYCLICAL UTROGESTAN
After three months, I switched to two pumps of Oestrogel per day, plus 200mg Utrogestan for 12 out of 28 days.
This is FABULOUS, and has improved my life in a range of ways. It also improved my eye puffiness by about 50%, which was a dramatic improvement. Much as I had when I briefly went back on Yasmin, I could literally see the skin of my eyelids puckering and tenting as it shrank back into my eye sockets.
Therefore, I know that oestrogel + cyclical utrogestan is a partially effective treatment.
Unfortunately, 50% improvement is not enough, but I hoped it would continue to improve over time. It didn't. A year later, my eyes are still puffy enough to ruin my appearance. So this brings me to where I am now.
-----
MY CURRENT PROBLEM: CAN I IMPROVE ON MY CURRENT TREATMENT?
I paid through the nose to see a specialist.
They told me two things:
1. To increase the oestrogel to three pumps.
2. That the utrogestan regime is unsafe for someone of my post-menopausal status, so I must change to 100mg every single day.
Since changing to the new regime, my eye puffiness has got worse. I'll have to wait and see if it improves with time.
However, I've already spent three years on this, three years during which my eyelids have been stretched out by the puffiness at the exact same time as my collagen and elastin have dramatically decreased. The longer this goes on, the less I'll be able to recover from this stress on the elasticity of my skin, even if a complete cure for the puffiness is found.
----
A PAST EXPERIENCE THAT IS AFFECTING HOW I SEE MY CURRENT SITUATION
I should add that the BCP was part of an acne treatment regime. I had acne from the ages of about 10-11 until now, although since menopause I only need topical treatments to control it.
Because GPs don't really know how to treat acne, and don't want to, they would prescribe teenaged me enormous doses of tetracycline, which had no effect whatsoever.
When I pointed out "hey, all these enormous doses of antibiotics are having no effect whatsoever," they would tell me to accept my acne as an inevitable fact of life.
I didn't want to accept my acne, I wanted to control it. After 13-14 years of obsessive effort, and running between the political raindrops of self-treatment where I could, and the politics of appealing to doctors where self-treatment wasn't enough - I did finally manage to get my acne under control.
All that time was time I could have spent differently, if only I'd had a sympathetic ear from a knowledgeable doctor.
Because of this experience, I'm reading the letter from the menopause specialist, and one particular paragraph strikes me as hauntingly familiar.
----
To paraphrase:
1. She first says that it's likely my puffiness is a result of a hormonal imbalance after coming off BCP (agreed, all the evidence points that way, and that's why I came to her)
2. Then she says that collagen and elastin inevitably decline as part of the ageing process, and that is probably contributing to the puffiness.
I mean, yes, I know collagen and elastin decline. I know this is a problem that, overall, will not get better with age. No matter what I do to try to maintain my appearance, ageing is a process that only goes in one direction and it ain't backwards.
But here's the thing. I've already found a therapy that works. I repeat:
After six months off Yasmin, as a test, my GP gave me one (1) more pack of Yasmin. Within five days all my symptoms disappeared, INCLUDING MY EYE PUFFINESS. I could literally see the skin of my eyelids puckering and tenting as it shrank back into my eye sockets.
If all this were solely due to the ageing process, it wouldn't appear and disappear in a matter of days when a specific treatment was withdrawn and then restarted.
In particular, by emphasizing the decline in "collagen and elastin" as a cause - is it really believable that my collagen and elastin just disappeared within five days of my stopping Yasmin, and then came roaring back within five days of restarting Yasmin?
I know that one effective treatment exists, therefore other effective treatments must also exist.
Furthermore, I know that two pumps of oestrogel and 200mg of utrogestan for 12 out of 28 days is partially effective, because - to repeat what I wrote earlier:
It [oestrogel + utrogestan taken cyclically] also improved my eye puffiness by about 50%, which was a dramatic improvement. Much as I had when I briefly went back on Yasmin, I could literally see the skin of my eyelids puckering and tenting as it shrank back into my eye sockets.
It's possible that the treatment I'm currently on is the best treatment I'm ever going to get post-menopause, in which case I have no choice but to accept the situation.
However, I don't want to give up until I've tried everything.
The way the specialist framed her response leaves me feeling fobbed off, rather than reassured that I'm on the path to trying everything.
So: have I tried everything? If not, what else could someone in my situation try?
-
It reminds me..
when my stomach got more pronounced, at ca 45, I went to see gastrologist...
He told mevto check my birth date on my ID..
Not so long ago, I had that discussion with my GP about my swollen eyelids...
I am 69 now.
Nothing looks the same!
Body changes!😏
Though.
🤗
-
You can stay on sequi gel/utro if you choose too. They told me there's a slightly higher risk of endometrial cancer this way but I choose that over being permanently doped from utrogestan. I don't really know what to suggest, perhaps try 3 pumps gel with cyclical utro?
-
You can also get Slynd (drospirenone) independently as the progestin to use in your HRT.
This is the same progestin as yaz, and because it is a diuretic it was probably helping you with the puffiness.
I don't know if slynd is widely available on the NHS but you can ask, and if not it probably isn't too expensive to buy. I've seen UK ladies on here taking it.
-
You can also get Slynd (drospirenone) independently as the progestin to use in your HRT.
This is the same progestin as yaz, and because it is a diuretic it was probably helping you with the puffiness.
I very specifically begged the specialist to help me find something with a similar composition to Yasmin. There's probably a reason why she didn't suggest Slynd - could it be because I'm postmenopausal? I had understood that Slynd is not allowed postmenopause, but am I wrong about that? I can't quite work it out from what's been posted here.
In any case, the eyebags are dramatically worse since changing to the regime recommended by the specialist.
Last night I snapped and took two utrogestan instead of one, I'm going back to cyclical.
1. If continuous didn't work before, I don't see why it would work now.
2. This way, I'm only changing one thing at a time, so if my eyebags continue to be worse, I'll know it's the increased dose of oestrogen.
-
She probably just didn't know.
Or if she is an NHS specialist it might not be funded in your area.
Slynd is quite new to the market anyway, even as a contraceptive, and has only recently started being used as the progestin in HRT.
There's no reason not to use slynd if you are menopausal. It's licenced for birth control up to 55.
Why not read up on it and buy it from an online service. Even if you have to say it's for contraception. At least then you'll know.
-
OK, I see. She is a private specialist. Given that it is her entire job, I think she should have known.
I have just tried placing an online order, and they came back to me with more questions. I gave an honest answer.
ETA: the suspense is killing me. I hope they let me have the Slynd.
When I was on Yasmin, my life was perfect. I skipped out to greet each day with a joyful cry of "hello clouds, hello sky". Crocuses sprang out of the ground and sang choruses just for me. Small woodland creatures followed me around.
Well, that's how I remember it, anyway. And I have photographic evidence of lack of eyebags.
-
Okay, well. Yesterday I was getting the beginnings of water retention in my lower limbs, and my joints were aching. So I went back to two pumps of oestrogel. I feel better now. Ankles and feet looking OK, no more aching joints.
Today, the online pharmacy declined my request for Slynd: "Sorry slynd is not licensed as the progesterone component of HRT - so cannot be used for protection of the uterus. Hence we cannot prescribe."
:(
-
Just try somewhere else and say it's for birth control.
It may take years for it to be licenced for MHT, and that may never come. This doesn't mean its use isn't safe or appropriate. There used to be a combination oral HRT called angeliq with drospirenone in it. I think this has now been withdrawn in the UK.
None of the antidepressants so many women our age are rattling with are licensed for menopause treatment either but that doesn't deter prescription of them!
If you try it and it works, then you can have the battle to get it on prescription.
Either as the progestin, or as "birth control" in addition to a licenced progestogen if that works for your clinician.
It is perfectly ok for progestin only contraception to be used alongside HRT.
You could get it like that up to 55.
-
Yeah, I could try another place and say it's for birth control. They will definitely ask for my doctor's details, so I assume they'll check with them, and I may be found out.
Another thing I could do is go back to this specialist and say: you wrote this letter, but the letter doesn't mention the central question I brought to the consultation: this treatment worked for me before, the only HRT equivalent would be Angeliq which isn't available now, so are there any other treatments with similar active ingredients that I could try?
She may say: no, you can't try Slynd because reasons. I have a feeling she will say that, given the overall tone of her letter.
The other thing I could do is go back to my GP, explain what happened with the specialist, and say: look, I used to be on Yasmin; when I started HRT there was nothing available that had the same ingredients as Yasmin, but since then Slynd has been released, and according to these guidelines [https://thebms.org.uk/wp-content/uploads/2024/02/15-BMS-TfC-HRT-preparations-and-equivalent-alternatives-JAN2024-B.pdf] it can be prescribed off-label. So: will you prescribe it? If the NHS won't supply it, would you endorse my seeking a private prescription?
Out of these three, approaching my GP feels like it's most likely to succeed. But if it fails, that could be a problem, because the GP is the gatekeeper and I don't want to rub her up the wrong way.
-
What would you be "found out" for?
Progestin only birth control is licensed up to age 55.
-
Perhaps I'm just overthinking.
The Lowdown doesn't have any Slynd in stock, can anybody recommend a trustworthy online UK pharmacy?
-
Oxford online pharmacy
( I have used them and they are reliable)
May be worth phoning first to check stock before filling in reams of medical information.
Treated.com also seem to have it. I have no personal experience ordering with them.
-
Cool, thanks for the tipoff.
A propos of nothing, I'm irked by what the specialist wrote about how utrogestan will help with sleep. I explained quite clearly that I don't have trouble sleeping, and that the sedative effect of utrogestan is actually a problem for me. The biggest problem in my life - no exaggeration - is literally WAKING UP, and utrogestan is the opposite of helpful with that problem.
-
Hey look everyone, I'm doing bad and naughty lifestyle things like staying up late!
And working at night!
And watching television beaming blue light into my eyes!
And reading my Bible under the covers when I should be asleep!
I'm going to eat after 11pm now! Which is bad somehow!
And worst of all... I think there might be a solitary Coca-Cola in the fridge.
I know it's only a matter of time now. I can hear the sirens in the distance. The lifestyle police are coming for me. But I have accepted the reality of ageing, and decided to drink life's cup to the dregs in the brief instant I have left. I've seen things you people wouldn't believe.
-
I have Slynd! I have Slynd!
Tomorrow is the 12th day of Utrogestan, so I'll follow through on that, then try the Slynd on Sunday.
-
Whoop whoop 😁!!!
Hope it does the trick for you!
Do let us know
-
Hi … I have one huge puff under one eye. It came just as my period ended and the start of all my problems. I’ve tried a lot of things to get rid of it . I’m not on any pills or HRT !
The only thing that helps in rubbing a tiny bit of the RED tiger balm on it before bed !
You did ask what helps!
-
Hi … I have one huge puff under one eye. It came just as my period ended and the start of all my problems. I’ve tried a lot of things to get rid of it . I’m not on any pills or HRT !
The only thing that helps in rubbing a tiny bit of the RED tiger balm on it before bed !
You did ask what helps!
You know what else helps for puffy shopping bags under your eyes? Anusol cream. I kid you not! Apply a small smear under each eye and everything tightens up. Just don't use too much and don't rub your eyes!
-
Hi … I have one huge puff under one eye. It came just as my period ended and the start of all my problems. I’ve tried a lot of things to get rid of it . I’m not on any pills or HRT !
The only thing that helps in rubbing a tiny bit of the RED tiger balm on it before bed !
You did ask what helps!
Under just one eye? Hmmm.
I'll make a note about red tiger balm, for future reference.
-
You know what else helps for puffy shopping bags under your eyes? Anusol cream. I kid you not! Apply a small smear under each eye and everything tightens up. Just don't use too much and don't rub your eyes!
I went to great lengths to find the original Preparation H, which was reputed to do this. It made no difference at all. I confess that I did not try Anusol. I'll add it to my list, along with the red tiger balm.
-
Just a brief update, since there has been some activity here.
My upper eyelids began to lift within two hours of taking my first Slynd, at 9pm last Sunday.
I have photo records going back some time, taken at intervals daily in similar lighting conditions, so I can prove I am not imagining it; but I'm not finished gathering data. It hasn't even been seven days yet.
To the mirror, however, the difference to the upper eyelid is unmistakable, because I have very deep-set eyes. Before Slynd the upper eyelid was bulging out, sagging downwards, and tucked. Now as the day progresses, they lift and hollow until they are holding themselves up and clearly conforming to the contour of the eye socket.
Basically the upper eyelids are now looking much more like the "before [all my trouble began]" photos, and looking that way earlier in the day. They're still pretty puffy in the mornings, but even that isn't as bad as it used to be.
The undereye area is improving, albeit more slowly.
It suddenly looks like I've got my forehead on tighter. I was not expecting that, but it makes sense that the swelling would have been in my whole face, not just around my eyes; and so any improvement would be seen over the whole face, not just around my eyes. I thought yesterday that my cheekbones were standing out more, but maybe they've been like this all along and I just wasn't paying attention to them.
I started taking it at 9pm, since that is the time of day I'm guaranteed to be up. I found the immediacy of the effect hard to believe, but the signs are pretty definite. However, it looks like it's really important to take it at the same time as applying the oestrogel. So I'm working my way forward around the clock. The end goal is to be taking the Slynd and applying the oestrogel at 5am, which is an hour before I get up.
Anyway, we'll see how this goes. I'll know more in three or four weeks.
-
Glad it's working. You'll soon be looking like a 25 year old again :) ( then you can bottle it and send it to me).
-
So glad it's doing the trick for you!
-
Hmmm, not so fast.
Drospirenone doesn't only dry up water, it dries up oil.
When I was taken off Dianette at age 27, I was so greasy I had to wash my hair twice a day. It was three months before I could go back on it, and the first dose immediately turned off the grease like a tap. (I was still greasy, just not to the point where it was socially unacceptable.)
Fast forward to today, I'm no longer greasy. And Slynd has twice as much drospirenone in it as I used to take in Yasmin.
I mentioned that my tears apparently are fewer, but greasier, than those of the average person. Last night when I took my contact lenses out, I thought I was going to rip my corneas off. This morning when I woke up, my left cheek (why only my left cheek?) looked like crumpled paper.
I've been in the habit of washing twice daily with a salicylic acid wash, and following once a day with benzoyl peroxide. This morning my skin was too dry to even think about that.
And you know what makes water retention worse? Dehydration. I think the under-eye bags are actually getting worse now, not better (the upper eyelids are doing better).
The specialist did say to increase my oestrogen to three pumps, which I did feel like I needed that - but it gave me so much water retention that I couldn't tolerate it. This morning, however, I couldn't stand it and I took a third pump at 8am, three hours after my regular dose.
So I'm not sure what I'll do now. I am finally getting a handle on my sleep schedule, and I don't want the sedative effect of utrogestan undermining that. It's the horseshoe nail for want of which the battle and then the war is lost.
As I said, I probably do need a bit more oestrogen, so I'm going to go on with three pumps and see if that makes for a better balance.
Slynd has a 24-hour "safe window" for birth control. I wonder if I could take it every other day, or something like that.
-
Quick update:
The last time I posted was three days ago. That was the day I first tried combining one Slynd with three pumps of Oestrogel in the morning instead of two.
That afternoon, I looked in the mirror and saw my own face looking back at me again.
On the second day of increased Oestrogel, the puffiness started to return.
Today - the third day - I'm puffier still.
Clearly oestrogen is what's making me puffy. Slynd is counteracting the puffiness. However, Slynd is too dehydrating to take with just two pumps of oestrogel. And three pumps of oestrogel are too much.
From reading around the forums, I see that some of you take half a pump. So tomorrow morning, I will try 2.5 pumps and see if that's the sweet spot.
-
I was using 3.5 pumps oestrogen and I used a cheap set of jewellers scales from Amazon to measure out the half dose. I actually bought the scales as the oestrogel pumps started to get erratic in dosage several months ago so I used the scales to measure all pumps.
If you find the half pump works for you, I'd recommend buying jewellers scales ( around £5 from amazon) so you can be sure you're getting a half measure.
Suzie
-
Thanks for the tip!
Do you keep the remaining half dose somehow? Or just write it off?
-
Given the dose of drospirenone in Yasmin (which has 30mcg ethinylestradiol), and a historic HRT preparation called Angeliq, I am pretty sure you could cut the Slynd pill in half and take 2mg daily with 2 pumps of estrogen.
Obviously this is not standardized but your doctor might agree to this if you were willing to get a scan now and then to monitor your endometrium.
-
Thanks for the tip!
Do you keep the remaining half dose somehow? Or just write it off?
I just slightly pressed the pump so less came out, none wasted :)
-
Given the dose of drospirenone in Yasmin (which has 30mcg ethinylestradiol), and a historic HRT preparation called Angeliq, I am pretty sure you could cut the Slynd pill in half and take 2mg daily with 2 pumps of estrogen.
Shame there isn't a conversion table for this kind of thing, but of course it doesn't work like that.
Obviously this is not standardized but your doctor might agree to this if you were willing to get a scan now and then to monitor your endometrium.
I will remember that when the time comes to have that conversation.
-
Do you keep the remaining half dose somehow? Or just write it off?
I just slightly pressed the pump so less came out, none wasted :)
I will try that! Thanks!
-
Quick update for the curious:
SUCCESS! (for one day):
Four days ago (Friday), I tried the 2.5 pumps of oestrogel + 1 Slynd.
On Saturday (the second day), there was finally some major progress on the undereye bags, and my eyes were looking like they're supposed to.
POSSIBLE CONFOUNDER: Short night Fri/Sat. Puffiness is a function of how long I spend lying down. And I was a bit puffy (better, but a bit puffy) on Sunday. So, I don't know.
POSSIBLE CONFOUNDER: Realized on either Friday or Saturday that I'd had the dehumidifier running since Monday. I don't know how much that was contributing to the dehydration. Normally it would take more than 24 hours to become uncomfortable, but normally I'm not taking Slynd.
The dehydration was making my teeth feel squeaky and crumbly. If I hadn't been to the dentist within the last month I would be worried. Certainly a dry mouth can give you tooth decay, so, that's not good. Since turning off the dehumidifier I feel OK again.
====
This morning I tried 2 x oestrogel + 0.5 x Slynd. I still feel OK and not dehydrated, and my eyelids look pretty much like they did yesterday.
I'll give this three days, then possibly try the 2.5 x oestrogel + 1 x Slynd again, in case the dehumidifier was screwing me up.
===
You know... I TOLD them my upper eyelids are supposed to be concave. My MUM's upper eyelids are concave. My MUM's. And she is NINETY EFFING FIVE. Pardon me for wanting to look younger than 96, I guess?
-
In today's exciting episode: my eighth day of trying 0.5 x Slynd + 2 pumps Oestrogel at 5am daily.
Definitions:
baseline regime: 2 pumps Oestrogel daily, plus 200mg Utrogestan cyclical. This is what I was on, for about 18 months, before I saw the specialist.
specialist regime: 3 pumps Oestrogel daily, plus 100mg Utrogestan continuous.
current experiment: 0.5 Slynd + 2 pumps Oestrogel daily, for the last eight days.
next experiment: 1 Slynd + 2 pumps Oestrogel daily. I will start this tomorrow.
post-Slynd regime: My experiments with Slynd before the current one. 1 Slynd + 2, 2.5, or 3 pumps Oestrogel daily.
Overall:
- upper eyelids seem (subjectively, it is harder to photograph) to be heavier each day on waking. But they don't ever seem to look particularly good on waking.
By now, having been up for over five hours, I'm in "A++, can't complain" territory; they are totally holding up by themselves. They were never this good on the baseline regime, not even once.
Evening photos (taken just before getting ready for bed, around 11pm on average) show a much clearer progression over the seven days of the current experiment. Upper eyelids are good in seven photos out of seven, but have gone from "really hollow" to "less hollow".
- structural bags (puffy volume under the eyes) This is hard to photograph, and hard to measure objectively in any other way. I can tell an extremely terrible photo apart from others, but "meh" photos are harder to tell apart. The very worst photo I can point to is six days into the specialist regime: very voluminous, very low-hanging undereye puffiness, outlined with vascular redness, which I don't normally suffer from. Almost anything looks better than that photo.
Subjectively I think the structural bags are less voluminous after the current experiment than on the baseline regime, but I have no way to actually prove this.
My entire face is less puffy, which contributes to the subjectively better impression.
- scale weight: this tells me something about overall water levels. Was not surprised to see it go down by 3lbs on Slynd, despite eating at least 10% more than usual. During this week on 0.5 Slynd, scale weight has gone back up by 1lb, despite no change to calorie intake from previous weeks.
tl;dr my scale weight is further evidence of water loss from the Slynd.
side rant: every article I've ever read about hormonal water retention has condescendingly focussed on scale weight. I do not care about the effect of water on scale weight for its own sake. I do care about it as evidence that the water retention is being treated by the Slynd.
- dehydration: I don't feel generally dehydrated, so that's good. Mouth is not dry, eyes are no drier than usual.
- oiliness: I feel like I have no oil production at all, which is a weird sensation. I have stopped washing my face in the morning; and am only using Differin, not benzoyl peroxide, as a topical treatment. Despite this I have had no acne on my face or body.
I have been washing my hair less frequently because it does not feel like it needs it. Apparently it does, because on the third day of not washing my hair, I find I have some breakouts on my scalp.
I haven't been pathologically greasy since stopping Yasmin. I have only been greasy a normal amount. But even that normal amount of greasiness has stopped since my first Slynd. It's a bit weird, I'm not sure I like it.
- mood: mostly boredom. But that could just be because my daily routine is, in fact, boring and there's not much I can do about that. (To be clear, I'm not complaining. Many people around the world, and many past and possibly future versions of me, would love to be bored in this fashion.)
- sleep: I still hate getting up, but at least the oversleeping is within predictable limits, unlike with Utrogestan. I remain optimistic that my self-discipline has a window of opportunity here.
- libido: could be worse. But I kind of miss the early days of the baseline regime. Wouldn't mind getting that part of it back.
-
In today's exciting episode: results of seven days of trying 1 x Slynd + 2 pumps Oestrogel at 5am daily.
For definitions, see previous post.
next experiment: 1 Slynd + 2.5 pumps Oestrogel daily. I started this yesterday and will report in five days' time.
Overall:
- upper eyelids: same as previous post, only better.
- structural bags (puffy volume under the eyes): peaked on the fourth day, then seemed to get worse. I had this same experience with the previous experiment. I am wondering if this is because the relative levels of each hormone balance in the middle of the week and then tip one way or the other; or if it actually has something to do with weekend habits (sleeping later, eating more crisps etc.)
- scale weight: down another pound over this week. Similar conditions.
- dehydration: I don't have the alarming dehydration I experienced the last time I tried one whole Slynd. That must have been because of the dehumidifier, not the Slynd.
Notably, on the first couple of days I felt recognizably headachy because of the dehydration; I had to keep drinking water to keep the headache at bay. On the next day I was chugging lots of water - not excessive amounts, but at least 2 litres in the span of one day. Over the last three days I wasn't as thirsty. This could be why the puffiness seemed to get worse again: maybe I just wasn't drinking enough water.
- oiliness: Started getting minor breakouts, so I've gone back to my previous regime *except* that I no longer apply benzoyl peroxide. Skin doesn't feel oily, but it doesn't feel eerily dry either.
I've gone back to washing my hair the same amount as before, and the acne breakouts have cleared up.
- mood: started out possibly more agitated than usual, tapered off to being agitated a normal amount.
- sleep: same as previous.
- libido: same as previous.
tl;dr I think the main difference between a half a Slynd and a whole Slynd is that my upper eyelids are better. They seem to get worse on both towards the end of the respective weeks, and I can't tell if that's because of the hormonal balance, or because of some weekend habit e.g. sleeping later. My habits are depressingly similar on weekends as weekdays, though. More likely it's because I wasn't drinking enough water over the last three days out of seven.
-
Okay, final round, and the results are in.
I tried one last titration: 1 x Slynd with 2.5 x Oestrogel. Puffiness got worse. 1 x Slynd with 2 x Oestrogel is the best balance I'm likely to get, for now.
=====
An explanation of why eyes get puffy post-menopause: this all gets blamed on oestrogen withdrawal. Upper eyelid droop happens because the skin of the upper lids becomes lax. With the lower lid, which is basically padded with fat - the orbicularis muscle AND the skin, which previously were holding that fat in, both become lax such that the lower eyelid pooches out into a bag.
I'm pretty sure the specialist I saw thought that this phenomenon was the main cause of my problems. This is probably why she prescribed an increase in oestrogen, while dismissing my questions about progestins entirely. However, it's perfectly clear by now that increasing oestrogen increases my oedema. Three pumps are enough to give me joint pain and headaches after a week.
=====
I've compared pictures of the same eye, taken under similar lighting conditions after performing the same series of actions, in the mornings. The morning is the worst possible time of day for puffiness, so morning photos are the acid test for visible improvement.
- [1] Old regime: 2 x Oestrogel + 2 x Utrogestan, photo taken on morning of 12th day of Utrogestan cycle. This is where I came in.
Rating: not great, not terrible. Upper eyelid droopy, lower eyelid a bit puffy.
- [2] Specialist prescribed regime: 3 x Oestrogel + 1 x Utrogestan, not cyclical. Photo taken on morning of 5th day.
Rating: terrible. Upper lid is drooping in a heavy curtain about as low as it can go; lower lid is the most swollen it's ever been, with a deeply grooved, reddish outline.
- [3] Slynd regime, take 1: 2 x Oestrogel + 1 x Slynd. Photo taken on 5th day.
Rating: obviously better than [2], but looks almost the same as [1]. However, there are creases in the upper lid, which look bad cosmetically, but are actually a sign of progress, because it means the skin is shrinking as it recovers from the swelling.
- [4] Slynd regime, take 2: 2 x Oestrogel + 0.5 x Slynd. Photo taken on day 4 of 8.
Rating: Worse than [3].
- [5] Slynd regime, take 3: 2 x Oestrogel + 1 x Slynd. Photo taken on day 4 of 7.
Rating: Better than [1] and the first time I have seen an improvement from baseline. The upper eyelid is holding up on its own, still with some morning puffiness but NO DROOPING. The lower eyelid is no worse than [1] and maybe better.
- [6] Slynd regime, take 4: 2.5 x Oestrogel + 1 x Slynd. Photo taken on day 4 of 7.
Rating: Not as good as [5], and it got much worse over the next three days.
It looks like [5] is about as good as it gets. Time to stick to [5] until further notice.
So yeah, the upper lids are holding up on their own now, which makes a huge difference. It's the lower lid I'm having the most trouble with. They look either fine or rather visibly baggy, depending on lighting conditions. But at least they aren't visibly baggy in every light. What this means is that I've progressed point of fretting about fairly minor flaws, so that's great. Oestrogel + Slynd for the win!
One would also think that, if part of the problem is oestrogen loss to the skin, that wiping the excess oestrogel off on my face would help. So that's what I've been doing; it's only a faint residue, and it doesn't seem to be doing any harm.
Also, if part of the problem is laxity of the orbicularis, one wonders why exercising those muscles *wouldn't* help. Unfortunately there's no evidence in favour of facial exercises, but they also aren't known not to work. I suppose I could try exercising just one eye and see if it gets beefier over the span of say 3 months, compared to the other eye.
But anyway, to stay on topic: as far as HRT is concerned, it's pretty clear that 2 x oestrogel plus 1 x Slynd [5] is the best combination for overall water balance for me, and also that the Slynd makes a visible difference to my eye puffiness, which is exactly what I expected/hoped it would do.
I still have trouble getting up in the morning, but I'm gradually improving. I'm now able to wake at 6am reliably, even though I can't get up. It helps that I'm not being sedated by Utrogestan. I wouldn't go back to Utrogestan unless I had to.
-
Update after finishing second pack: everything was fine until a week or two ago.
However, I was getting acne breakouts that were getting worse, with new and more severe breakouts every day. Then the cystic acne kicked in.
ME: I WANT TO SPEAK TO THE MANAGER OF EXOGENOUS HORMONES. I DEMAND THAT YOU PUT EVERYTHING BACK THE WAY IT WAS BEFORE
HRT FAIRY: OK, here you go.
ME: Great!
ME: ...NO, NOT LIKE THAT
The worst case would be if this were somehow caused by the Slynd. I don't see how, but anything's possible.
It's also possible this was caused by smearing the oestrogel on my face.
However, I scaled back my topical treatments far more than usual since starting Slynd. For a short time I was not even washing my face in the mornings so I was cutting back on salicylic acid.
And I stopped using benzoyl peroxide, which previously I had used once a day. The only treatment I was using daily was adapalene. I have not been so lax with topical treatments in living memory.
So the first thing I did was stop putting oestrogel on my face. No Vitamin C serum either, no anything that could theoretically cause breakouts. And I started applying the benzoyl peroxide twice daily.
As of a few days ago I am not getting any new breakouts and the ones that I have are starting to heal.
I am also washing my hair every single day, and my scalp breakouts are calming down.
Once the existing acne has cleared up (probably in a couple of months) I will try smearing the leftover oestrogel onto my face again, and see what happens.
I do notice I have been a bit puffier than I'd like over the last couple of days. I wonder if stopping the oestrogel-on-face has something to do with that.
Or it could be because I ate only simple carbs (no protein) and a lot of salt over the last two days, and barely slept. In other words - the lifestyle things that are SUPPOSED to cause puffiness in normal people, are now causing puffiness in me, THE WAY THEY'RE SUPPOSED TO.
I also note that my calorie needs seem to be back the way they were before - about 10% higher than before I stopped Yasmin. I think, and there's no way to prove this, that my calorie needs have been this way throughout (OK maybe not post-menopause, but probably post-HRT) and the excess water has been masking my real weight, interfering with the calculations. Now that the excess water has drained, I know what I *actually* weigh and, therefore, what I need to consume in order to maintain that weight.
Everything else is fine. Mood is just that bit more even-keeled, and in general, everything else is back the way it was before. As nature intended. Or, I guess, as God intended, since nature seems to have never been quite on my side in these matters.
Next I need to get an appointment with my GP about this. I hope I'll be able to see the one that knows my history in all this. I'm nervous, I don't like having these conversations.
I also see that the pharmacy I ordered from has me on a 3-month subscription. Which means I'm going to run out before I receive the next one. Why is everything so stressful all the time.
-
OK, I have almost come to the end of my third pack of Slynd (so just over 2.5 months).
I have been relentless in applying benzoyl peroxide twice daily, followed by adapalene after 30 minutes at night. I have not had any new breakouts in several days, and my existing breakouts are healing, though it will take some time. As I haven't had any breakouts on my back and chest, that relieves some of my worry that the Slynd was actually provoking the acne. Most likely it was because I stopped all topical acne treatments for more than 14 days, which is something I have not done in living memory, and will certainly never do again.
Once the acne is completely healed I'll cautiously try wiping off the excess oestrogel onto my face again. If I get any breakouts after that, I'll know it was the oestrogel that caused it.
=========
I have requested an appointment with my GP asking to change to Slynd from Utrogestan. I supplied a "before Slynd" photo taken on 9 September, and an "after Slynd" photo taken yesterday, both at almost the same time of day, under similar lighting conditions. The difference is very obvious to the naked eye.
I have an appointment on 18 December. Pray for me :'( Until then, I am living in fear that they might say no.
On Slynd, I don't have to be messed up by the sedative effects of Utrogestan.
On Slynd, my stress tolerance is above the line, whereas it was below the line on Utrogestan.
Everything globally feels just better.
=====
I can definitively say that my daily calorie requirements are 28% higher on Slynd than I thought they were on Utrogestan, and before starting HRT at all. I say "I thought", since there was no way to reliably measure it because of the constant and unpredictable interference of water weight every time I did anything at all - including cutting calories. (Memories of that one time I cut by 15% and gained two pounds, taking me to my highest ever recorded scale weight.) GOOD RIDDANCE, WATER.
-
Hi TMS
I got a couple of spots when I tried a little oestrogen cream on my face, it was biovea, one I bought while the GP was playing silly beggers with me in her blissful menopause ignorance which will end in about 15 years I'd say.
I'm on tibolone because I'm progesterone intolerant, always have been, so that is the first line HRT that the GP should have offered me, but she forced me through various treatments first that made me feel awful, so I do sympathise.
Why do you want oestrogel on your face? Can it make you appear more youthful? I've still half a bottle of oestrogel myself, from the failed, horror story treatments.
I couldn't tolerate utrogestan, I wasn't offered one like Slynd, so it makes me wonder, was there a progesterone out there I could have tolerated?
-
Why do you want oestrogel on your face? Can it make you appear more youthful? I've still half a bottle of oestrogel myself, from the failed, horror story treatments.
Hi flo69, sorry to be so late replying, I only just saw this.
I was just curious because everyone says putting oestrogen on the face is rejuvenating.
As soon as my acne was completely cleared up, I tried the oestrogel on my face one more time. I got one small breakout straight away. The timing suggests it was coincidental. However I think it's not worth introducing another step into my already complex routine.
I think I get enough of a rejuvenating effect from the Differin (it's not exactly proven to have that effect, but I smear it on my hands last thing at night, and I don't know what else would explain why my hands aren't aged worse). It also helps that my face is no longer baggy from unnecessary water retention ::)
I couldn't tolerate utrogestan, I wasn't offered one like Slynd, so it makes me wonder, was there a progesterone out there I could have tolerated?
Maybe? People have to try various different BCP before they find the one that suits them. Logically the same must be true of HRT.
-
A small update on the statistics:
Right through to the end of December, it seemed like my calorie needs were about 24% higher on Slynd.
It now looks like that might have settled down to only about 12% higher.
Not sure if this was caused by:
- continuing to lose water weight, just more slowly, until it was finally drained?
- inconsistent exercise? I have kept to a consistent daily minimum in January, but was all over the place at the end of 2024
- just a temporary startup effect of the Slynd on my metabolism?
Anyway, who knows. I had a ravenous appetite after starting Slynd, but it seems to have levelled off now. I'm still hungrier than I was before Slynd, but not so hungry that I could eat western Europe and be looking around for a second helping.
-
When did U last have a thyroid function blood test?
-
Maybe around 2021.
I don't think there is anything going on with my thyroid.
-
Intense hunger is a sign of thyroid function issues. As are bulging eyes and some1 being hyperactive.
-
Well, if it were a thyroid problem, you would expect my puffy eyes to have gotten worse as I got hungrier. Instead, they got better.
Also, I understand that with thyroid problems, it's traditionally the eyes themselves that bulge out of their sockets. Not the eyelids that swell and droop over and around the eye.
I'm going to proceed on the assumption that the water retention is caused by what I think it is - hormones - and that the improvement that followed hormone treatment is a result of that hormone treatment.
-
Hello ladies.
I just wanted to say that when I was diagnosed with Hashimoto's Thyroiditis ( low thyroid) I felt very tired and cold and I developed bags under my eyes. I felt very ill and saw my GP who immediately recognised the signs of low thyroid.
I hope this is helpful and take care ladies.
K.
-
Yeah, it seems menopause shares symptoms with a lot of other conditions.
Just to reiterate that I ruled out all non-hormonal causes, including thyroid disease, the first time I saw the GP about this in 2021.
I also do not now, nor have I ever, had any combination of symptoms that resembles thyroid disease.
Therefore, I'm convinced, to within an acceptable margin of error, that I did not develop thyroid disease immediately after starting Slynd, nor did I develop thyroid disease at any other time since I was last tested for it in 2021.