Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: pepperminty on February 01, 2025, 05:59:53 PM
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Hi Ladies,
I am on sequi HRT. Whilst on the combined progesterone phase/ part I start off from day 15 to 20 fine and then bam day 21 ish to day 25 ish I am stiff and very achy. Then whilst i am still on the progesterone phase about day 25 I start to feel better. I would have thought if it was over load of progesterone I would continue feeling terrible right up to day 28 until I start the just estrogen part - Not whilst still taking them? If that makes sense.
I am sure my natural cycle had stopped.
Any ideas?
PMxx
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U won't know whether your cycle has stopped whilst using any form of HRT.
The ovaries may well continue to kick out small amounts of hormone for years.
Aches and pains may be due to loss of oestrogen, the elasticity of the body.
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Perhaps it is your body adapting to the progesterone.
When you first start it, among other functions it antagonises mineralocorticoid receptors and has a diuretic effect.
After a few days your body catches up and increases aldosterone secretion to help restore fluid and sodium balance. Sometimes this transiently overshoots, leading to fluid retention which can cause that PMSy feeling, then it rebalances.
I am aware of this because I am on mineralocorticoid replacement and when I was having natural menstrual cycles the luteal phase increase in progesterone made it difficult to titrate my fludrocortisone.
The solution to this is to achieve stable hormone levels rather than seesawing up and down with progesterone.
For me this means continuous intake of a combined pill for menstrual suppression.
As you are postmenopausal this could be achieved by taking a lower dose of progesterone every day rather than cycling.
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Perhaps it is your body adapting to the progesterone.
When you first start it, among other functions it antagonises mineralocorticoid receptors and has a diuretic effect.
After a few days your body catches up and increases aldosterone secretion to help restore fluid and sodium balance. Sometimes this transiently overshoots, leading to fluid retention which can cause that PMSy feeling, then it rebalances.
I am aware of this because I am on mineralocorticoid replacement and when I was having natural menstrual cycles the luteal phase increase in progesterone made it difficult to titrate my fludrocortisone.
The solution to this is to achieve stable hormone levels rather than seesawing up and down with progesterone.
For me this means continuous intake of a combined pill for menstrual suppression.
As you are postmenopausal this could be achieved by taking a lower dose of progesterone every day rather than cycling.
Thank you Bombsh3ll,
That makes sense, I had the coil once years ago and I got very swollen legs - so they had to remove it. So if I am reading what you put correctly a continuous intake of progesterone may be a solution also? I am always interested in the scientific reasons why things happen.
Many thanks PM x