Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Tulip15 on November 02, 2025, 09:45:52 PM
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Hi everyone.
I started HRT about 3 months ago (50mcg patch and 2 utrogestan tablets for 12 days a month). I am 45 and still have regular periods. I know that blood tests are not useful in perimenopause, however my most recent blood test showed an increase of only 10, from 160 before starting HRT to 170 now (both blood tests were taken on the same day of my cycle). I am concerned obviously because of bone density etc and know that these levels are still low. Surely I should have seen more of an increase in the 3 months, or is an increase of 10 what I should expect. It all feels so much like trial and error and a complete mystery half the time, which leads me on to my next problem...
I posted before about my headaches, however these have got worse sadly and I have realised that they are migraines. OTC meds don't touch it, aspirin did for a while but no longer. My GP put me on fluoxetine which worked for a few weeks until it didn't and they came back worse than ever. They make me sick, and the only relief is lying in a dark room. It is increasingly debilitating and is affecting my life in so many ways.
I had a consultation with a dr at the national migraine centre who suggested amitriptyline, and sumitriptan but unfortunately these haven't touched the migraines either. Now I wake up with a permanent migraine that just doesn't go away. I've been on annual leave this week but am dreading going back to work. I've stopped taking absolutely everything now as it feels like I am completely overloading my body, until I figure out what is going on. It feels madness to treat the migraines when I am sure they are caused by my fluctuating hormones.
The only respite I have had is when I was away in the summer, and took norethisterone (I believe a type of progesterone) to delay my period (before I started the HRT). One of the other options the headache specialist suggested was the mini pill, specifically desogestrol. Has anyone had any success with this for their headaches or peri symptoms?
I have an appointment next month at the migraine clinic who prescribed my HRT, but am trying to arm myself with as much knowledge as I can. I'd appreciate any advice or links or suggestions!
Thank you in advance.
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I'm so sorry to hear you are suffering from horrible, debilitating migraines. I'm positive they are hormonal migraines and they are being made ten times worse by the dreaded Utrogestan. A 50mcg patch is far too weak too and this is borne out by your low oestrogen levels. You may be in peri menopause but that is an incredibly low oestrogen level that is unlikely to shoot up to something much higher. I had consistency low oestrogen levels at 45 in fact off the top of my head they were about 180 pmol.
I would switch to Cerazette (desogestrel) immediately and top up with oestrogen but not a 50mcg patch. Either go with a higher dose patch or better still switch to Oestrogel because it's stronger.
At the moment you have the worst of both worlds, low oestrogen and high levels of progesterone which is causing hormone instability and migraines. Cerazette will shut down FSH and LH and will create a stable hormone environment which will enable you to add in the oestrogen you need for symptom control.
The only way to resolve hormonal migraines is with hormone manipulation. I've been there myself although I have silent migraine auras but these are purely caused by low oestrogen, high progesterone (Utrogestan being one of the worst triggers) and general hormone fluctuations. I didn't have migraines pre menopause.
I'm much older than you (64) but I'm using two pumps of Oestrogel, testosterone,75mcg Cerazette plus progesterone gel every day and it's working extremely well.
I hope that helps.
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I'm so sorry to hear you are suffering from horrible, debilitating migraines. I'm positive they are hormonal migraines and they are being made ten times worse by the dreaded Utrogestan. A 50mcg patch is far too weak too and this is borne out by your low oestrogen levels. You may be in peri menopause but that is an incredibly low oestrogen level that is unlikely to shoot up to something much higher. I had consistency low oestrogen levels at 45 in fact off the top of my head they were about 180 pmol.
I would switch to Cerazette (desogestrel) immediately and top up with oestrogen but not a 50mcg patch. Either go with a higher dose patch or better still switch to Oestrogel because it's stronger.
At the moment you have the worst of both worlds, low oestrogen and high levels of progesterone which is causing hormone instability and migraines. Cerazette will shut down FSH and LH and will create a stable hormone environment which will enable you to add in the oestrogen you need for symptom control.
The only way to resolve hormonal migraines is with hormone manipulation. I've been there myself although I have silent migraine auras but these are purely caused by low oestrogen, high progesterone (Utrogestan being one of the worst triggers) and general hormone fluctuations. I didn't have migraines pre menopause.
I'm much older than you (64) but I'm using two pumps of Oestrogel, testosterone,75mcg Cerazette plus progesterone gel every day and it's working extremely well.
I hope that helps.
Thank you so much Mary. This year has been awful. It started with headaches around my period, then around my period and ovulation, and now all the time. I feel so completely overloaded with medication and it feels like nothing works.
I will give myself a bit of a break then order the desogestrel.
Thank you again Mary, I really appreciate your advice.