Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Nikkisyard on October 17, 2018, 02:20:58 PM
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While I try not to over-complicate things perhaps I am... so I need some help.
Ive posted here and there and referred sometimes to my issues but I think i need to pop it all down in one place so that I can follow the great advice given on here.
I'm 51, post meno for 5+ years. Been living most of the time in Switzerland but return to the UK and Spain regularly. Im currently in Spain.
With menopause came terrible hot sweats, insomnia, weight gain, zero libido and depression for many years. Usually I am a happy positive person.
I started BHRT earlier this year, starting with 2 pumps of Oestrogel and Utrogestan200 sequentially. I only did sequentially as the Utrogestan was advised as too high a dose to do continuously.
WOW - this changed things significantly! Almost within a week I was sleeping, no hot sweats and felt happier. However, I didn't welcome the bleeds and felt the pessaries and gel was laborious and messy.
So when i saw my GP last month we changed to Evorel Conti. I quickly found that I was bloating, losing hair (!) and getting headaches - I didn't like that the progesterone element wasn't BHRT and I read that my symptoms were common with this type of P. So we swapped again, to Estradem MX50 patch and Utrogestan100 continuous. The Utrogestan100 pessaries were much smaller and not so messy - so this seemed to suit me. We discussed the possibility of Testosterone for the Libido but my blood test revealed that I was borderline so she didnt want to prescribe T to me... which is SO annoying. My poor long suffering partner and I have had sex once in around 3 years... I really feel like T is the missing piece of the puzzle.
Here are the issues I am now having.
MOODS
I am super moody! Snappy with my partner and can feel myself slipping into depression with negative dark thoughts. I read too much P can do this. But could it be i need more Estrogen? Is 1 Estroderm 50 patch equivalent to 2 pumps of Oestrogel??
ZERO LIBIDO
I am SOOOO unhappy about this... as suggested before, I guess all I can do is ask for a referral or just push my GP to prescribe it!
However.... I am in Spain. Can this be bought OTC? Someone did say they knew a lady in Alicante that could help? @suziq99? Was that you?
BLEEDING
This has worried me... 2 weeks ago I started to bleed a very dark brown/black "old blood" and its not stopped. There is no odour and no pain, however today I seem to have "period pains". Again could this be an imbalance of the patch/pessary? I am a little clueless as what would cause this.
Currently I don't have a Doc here in Spain (tho if anyone has any suggestions for one on the Costa Blanca?), but I am planning on seeing my GP again for a checkup when I return to the UK late November.
Advice and thoughts on all or any of these things are welcome! :thankyou:
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Why did you alter medication if it was working :-\ ?
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Why did you alter medication if it was working :-\ ?
Starting HRT was fab... but as I think I explained I found using the 2 pumps of the gel and the huge pessaries really laborious and messy. It was time consuming and the pessaries seemed to just come out as a big blob of cream!... also I really didnt want to have the bleeds after 5 years post meno.... thats why I changed.
i guess I thought a different method would be ok but hadn't realised quite how different the brands/methods can be...
I am not sure what, in my current regime, isn't working...
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Having found out that you are now in a pickle, would it be wise to re-start the regime that you know actually works? :-\
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Having found out that you are now in a pickle, would it be wise to re-start the regime that you know actually works? :-\
But thats the point CLKD - it didn't work... thats why I changed.
Yes starting HRT made a huge difference to most (but not all) of my symptoms, so I am super happy with that... but the methods I have tried have not worked for me. Isn't this about finding a dosage and method that works for each of us?
I don't really want to go back to a method that was messy, time-consuming and had me return to the bane of periods every month... besides, travelling with a oestrogel proved a pain as I almost had it confiscated at the airport because it was over 100ml!
Evorel Conti had me lose hair and bloat... This current method sees my mood drop and I am constantly bleeding what looks like old blood...
So none of it actually worked.... hence my asking here for some help...
I am seeking advice to find a balance that works, and perhaps some possible explanations to why I am bleeding, and why my mood has dropped.
I could go back to using Gel if push came to shove (and I remember to carry the prescription with me when I travel... ugh) - but perhaps the estrogen only patches are working and I just need to up the dose?
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Now I'm confused, but that's probably connected to menopause?
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I started BHRT earlier this year, starting with 2 pumps of Oestrogel and Utrogestan200 sequentially. I only did sequentially as the Utrogestan was advised as too high a dose to do continuously.
WOW - this changed things significantly! Almost within a week I was sleeping, no hot sweats and felt happier. However, I didn't welcome the bleeds and felt the pessaries and gel was laborious and messy. "
Maybe send an e-mail to Dr Curry on here and ask? There is a charge.
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Is 1 Estroderm 50 patch equivalent to 2 pumps of Oestrogel??
I am going to attempt to answer one of my own questions here... I have been doing some digging but need to check this with you all... and in a way this is checking to see if my original dose was what worked despite the method itself not working... (which is why I asked the Q)
Apparently 2 pumps of Oestrogel contains 0.75mg of oestradiol - so my daily does was 1.5mg.
One EstrodermMX 50 patch releases 50 micrograms of oestradiol a day...
If I convert 1.5mg to micrograms this equates to 1500 micrograms?! So the 50 micrograms a day from the patch is woefully inadequate??
If I am not getting enough Oestrogen would this contribute to low moods and bleeding?
Have I got this right? Or dreadfully wrong?? :neutral:
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;D. that's sums and I don't do sums ........... maybe someone else will be along who knows more about HRT regimes which will help.
Or put the medications into the search box on here? See what pops up?
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Now I'm confused, but that's probably connected to menopause?
"
I started BHRT earlier this year, starting with 2 pumps of Oestrogel and Utrogestan200 sequentially. I only did sequentially as the Utrogestan was advised as too high a dose to do continuously.
WOW - this changed things significantly! Almost within a week I was sleeping, no hot sweats and felt happier. However, I didn't welcome the bleeds and felt the pessaries and gel was laborious and messy. "
Maybe send an e-mail to Dr Curry on here and ask? There is a charge.
Yes perhaps I should ask Dr Currie... good plan. Im sure she will know re the dosages too...
And perhaps I complicated things myself (nothing new there!) by not explaining adequately that the first method didnt work for. me.. the dose seemed to as it dealt with the symptoms - but the method didnt...
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Clear as mud, probably an age thing ::)
Let us know how you get on.
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Hi Nikkisyard
Your post was perfectly clear to HRT users! You explained what you had been using and your reasons for changing...
You can't equate the gel dose with patches though! The gel dose is what you actually put on your skin. The patch dose is the assumed average daily release into bloodstream. You have to go approx by low medium or high doses (see Treatments menu) and then adjust if you are someone who absorbs better by one method than another.
I understand what you are saying about the gel. I changed to it briefly for a few weeks and it's such a faff (I find) although regular devotees swear by it - we have to do what works for us. If you can get Estradot patches (or similar in Spain - Vivelle Dot or something) - these are the tiny ones that work on a dot system - then I suggest changing to them and increasing the dose say to 75 mcg ( starting with 62.5 for a few weeks - cutting a bit off the 75 mcg) and see how you feel.
That leaves the prog. I take it cyclically so put up with 12 days of a little bit of goo (of 200 mg) - I really don't find it that messy - if you sitck it up far enough - and wear a thin daily panti-liner anyway. There is no way I would take prog every day as it is a sedative and maybe also helps to reduce libido. Taking it cyclically also means a bleed - could you go on a long cycle under medical supervision and have a bleed every 6-8 weeks as I do?
Have you thought of a Mriena ( not bio-identical though...)
As you have been changing hRT then the spotting could be your body settling down -after 6 months it should settle especially if you are using it vaginally. Also I can't see how daily vaginal use of anything would help one's sex life especially with seminal fluid sloshing about - maybe affecting the absorption of the prog, although if this is a rare occurrence then it's more academic.
My regime is brilliant - 62.5 mcg Estradot patch. 200 mg Utrogestan vaginally for 12 days every 6-8 weeks. Tiny blob of Tesosterone 1 % gel daily. Vagifem twice weekly. Yes I do have a bleed and feel rough sometimes on the prog and the come-down from it but the rest of the time I feel great - well - I'm tired sometimes but I am mid 60's!
Does this help at all?
Hurdity x
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Hi Nikkisyard, sorry just seem this. Yes I know a lovely lady in Alicante.
She speaks perfect English as well I can pm you her number if you like.
How's your Spanish ? You need to speak to the receptionist for an appointment.
Yes you can get testogel OTC.
Generally speaking gp, s in Spain are not that keen on hrt. So you are much better off seeing a gyne directly.
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Hi Nikkisyard, sorry just seem this. Yes I know a lovely lady in Alicante.
She speaks perfect English as well I can pm you her number if you like.
How's your Spanish ? You need to speak to the receptionist for an appointment.
Yes you can get testogel OTC.
Thank you Suziq99!! I have received your PM :) so kind of you.
I was considering taking the T into my own hands.. but I feel, under the circumstances, I should be seen by a specialist! Great to know there is one not toooo far away. I will be in touch!
Does this help at all?
Hurdity thank you!!... Yes it does help :) Glad I was understood.. I didn't consider that non HRT users wouldn't get it but of course none can assume... and for a moment I assumed we were all on HRT! Duh!
I actually spoke to a duty Doc at my regular practice in the UK today, on the phone.. we discussed things as they stand and we decided I should up to TWO of the '50' patches each time and see how I go... it may or may not help with the bleed but examination isn't an easy thing to organise when I travel so much - however with Suziqs help this may change! I would like to see if my general mood is lifted though - because I am sure I need more Oestrogen. Then perhaps I can begin to understand how these hormones are working for me, and also if patches are the way to go. I will check out the "dot system" as I wasnt aware of that... I thought patches were patches!
If the current bleed (and it is a bleed... not spotting) doesn't stop we spoke of stopping HRT all together but I cant bare the thought of that... perhaps as was suggested before somewhere I stop only the Prog, to see if Prog is the prob - but I cant see why it would be as Utrogestan is what I have pretty much always used aside for a short time on Evorel. I can however understand my body is probably still in freak out mode after so may changes.. this whole HRT thing is far more complex than I imagined and I hadn't realised that just changing the 'method' would affect everything... now, of course, I am learning...
I wont rule out the possibility of putting up with a cyclical bleed if it helps with the long term balance and wellbeing...
As for the T... well, with regards to my UK Doc I am still a bit stuck as even talking to the duty Doc today she said my regular Doc was very reluctant to prescribe it... because my levels were 'normal' (well - 'borderline' was what I was told before). They are also waiting for advice from the Meno Clinic still.
No idea if the lady in Alicante would help me on this point but its worth a try... in any case I have an appointment to talk with my regular Doc on the 31st Oct so we shall see what happens then!
Thanks ladies!
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So.... here's my update...
Suzieq99 has been so kind in offering to meet.me.in Alicante and take me to her Gynae there... and it coukd still be a possibility but I woke the other day with sharp pains in my uterus.. the kind that causes a sharp.intake.of breath... so, what with the constant bleeding I was worried. I quickly found a Gynae closer to me and now have an appointment for next week - private - but I dont have much choice as my EHIC doesnt cover me at this clinic and I havent yet set up Health Care here in Spain.
Anyways... as explained, following advice from my UK Doc a few days ago I had upped my Oestrogen to double what I had been taking, and, having missed a dose of Prog and read lots about Prog making one tired/low plus the pro's of taking cyclicly I thought perhaps I should give the Prog a break... so its been 2 days off Prog now...
The bleeding appears to be subsiding and today no pain.
I think the increase in Oestrogen has lifted my mood.
Yesterday I was able to buy T from the local pharmacy (they know Im on HRT) and I have been reading numerous medical research papers about giving T to post menopausal women so am now convinced this is my next step...
I need a health check by this Gynae local to me in Spain (he is Dutch)and will see what he is like... if, as I have read, he is as good as they say and is open to the idea of monitoring me with T included I will stick with him... if not I shall be hooking up with Suzieq99 in Alicante as well as pushing my UK Doc to open her eyes.....I think she will...
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Hi Honeystar
I live in the north of Spain near Dénia. I have private insurance here & so have a private Gynae. I don't find her that much use & she isn't really keen on HRT after a certain age but I insist.
You can get most things here. They do have estradot but it is more expensive because it is imported. I use a patch called Evopad, it is similar to the Evorel that you get in the UK. That costs €2.50 for a box of 8 patches. Don't take progesterone as have had a total hysterectomy 7 years ago.
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That's great news then, far better to find some one closer to you. And not meaning to upset anyone but you probably have a better chance of getting hrt advise from a non Spanish doc.
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Why did you alter medication if it was working :-\ ?
As someone who can't find any solution to menopausal symptoms which are literally making me feel suicidal, I have to echo CLKD's question. You're very unlikely to find the ideal solution, to find something that makes a huge difference but is a bit messy and inconvenient is, to be honest, a pretty good result and one that I'd give my eye teeth for. If I was in your shoes I'd just stick with that. You'll probably end up going all round the houses, spending a huge amount of money and coming back to your original regime in the end anyway.
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Why did you alter medication if it was working :-\ ?
As someone who can't find any solution to menopausal symptoms which are literally making me feel suicidal, I have to echo CLKD's question. You're very unlikely to find the ideal solution, to find something that makes a huge difference but is a bit messy and inconvenient is, to be honest, a pretty good result and one that I'd give my eye teeth for. If I was in your shoes I'd just stick with that. You'll probably end up going all round the houses, spending a huge amount of money and coming back to your original regime in the end anyway.
Thanks racjen ... yes I've followed your plight on occasion and I truly feel for you. However as I explained before it wasn't working for me... and I'm not one to just settle for something when I feel there is still things to be explored. That way of thinking has served me well in the past. I'm happy to say that while it has often felt like “one step forwards two steps back†it is going in the right direction..... slowly. I'm in a far better place now that 3 to 4 years ago when I was attempting other ways of dealing with this....
I truly hope you find some balance.... I've been 5 years trying but when I finally took the plunge with HRT I knew I was on the right track... You will find your happy medium I am sure. Look after you xx :foryou:
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Hi Honeystar
I live in the north of Spain near Dénia. I have private insurance here & so have a private Gynae. I don't find her that much use & she isn't really keen on HRT after a certain age but I insist.
You can get most things here. They do have estradot but it is more expensive because it is imported. I use a patch called Evopad, it is similar to the Evorel that you get in the UK. That costs €2.50 for a box of 8 patches. Don't take progesterone as have had a total hysterectomy 7 years ago.
Hey Paisley you aren't too far from me! I'm in Moraira.
Yes, armed with my boxes of Estroderm and Utrogestan prescribed in the UK I went to my local pharmacy here and topped up.... I was also able to by the Testogel so am arming myself with all I might need now... let's see what this Dutch Gynae is like on Wed! I will let you know!
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That's great news then, far better to find some one closer to you. And not meaning to upset anyone but you probably have a better chance of getting hrt advise from a non Spanish doc.
:thankyou: for all your support Suziq99! Let's see!!
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Honeystar
What is the name of the Dutch Gynae you are seeing? I saw one in Moraira a few years ago. Can't remember his name though
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Honeystar
What is the name of the Dutch Gynae you are seeing? I saw one in Moraira a few years ago. Can't remember his name though
Hey paisley... its Dr. Michel Vleugels. He had been at the HCB Asistel Moraira clinic since Spring this year...
There is another named Dr. Javier Server, i have no idea of his history in Moraira however not someone I would want to see having read that he published some misogynistic cartoons in a medical journal a while back... other practitioners had complained....
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Hi Honeystar
Just googled the one I saw. He was called Dr Walter Van Harmelen & I am glad it isn't the same one that you are going to see as he was awful. He told be to get some blackout curtains for my bedroom & that would fix me.
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Sorry, I still don't really understand what the problem is. In your original post you said of the first HRT regime you tried:
'WOW - this changed things significantly! Almost within a week I was sleeping, no hot sweats and felt happier. However, I didn't welcome the bleeds and felt the pessaries and gel was laborious and messy.'
Did things then deteriorate? Otherwise I'm just not getting it - putting up with a monthly bleed and a bit of mess, sounds like heaven to me if it sorts everything else out. I must be missing something, sorry if I'm being difficult....
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I don't get the problem either. :-\
I much prefer the regime of VA treatment to periods .......... now that WAS messy, for 10 days at a time with intense pain and clots :'( at a time when I was trying to work in a busy mixed-sex environment which meant travelling .........
What regime would you like to try Honeystar? Which symptom do you need to ease in the first instance?
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Sorry, I still don't really understand what the problem is
I don't get the problem either. :-\
Racjen and CLKD I'm sorry you don't understand.. but that's ok.. I'm not here to make you.
Neither was I here to press my own issues onto anyone.. just simply to ask advice from those who might understand or have some deeper learned knowledge of HRT and it's intracacies.
I also don't feel a need to explain, certainly no more than I have done already, to anyone who doesn't get where I'm coming from.
I'm genuinely sorry you are having issues racjen, and I'm glad you've found your preferred regime CLKD.
:peace:
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Hi Honeystar
Just googled the one I saw. He was called Dr Walter Van Harmelen & I am glad it isn’t the same one that you are going to see as he was awful. He told be to get some blackout curtains for my bedroom & that would fix me.
:stupid:
What an idiot.... at this stage in my journey I would have probably stood up and told him exactly that.. and suggest he educate himself. And this IS what I will do when faced with such ignorance nowadays....
I saw a female Gynae in Switzerland a few years ago... I truly thought this would be the be all and end all... but she sat there, obviously hadnt even looked at my test results, didnt listen to me until I spoke about Libido then proceeded to tell me to go see a sex therapist. And handed a leaflet.... FFS???
Ive grown some balls since then ;)
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Hi Honeystar
Have you thought about trying tibolone for your issues?
It's for post menopausal women, and is actually a non hormone that acts on your oestrogen, progesterone and testosterone receptors in your body.
Just a thought if hormonal hrt doesn't work for you. I tried it for a while, and it was good, but being peri meant my own cycle kept overriding it. It's definitely one I'll go back to once this journey is done 😁
ps- was fantastic for libido
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Have you thought about trying tibolone for your issues?
Hi Northarm! No I hadnt even heard of that... i will look it up! Thank you!
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Sorry if my reaction was inappropriate - it's my frustration and desperation speaking, seems like I can't get anywhere near a solution, my life is a daily nightmare so I feel envious of those who are coping a bit better x
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Sorry if my reaction was inappropriate - it's my frustration and desperation speaking, seems like I can't get anywhere near a solution, my life is a daily nightmare so I feel envious of those who are coping a bit better x
Racjen please please don't apologise - I completely understand. I have been in similar position before - wracked by my own depression and confusion.
I sincerely feel for you and I am sure you will find a resolve soon.... there is so much wisdom here on this forum so dont give up - and please know we are all here for you too.
:foryou:
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Good luck for tomorrow, let us know how it goes.
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Good luck for tomorrow, let us know how it goes.
Thank you Suzi! I will...
Just to say, since stopping Utrogestan I have stopped bleeding (almost). Mood has been better but motivation v low... but that could be circumstances.
Im popping into my lovely local hairdresser after my Gynae appt. To see if I can book in a bit of a treat...
Thanks for checking in! xxxx
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Good luck for tomorrow, let us know how it goes.
So!!
I am SO happy to have finally found someone who both listens and is up to date with our needs.
My “new†Gynae listened to me... asked me questions and really helped me to work out what was best for ‘me'.
He also studied my past test results dating back to 2012 and explained them, and the patterns from year to year...
He carried out an ultrasound, explaining everthing... my lining was super thick... only found one ovary... the other prob way too small to be found... shrivelled ;) All good down there... no health concerns :)
He is fully in favour of Testosterone for women and noted I was very low on T and needed it. Thankfully.. and he was as happy to tell me as I was to hear it... Spain now has a Testosterone patch for women!!
So I now need to start the T, take off the E patches, shed the lining by taking P for 7 days, letting it bleed a while then start my new E patches...
We shall see!!
My challenge is the travelling... so he prescribed enough to keep me going til our 4 month phone consultation... I can keep check on levels when I return to UK at Xmas and talk to my Doc to see if I can replenish my T patches. If I can't replenish in UK or CH I will just have to return to Spain for my patches.
Simply having someone who will listen and is open minded (and knowledgable) has really helped me feel like I'm on the right track..... so relieved.
Been quite low about it all so now booked myself in for a hair appointment on Monday.... :yipi:
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:D. Wow way to go HS.
Didn't know about the T patches, I am due to see my lady for a review & will ask about them.
Sounds good, may be that thick lining was giving you the aches & pains. Get ready for a good clear out :o
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:D. Wow way to go HS.
Didn't know about the T patches, I am due to see my lady for a review & will ask about them.
Sounds good, may be that thick lining was giving you the aches & pains. Get ready for a good clear out :o
Thanks SuziQ! I will message you with the brand/name as soon as I pick it up tomorrow...
Yes I'm now preparing myself for a VERY messy time ahead... somehow though, I feel it's a means to an end so the mess I can deal with this time. With his guidance and support I feel like I will get there.....
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Well..... my elation was short lived!!
It turns out the Testosterone Patch isn't in fact available... despite being in the ‘bible' of prescribable medicines..... so when my Gynae is back in the office next week he will likely prescribe me Testogel which is designed for men and in 50mg sachets... so dosing will be tricky.
Still... must be grateful that at least he is clued up and prescribing the T....
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So put the product name into the search box on here and see what pops up. Make notes.
Once you get the product make sure that you send details to the GP in the UK to avoid any confrontation over here?
As 4 Suzi Q - she is a different Member altogether ;-) hasn't posted for almost 12 months but wrote LOTS about atrophy!
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Check out the thread - testosterone here we go! under Private Lives.
You will find everything you need to know there Honeystar - its very interesting - post any questions there are quite a few women here on it. All testosterone in the UK is for men, there is no womens product anymore. Women only use pea sized amounts of the dosage for men. Hurdity wrote a couple of comprehensive posts when she was prescribed it and followed up as well. Let us know how you get on.
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Check out the thread - testosterone here we go! under Private Lives.
You will find everything you need to know there Honeystar - its very interesting - post any questions there are quite a few women here on it. All testosterone in the UK is for men, there is no womens product anymore. Women only use pea sized amounts of the dosage for men. Hurdity wrote a couple of comprehensive posts when she was prescribed it and followed up as well. Let us know how you get on.
Thanks Ladybt! I saw the thread a while back and intend to head over there... I remember it being very informative.
Alas the patch I was talking about was taken off the market in 2016... infuriating. I hope it comes back. Until then its the gel!
Will be following advice here as well as from the Gynae...
Thank you!
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Defo no plans for the patch coming back or testosterone specifically for women ::) I think I read somewhere that some private consultants can use a pellet under the skin but even that I think has too much of a dose in it for women. To be honest we all fluctuate and react so differently to gels, I think it is a good thing that testosterone is a gel so we can up the "size of pea" dose or drop it depending on how we react. That kind of thing is so much more flexible - well I think so anyway. Good luck!
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Good point Ladybt... im.looking forward to seeing/feeling the changes.... diary at the ready...
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Defo no plans for the patch coming back or testosterone specifically for women ::) I think I read somewhere that some private consultants can use a pellet under the skin but even that I think has too much of a dose in it for women. To be honest we all fluctuate and react so differently to gels, I think it is a good thing that testosterone is a gel so we can up the "size of pea" dose or drop it depending on how we react. That kind of thing is so much more flexible - well I think so anyway. Good luck!
Yes I agree I like being able to adjust the dose so easily..
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Honeystar
Really glad you had a good outcome with your gynae in Spain. He sounds much more clued up than my Spanish gynae.
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Hi
Sorry to bump an old thread.
I did a search for Evopad as countrygirl helpfully directed me here from the shortages thread.
I would like to know if they do evopad 75mcg, i looked online but couldnt make out if they did.
My mum is going to spain in October and i just emailed her to ask if she can get me some patches, if the 75mcg are available I will email her again to ask her.
Thanks