Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[jojo999]

Hi
Currently on month 3 of taking 2 pumps oestrogel and 100mg Uterogestan daily orally.
Feel very low in mood, flat, tearful, getting by but not really feeling any joy or fun or happiness. Some days are really tough and I don't really want to do anything or talk to anyone. Struggling with work. Pretty shit really.

Had my ovaries removed in 2013 so straight into a hideous surgical menopause (tried HRT but the progesterone part of it nearly killed my with depression so have just managed to survive until this year, when i just couldnt continue feeling so shit..anxious, tearful, no confidence, gave up all hobbies, hated myself, depressed!!)

Had ovaries removed as had PMDD (i know they should have done a hysterectomy but i had shit advice and they left womb so i need to take a progesterone if i want to have any HRT).


I know that if i dont change the progesterone part of my HRT I will either have to stop it altogether or consider a hysterectomy.


I have read lots on this forum about altered progesterone cycles etc..and that is what i would like some advice about.

Would a non continuous regime lessens the side effects? Also i take 100mg daily so if taking for less days, would it be 100mg or 200mg.  Would taking 200mg potentially make the intolerance effects worse, even if taking for less days.
Vaginally or orally. I am seeing a consultant but she is not comfortable with vaginal (also i have a prolapse so might struggle!!!)

Its a minefield and i know everyone is different, but at the moment i feel i am functioning at a low dull sad level and its not ok.

Any tips and advice would be much apprectiated.

My consultatn has talked about adding testosterone but i feel that the progesterone element needs addressing first so i feel happy again instead of just having to work hard every day to stop being dragged into the black hole..

Cheers

Jojo

[Mary G]

Welcome to MM!

Sorry to hear about your low mood.  My first thoughts are what a pity you didn't have a full hysterectomy, it was very shortsighted on the part of your specialist, what was the thinking behind retaining a womb with no ovaries?  They knew you would need hormone replacement and clearly have a problem with progesterone.   You mention a prolapse, could that lead to a hysterectomy?

From what you have said, it sounds like you can't tolerate Utrogestan every day which is not surprising, a lot of women have bad side effects with it, particularly low mood and migraines.   

Dotty on here uses Utrogestan every day but she uses 4 pumps of Oestrogel to stop the Utrogestan becoming too dominant - too much progesterone will stop all the good work the oestrogen does.  This regime might work for you depending on how progesterone intolerant you are.

You could switch to the bog standard NHS cyclical regime but you need to take Utrogestan for 12 days each month.   The Professor Studd regime is 100mg Utrogestan for 7 days each month which is more palatable if you are progesterone intolerant.

The other alternative is to do what I do and seriously limit your progesterone intake and have regular uterine scans.   I take a tiny dose of progesterone every 5-6 weeks but still get a post bleed lining measurement of 2mm so I don't need anything like the NHS recommended dose to get adequate clearance.   There is no guarantee you will be able to get away with taking a super low dose but if you have regular scans, you can tailor the progesterone dose to suit your personal needs.  Flexibility is the key to success with this HRT regime.  Definitely use Utrogestan vaginally, it works better and you only need 100mg because it's not getting lost in your digestive system.

I hope that helps.

[racjen]

Hi jojo999, sorry you're having such a hard time. Like you I had a sudden menopause, from chemotherapy rather than surgery, and have struggled with awful anxiety and depression  since then. I'm still trying to get to grips with the right balance and frequency of utrogestan - when I first went onto HRT about a year ago my estrogen level was pretty much zero; not surprisingly I had a really bad time with any progesterone I tried because there was nothing there to oppose it.

I'm now on Evorel 100 patches (equivalent to 4 pumps of oestrogel I think) and my estrogen level was around 1000 pmol last time it was checked a few weeks ago. I reckon I need this level of estrogen to feel OK, it has really helped with the depression, and I'm sure I remember reading on here that Prof Studd thinks some women do need at least this level to feel OK emotionally. The problem is still the progesterone. Like you I can't tolerate a continuous regime of 100mg a day, it makes me feel depressed, tearful, exhausted and gives me terrible stomach ache. However, as my estrogen level has risen I've realised that I can tolerate a certain amount and that if I can get the balance right it may actually be beneficial.

So I've been experimenting - the private specialist I saw a few times said the minimum you can get away with is 100mg for 10 days every month, or 200mg for 10 days every 3 months. Tried the 3 month one and there's no way I can tolerate 10 days at 200mg - awful. The last couple of months I've made it through 10 days at 100mg and it's been OK - for the first 5 days I actually felt better, much less anxious, slept better, eating better. Then around day 6 the depression kicks in and it all goes pear-shaped. This month I cheated and slapped on an extra half patch to counter the bad effects and it definitely helped. But now I'm in the horrible withdrawal phase and feeling crap, also anxiety level rising again.

Once I've had the bleed from this one I've decided I'm going to try taking it continuously, but 100mg every other day, to see if getting a stable lower level in my bloodstream will actually help. It's so annoying that progesterone seems to be doled out on a one-size-fits all basis, so you can't lower the dose even if you need to. Oh and by the way, I also use Utrogestan vaginally, far fewer side effects and you should be able to get away with using less that way.

You haven't mentioned the possibility of a Mirena - that's another thing I'm holding in reserve for if this doesn't work. Is that an option for you? Also I'd leave the testosterone for now - although with no ovaries your level is probably (like mine) non-existent, I think it makes sense to sort one thing out at a time, otherwise you end up in a right mess. I've tried testosterone and unfortunately it just made me very depressed, not what it's meant to do but this HRT thing is so unpredictable it's not true.

Good luck!