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[Graciemouse]

Hello
As experienced peri menopausers what seems to be the best progesterone to opt for to work alongside Oestrogel?

My heart is pulling me to Ultrogestan because it's the “gold standard” way to do it. I've also have read it has sedative properties and insomnia is my probably my biggest menopausal issue.

My head is saying 100mg tablets will be too strong as I seem to be very sensitive to hormones.

I had the mirena taken out recently so I'm cold turkey until I see the Dr next week. I like the idea of going for the two most natural ways (gel and ultrogestan) but maybe I'd be better going back to tablet form?
(what worked for me prior to going down the mirena/gel route)

In a bit of a pickle as hormones have hit the floor without anything obviously.  Had there not been a shortage I'd have just stuck to good old Elleste Duet months ago!

Thanks ladies

[KiltedCupid]

Hi Graciemouse - if you did well on Elleste, why not ask the doc for Norethisterone tablets. I know they come in mini pill strength as I've used them at double dose, but they may also come as 1mg which you can tailor to suit. You're lucky you get on with them.

The other option is another coil. There's a newish coil called Jaydess, it's smaller in size than Mirena and has quite a bit less levonorgestrel so any side effects are reduced and it's hassle free.

[Hurdity]

Hi Graciemouse - I'm not sure why you had the Mirena taken out because from your previous posts although you bled initially a lot,  in mid Aug you said it tailed off? Bleeding is normal with the Mirena for the first 6 months at least and then it should stop. Was there another reason for its removal?

If you really don't want to have another one fitted then I would go for Utrogestan yes. It's difficult to say where in menpause you are but if you went 10 months without a natural period - without Mirena or mini pill then you might be nearly there although you can't say definitely.

Yes it definitely has sedative proprerties! It's too much for me as I already sleep too deeply!

You can use the utrogestan vaginally off licence. Why do you think 100 mg will be too strong. Initially I would take it cyclically anyway (the dose is 200 mg for 12 days per 28 day cycle) to see how you feel on and off it, before deciding whether to take it daily.

Personally I wouldn't take norethisterone which for me and some others is the devil's prog.   Also you probably won't get doc to precribe it separately for hRT although you can get it and it is in the combi products!

Hi Graciemouse - if you did well on Elleste, why not ask the doc for Norethisterone tablets. I know they come in mini pill strength as I've used them at double dose, but they may also come as 1mg which you can tailor to suit. You're lucky you get on with them.

The other option is another coil. There's a newish coil called Jaydess, it's smaller in size than Mirena and has quite a bit less levonorgestrel so any side effects are reduced and it's hassle free.

Do you have experience of the Jaydess Kilted Cupid - I gather it is not licesned for HRT? I seem to recall it has been mentioned on here but not recently.

Hurdity x

[Perinowpost]

Jaydess isn't licensed for hrt I was all set to have one but didn't in the end ‘cos I had a failed attempt at fitting. Gynae was wanting me to sign a disclaimer though to say it was my own risk. I've since decided against it, as if it didn't work don't think I could face removal x

[KiltedCupid]

Hurdity - no I haven't had a Jaydess but read about it recently when searching for prog alternatives. It seems a great alternative to Mirena for ladies who can't tolerate that amount of Levo. Mirena is, after all, a contraceptive, and indicated for fertile women with much higher natural levels of oestrogen.

Graciemouse - my GP happily prescribed norethisterone tablets for me alongside my oestrogen patch, I can't see any reason why yours wouldn't as it's essentially the component of Elleste duet, just taken separately.

[KiltedCupid]

Jaydess isn't licensed for hrt I was all set to have one but didn't in the end ‘cos I had a failed attempt at fitting. Gynae was wanting me to sign a disclaimer though to say it was my own risk. I've since decided against it, as if it didn't work don't think I could face removal x

I believe the Chelsea and Westminster fit them.

[Perinowpost]

Yes that's where I got the idea from and as I struggle so much with prog I thought it was the answer to my prayers. However, they're still not licensed to be enough for protection so it's very much an experiment as to whether they'll do the trick, hence having to sign a disclaimer x

[Graciemouse]

Was there another reason for its removal?
I spoke too soon as to thinking it was tailing off. In the 9-10 weeks that I had the mirena I had about 5 days of not bleeding on it. Some days were spotting but most days I was needing a proper sanitary towel. Started getting me down. On my holiday in Italy I bled profusely and it stopped me going in the pool/sea. Lessened the Gel to see if it was that - but still it kept coming! Been the summer of discontent really and I felt (whether it was to do with the constant bleeding or not) that I had a black cloud over me. Never been so grumpy. I didn't need it for contraception so I decided it was all too intrusive - and I was too much of a grumpy b**ch! So out it came. Bleeding stopped, mood lifted - but it meant that I had to to stop the gel too. Hence where I am now.

Yes I'd gone 10 months without any period prior to the Elleste at xmas. As much as the Elleste suited me as regards symptoms I didn't like the green tablets so much (felt grumpy and my sleep was worse on those green days) I'm wondering that perhaps I'm not good with the Prog in those OR in the mirena. Hence why I'm steering to perhaps trying Ultrogestan?

I'm liking that you think Ultrogestan has sedative properties. My sleep is shocking and I'm very aware that I'm not coping too well without any HRT at the moment. As much as I like the idea of my body being my own again and me "trying" to control things with magnesium, black cohosh, EPO, menopace - etc, I know in my heart of hearts that I'm a bit of a mess and I need something ...whether it be to get back on the gel (with a Prog added in) OR try tablets again (even if its elleste which i know isn't perfect but it covered most bases) OR try patches? It's a minefield as to what to try isn't it.

Why do you think 100 mg will be too strong?
I guess just because its a large dose compared to the other preparations. That said, I know its more natural so I'm hoping it will suit me better. 

Thank you one and all. I really appreciate you ladies support. I was hoping to try to manage things once the mirena was out (and I'd stopped bleeding and the mood had lifted) I thought Yes I can do this, in reality its harder than I thought and if I need to reach out to some kind of HRT then ideally I'd like to go for the most natural option. If i can't go down the gel/ultro route then maybe I'd be better with patches so that the Prog part isn't affecting me so much. Who knows? xx

[Hurdity]

Hi again Graciemouse

Ah I see.

Well in your position I would go for either the patches or gel together with Utrogestan.

Don't be worried by the 100 mg dosing instructions. The amounts of progestogen in the different types are not comparable because they have different breakdown rates in the body and the extent to which they protect the uterus lining at a given concentration. Yes 100 mg seems quite high but this amount is needed to protect the womb. If you want to reduce side effects then best to use it vaginally (off licence - same capsule).

If you felt well on the dose of gel apart from the bleeding then go back to that especially as patches are a bit tricky to get hold of.

I understand what you're saying about wanting your body to be your own again - but actually - that is how I've almost always felt on HRT for 12.5 years! I can have a life, quality of life and not worry about what I'm going to feel (within reason of course and allowing for my age - mid 60's).

Good luck and keep us posted...

Hurdity x

[Graciemouse]

Hurdity
If there was a LOVE button, I'd press it! Thank you. You clearly know your stuff and I appreciate your time and knowledge. I will indeed keep you posted. Thank you xx