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[Mindfulmoomins]

Hi everyone,

Can I ask if people split their Estrogel dose?

The specialist I saw prescribed 3 pumps and as I keep waking up in the night (have been for a few months) I am wondering whether it's sensible to do one pump at night and two in the morning.

I am seeing GP today so can ask but any thoughts would e appreciated.

Thank you.

[Mary G]

I split my Oestrogel dose by doing one pump in the morning and one pump at night and it works very well.   I also split the location by doing on the upper outer arms and one on the upper inner thighs which has worked wonders for my minor VA.

Definitely worth a try!

[Hurdity]

It's also important to remember to avoid skin to skin contact with (male) partner or pet for minimum 1 hour after application, to prevent transference - so where on your body you apply it might also have a bearing on the timing (or vice versa!).

Hurdity x

[Mindfulmoomins]

Great, thank you x

[Mindfulmoomins]

Hello again,

I seem to be sleeping better with my new regime of 3 pumps of Estrogel and 200mg ultragestan orally days 15-26. I take both in the evening before bed.

Last night I felt a bit dizzy and still feel a bit off balance this morning. It could be something else of course but I notice it is a (rare I think) side effect of ultragestan.

I have taken 7 ultragestan doses so far.

I am worried that the next 5 doses might increase the dizzyfeeling and wipe out Christmas.

Both my GP and Menopause specialist said to take it orally.

If the dizziness persists shall I email the specialist?

Has a phone had a similar experience and better luck taking it vaginally?

Thanks.

[Mary G]

Mindfulmoomins, why do they want you to only take it orally?   It doesn't make sense.  There is no reason why you can't take it vaginally, it works better at lining clearance when used that way and has fewer side effects.    It usually means you can take less of it too because it is more localised.

I would try it vaginally tonight and see if it makes a difference. 

[Mindfulmoomins]

Hi Mary,

I think it's because it's not licensed to take vaginally here nor the US. I have emailed the consultant but might try it vaginally tonight.

Don't want to go against their suggestions without their approval really.

Thanks.

[Cassie]

Its not licenced for HRT use vaginally anywhere but in my humble opinion, its the only way to get the  best effect from it and the least side effects.

[Mindfulmoomins]

Thanks Cassie,

I am definitely dizzy today and it feels a bit like pmt dizziness or almost like a cold is coming (also a symptom of pmt for me at times). Also feel sleepy.

I am going to try the vaginal route tonight. I have a copper coil - is that ok? Also do you literally just put it up as far as you can?

Haven't heard back from menopause specialist yet. Thank you.

[Hurdity]

Mindfulmoomins - "Has a phone had similar experience"  !!! Love the phone typos!!

Just to clarify - Utrogestan is used vaginally or orally on the continent and is licensed for this purpose through whatever procedures they have in some of these countries. When I first started to use it 6 years ago I wrote to the manufacturers about vaginal usage and they sent me a translation of the French SPC (Summary of Product Characteristics) they provide, which gives vaginal use as an alternative to oral use if side effects are severe with oral use.

Here is an extract (these were written in 2003):

4.8 Undesirable effects

Oral route

- Drowsiness or transient sensation of vertigo occurring 1 to 3 hours after ingestion of the product.

In this case,
+ Reduce the dosage per dose,
+ or change the dosing schedule (for example, for a dosage of 200 mg/day, take the 200 mg in the evening on an empty stomach before going to bed) ;
+ or use the vaginal route.

The other important point is that the (licensed) dosage was listed as exactly the same for vaginal as for oral so the reduced dosage for vaginal use is probably not licensed anywhere ( unless the French SPC have since changed) but based on the results of some preliminary research studies. I presume the reason it's not licensed for vaginal use elsewhere is that the trials were not sufficiently large or extensive - which is very frustrating - but most knowledgeable gynaes are aware of this research and therefore allow reduced dosage for vaginal use.

Yes you just poke 'em up as far as you can at night  .

No idea about the coil but I doubt it impedes the diffusion of the utrogestan? Something else to ask Dr Currie although you are supposed to aks one question - I'm sure that can be included though!

I never feel dizzy - but just very tired and I expect that - I mean if that's the only side effect we can be thankful! I get foggy-headed and now and again a migraine but mostly just heavy tiredness.

I hope this helps and your side effects lessen soon

Hurdity x

[Mindfulmoomins]

Thank you Hurdity, that's brilliant.

Yes phones may have similar experiences using the vaginal route! 😉

Really appreciate you taking the time to share your knowledge. Going to try the V route tonight.

[Mindfulmoomins]

Hi everyone,

Just looking for a bit of reassurance.

I have been feeling a bit brighter and as though my thinking is a little more ‘me'. I am still experiencing some anxiety and a pounding heart when I wake in the night and at other times.

I am sooooo grateful for feeling a bit better than last week however.

I have only been on Estrogel three pumps for a week. Before this I was on 1 pump. My specialist said it will take 2-3months for my symptoms be resolved by the increase in Estrogel.

I am hoping the Estrogel will build up and the effects will be incremental. Can anyone share their experience of this?

I guess I am hoping that things will get better (anxiety wise) in the coming weeks even if there are dips. I am staying positive but this is quite a journey.

Thank you.

[Mindfulmoomins]

Also, to add to my last post I am on day 10 of ultragestan 200 mg (took it orally at first for 8 days then vaginally thanks to the suggestions on here).

I am supposed to take it for 12 days but gather 10 days is also often prescribed?

If I stop the ultragestan today and carry on with the 3 pumps of Estrogel what is likely to happen in the coming days? I gather I will get a withdrawal bleed? Will I get PMT also? Would really like to enjoy Christmas as much as possible but hormones seem to influence me quite a lot!


Thanks.

[Hurdity]

Hi Mindfulmoomins

I would start with the licensed dose if you can tolerate the utrogestan vaginally and see what sort of a bleed you get. Also if you are feeling more or less OK I wouldn't risk stopping after 10 days now because the day after your missed dose and for a couple of days you may get some pms and your bleed may start so  maybe hang on for another couple of days (depends also to some extent what your own cycle is doing...). If Day 10 is tonight that Day 12 will be Christmas Eve so Boxing Day will be your first missed dose - and if your own cycle hasn't kicked in and you are still feeling OK then take it an extra day if you want to feel OK on Boxing Day. Go easy on the alcohol especially later in the evening as it (prog) can sometimes trigger headaches at much lower amounts ( of alcohol)  than when we were younger. All the best!

Hurdity x

[Mindfulmoomins]

Thanks Hurdity,

Can I ask one more thing? Might the increased estrogel I'm on help minimise pmt?

I think I'll stick to the 12 days as it's my birthday on the 30th.

I am sort of feeling ok but quite anxious about what it will feel like to stop the ultragestan.