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[Pinkjan4288]

Hi, Im new to this thread. I started utrogestan 200mg and Estrogel 9 days ago. I feel better already, night sweats and sleep have improved.
I feel like I want to come on. I am passed the day I would have come on if I hadn't started HRT.  should I continue up until 14 days and then see what happens?

thanks

[Sooze]

I'm working my way through this thread - up to page 83 so far and have a couple of questions.
I'm post meno, (natural, at least 6yrs age 55 now), had been on Tibolone (plus very small amount of testosterone to top up) until last Sunday.

Now switched to Utero 100mg & Sandrena 1mg (plus testosterone at the same dose as previous, but aware I'll likely need to increase to manage my symptoms).  I notice that a lot here seem to have problems tolerating Utero. I don't think I have a progesterone issue to all progesterone, just some.  Levonorgestrel (had suicidal symptom when had it as part of BCP) and dydrogesterone (felt emotionally flat when on Femosten).  I was OK on a Mini pill which I think was Norethisterone but I had bleeding all over the place so was only on it for 6m and maybe too soon to be sure.  When not on hormonal contraceptives had very slight PMT, but horrendous period pains/back pain and digestive issues during my period.

My gynaecologist is keen on Mirena, but as it contains Levonorgestrel I don't want to risk it, which is why I'm giving the Utero a try. I'm taking it every day orally ATM and it seems OK. Little digestive upset second night but last night I took it later with more water and seemed better. Slightly odd dreams but not disturbing, and more relaxed than usual before I dropped off (never had a problem sleeping once flushes sorted). I was expecting to get a marked increase in flushes due to the change in regime but I've only had maybe an extra 1 or 2 and quite mild so far. Reading the thread it seem that migraine and IBS  sufferers have real issues with Utero, is there anything else that's made worse? I don't suffer with either so keeping my fingers crossed I'll be ok.

I'd rather do a continuous regime and avoid having a bleed (due to history of period pains). I had a scan 2 months ago & my endo was only 2.5mm - so no thickening while on Tibolone. If I manage with Utero every day do I need to get regular scans?

Re the gel. Does it make a difference in absorption if you put it on the inner thigh vs outer thigh?

Those who are using testosterone as well, how much are you using?

Does anyone know how quickly the Tibolone should leave my system?  My last dose was last Saturday, should it be gone by now?

[Sooze]

Thanks Stellajane,
The side effects would have to be significantly worse than my symptoms when I wasn't on HRT for me to consider not taking it - which I can't see ever happening.  I can deal with the occasional flush as long as I'm emotionally, physically and mentally stable and the regular sex life continues 

Had various side effects with Tibolone but none so bad that I wanted to give up. Part of my switch now was a bit of an increase in flushes, but also that we're looking to move next year and the likelihood of another Dr OKing Tibolone and the tiny bit of testosterone was in my opinion pretty low. By switching to this ‘more common' regime I'm likely to be able to keep the testosterone too, which really makes a difference for me.

[Hurdity]

Hi Sooze

You shouldn't need a scan if you are taking utrogestan at the licensed dose on a continuous basis and don't get any bleeding.

According to the product info Tibolone is metabolised very quickly into the 3 constituents but full information on the breakdown over time is not given although it says for one of them plasma levels are low and the other two - accumulation does not occur. However there will be changes in the body at cellular level brought about by the action fo the Tibolone constituents so these will alter but be replaced by the actions of the new HRT you have changed to.

Re the testosterone - that's for another thread. I'll bump up the two that I started - one in private lives and the other on this board.

Hurdity x

[Sooze]

Thanks again Hurdity, helpful as always 

I felt like I had a slight flush this morning, before I applied the Sandrena, but other than that I haven't particularly felt that the change over has had much impact yet, so I'm guessing that's a good sign.  I do think I 'feel' a bit better.  Difficult to explain what I mean - I think you could call it 'wellness' I suppose? 

[Sooze]

Just a quick update. I've now tried the Utero both orally and vaginally and I definitely prefer it vaginally. The drowsiness that comes on after taking it orally is quite nice and relaxing but taking it on an empty stomach gave me a touch of nausea. Not a big issue but obviously don't get any of those symptoms taking it vaginally and the drowsiness is less.

One thing I have noticed is I need more Ovestin at the moment. Whether this is a long term thing or just temporary due to the change in HRT time will tell. Anyone else find this (or that they need more Vagifem)?

[Sooze]

So a couple of questions. I've now taken 11 days of Utero & I feel OK (good actually)!  So, I'm guessing I would have noticed significant adverse side effects by now, if they were going to occur - or am I not out of the woods yet?

Re taking Utero 28 days vs 25 with 3 day break - what's the thinking re the difference? If I'm OK on it I'd rather not stop it for 3 days and avoid a trough in P by dropping it. Also I'd rather not risk getting a bleed - I know post meno I probably won't get one especially as at my last scan my lining was only 2.5mm, but is that what the 3 day break is for?  My GP said I can do either.

I have also increased T to alternate days as I've defiantly noticed symptoms coming back, and I've noticed an improvement quite quickly, which I think helps also.

[Sooze]

Just want to throw in something that may help the sensitive bladder ladies using Utero vaginally. When you insert it aim for ‘behind' your cervix, towards the posterior wall of the vagina not the front (which is the wall in front of the bladder). There's a small pouch, called the posterior fornix, and if you can tuck it up there it's not as likely to cause bladder irritation, especially if you sleep on you back rather than side. That way doesn't melt down to the front through the night.

I won't pretend it's not a challenge to do - long fingers, slight contortionist and visualisation of where you're aiming helps.  I've been doing this for the past week and had no sensitivity of the bladder, admittedly I only had a hint of it anyway.  Give it a try and feedback if it helps!

[maryware]

I hope this posts to the right place. I'm thinking of asking to try these 2 hormones when I see gynae next week. So far I have tried Evorel Sequi patches and am now on Evorel Conti 50, but still get frequent headaches from a couple of days before period till mid cycle. The gp doesn't like giving me the conti patches  but a previous gp suggested they would keep things more steady I'm 54 but periods are every 3 to 4 weeks still. Scan to check lining was fine. I'm sure the headaches are hormonal but drs are querying this... None of the migraine meds have helped and I think I was worse without HRT. Problem is, years ago I had cyclogest for PMS and it gave me severe headaches so I'm nervous of utrogestan doing the same. I'm obviously very sensitive to hormone fluctuations. The last gynae I saw was useless - told me that one progestogen was the same as another and if I still had periods I wasn't lacking hormones !!!! I've asked for menopause clinic this time but my NHS trust doesn't seem to have one. So I need to clue myself up before appt on 31st Dec. Any advice appreciated. Thanks

[Tc]

Hiya ladies hope you're all having peacefull holidays.
So glad to find this topic.
Since surgical meno 4 months ago ice been on femseven sequi 50. And my symptoms have been poorly controlled.
Blood test showed esrradiol 129 pm/ol. Tbh I'm very confused over what it should be and the pg/ml conversion thing. But doc said it's too low and has switched me to easteogel and utrogestan.
I pic up my scrip tommorow. At the moment I'm on 2nd week of phase 1 patch so due to start the progesterone phase this Friday
 I wonder if anyone could help me with when to make the switch over.
I'm pretty scared of progesterone overload as I've reacted realy badly to it.
Also. How many pumps would I need to have an increase over the patch. I'm blinking terrified  of falling even lower in E than on the patch as my symptoms have been so devastating and abrupt.
Thanks for any advice or experiences you may b able to offer.

[Ladybt28]

TC - Don't be terrified - nothing can go wrong so nothing to worry about - its all just about balance and if you dont have it at the moment then the only way is up!  Depends what the doctor puts on the script.  Gel applications vary from 1 pump right up to 4 (and I have heard of up to 6).  Also are you on continuous regime or a cycle with a bleed?  Apparently the gel absorbs really quickly transdermally and I find it much more flexible to deal with. If you have problems with the progesterone use it vaginally.  It is not licensed to take this way but loads of consultants recommend to do this.  Just pop the capsules as far up with a finger! (I use an plastic applicator that I have for canaston pessaries!).  Using them this way distributes the progesterone near the cervix for absorption it doesn't go through the stomach or the liver as it would if you took them orally and you don't get anywhere near the side effects by doing this.  Loads of us ladies do it, particularly those who have trouble of any kind with progesterone.  I am particularly progesterone intolerant and I can manage it, but I cant take it orally.

I believe that there is no sort of straight comparison between doses in patches against doses of gel but someone like Hurdity is better equipped to comment on that.  I increased my gel from 1 pump on each thigh until my sweats, panicks, etc went away.
The gel takes time to build if you figures are low,  I am on 4 pumps which is by conventional comments the "highest" but I have heard some women on here us up to 6. 

As you are poorly managed anyway, you cant go wrong and you don't need to start slowly either. Your body needs the estrogen.  Someone will tell you how to switch over - I'm not very good a counting days and cycles to be honest for others!

Dont worry this change is a good thing and just keep posting about how you are feeling each day and then you will be supported as you go along.  Mine took 4 months to fix most of the problems, not all mind, but I was not like you with a surgical meno - your body needs to adjust from the shock, the fact it's been left without proper support etc but the only way now is up. 

[Tc]

Thanks lady.such an encouraging reply will keep posting. Xx

[Tc]

Hiya ladies. Well it doesn't look like I'm gonna get my new scrip til new year now. GP said they haven't received the fax from specialist!!
I'm due to switch to phase 2 (inc.progrst) tommorow and the very thought is making me anxious. I am dreading it the phase 2 patches have had a devastating affect on my mental health.
I'm thinking of not using the phase 2 and just sticking on another phase 1 for a third week. I haven't had a bleed on 3 months of femseven sequi. I don't know if swapping the phase 2 for a phase 1 would be dangerous. But my experience of this type of progesterone (my only hrt I've tried so far) is making me afraid of it.
Help! Please
Best wishes to allx

[anon2021]

Hello there,

I am 48 peri menopausal started on Oestrogel 2 pumps and Utrogestan 100mg for 25 days (break for 4 to 5 days for period). Bit of testosterone if required. (I switched to taking Utrogestan vaginally for better sleep).

Initially I felt fantastic almost immediately. My brain fog lifted my memory was better and I just felt so much better.

I found the testosterone too much so I stopped that. From zero libido to crazy! 

Then I started to have tingling breasts, looked it up and saw it may be too much Oestrogel so reduced this to 1.5 pumps. Tingling went away.

Now 4 or 5 months in I am feeling back to rubbish. Brain fog, can't remeber names or normal words like house for goodness sakes!

I'm irritable and angry and my hair is just falling out all over the place. I have long hair and it's about half the thickness now it usually is. Mood is terrible. I'm so tired and back to terrible insomnia. Feeling just horrible and fed up with myself. 

Really I feel like just throwing it all away. I know I should return to the doctor up in Harley Strert but it's so expensive and we can't really afford it as all the tests they do push the bill up enormously.

I know this is a trial and error thing and I do get my prescriptions from my GP do I see him? He seems not to know much about it all.

Sorry everyone, having a bad day  and just can't seem to make any decisions. I'm just totally fed up with this all. I absolutely hate myself my emotions are erratic and I'm so angry!!!! For no reason!  . Literally can not control myself emotionally. Periods are still a nightmare.

Can anyone help guide me please? 

Thank you x

[Ladybt28]

Hi anon2021,
You are in peri so your own hormones are still fluctuating and mixing in with your oestro and Utrogestan.  I would slowly start to up your oestrogel again.  As we move towards the end of peri and then out the other side to post the ostrogen can drop suddinly.
GP's (my own included) and consultants  say you can up the gel pumps to 4 - that is what I use each day (2 on each thigh)  In fact one lady commented on here that in rare occasions when ladies dont absorb the gel well they can use 6 pumps but I would say this is fairly unusual.  Personally I think your oestrogen has dropped and your body cannot cope so you need some more, they are all the signs of low oestrogen.  I got some tingling intitially but after a couple of weeks it stopped as my doses settled.  I have been on 4 pumps for 3 months out of the 5 I have been on oestrogel and Utrogetstan as a cycle.  I am post meno but am progesterone intolerant so cannot the utro continuously - I have to have a bleed but for me it is no problem.

The thing about the gel is it is flexible and your really cannot go wrong nor to be honest do you need much guidance to up the dose.  The only thing is that if you use more pumps you will use your gel up quicker and need more repeat prescriptions.  Just make an appointment and tell him (dont ask if he is a bit clueless) that "you know you can use up to 4 pumps a day - your symptoms are back so you will be using it up quicker - can you change the repeat prescription because of that"  or if there is a lady doctor in the practice - see her! No need to see a consultant.  (if you really wanted to - do it by phone consultation - you dont have to physically go but the GP should be fine for this.  You just need to sound like you know what you need to do  As long as you keep taking the standard Utrogestan dose and dont change that in any way you pretty much cannot go wrong.  Up it again to 2 pumps then to 2.5 and then up to 4 if you have to.  Keep a diary about how you feel and up it half a pump per week at a time - see how you go I reckon your symptoms will go away.  There is no reason why they shouldn't.  The peri thing makes it more likely you need to keep adjusting  the dose - if you have enough it is easy enough for you to do - you can always drop it down again and there is not need to tell anyone if you have enough supply.  It is very much trial and error more so in peri.

Let us know what you think?