Hello all, I'm new to post but have read the forum for ages, and find it very helpful.
Been on HRT sequi, various brands via 50 patch, for almost 2 years. Am 48. All the symptoms before, flushes, serious joint aches (neck and back), vertigo, aura migraines, etc etc.
Vertigo completely gone whilst on HRT, joint aches and flushes improved. Migraines hit and miss.
My withdrawel bleed is random, bit more rare, and sometimes have breakthrough bleed which I think is my natural cycle breaking through.
Swapped to Utrogestan with Evorel 50 patches last month as think I'm prog intolerant. Orally was a nightmare, 200 for 14 days first month. Knocked me for 6, (migraines and extreme fatigue). No withdrawel bleed.
Am now trialling 100 vaginally (on day 6) which is much better but am still getting migraines, but not as many.
Question is, should I consider private consultation (Prof Studd) to get my HRT regime sorted? Realise I am slightly self medicating and understand the risk to womb lining if I don't get enough prog...
My life is on hold by how debilitating this is so any amount of money must be worth it if I can return to some kind of normal.
Any advice welcomed 
Sorry to hear you are still struggling Nitajbee and
. And - my perosnal opinion of course - you really do not need to pay money to see any private specialist and especially not a costly one like Prof Studd, and especially as you are already able to get hold of the HRT he recommends. Please don't waste your money. You could well be disappointed.
The first thing for us to know is what your cycle was doing before you started HRT - had you started missing periods at all and having an irregular (natural) cycle? Thjis will give us an idea of where you are in menopause.
How much, when and whether you bleed will depend partly where you are in menopause, the HRT you are taking (dose and type) and how well you absorb this. Some women do not get a bleed on cyclical HRT ( the figure given on this website is 15 % if I recall).
When I first started HRT I was taking Evorel sequi and then Oestrogen 50 mcg patches with Cyclogest progesterone pessaries (off licence). After about 5 years on a 28 day cycle my bleeds stopped - meaning the womb lining was not building up on the oestrogen and while taking the progesterone, it was not building up further. Because of this I was able to extend my cycle ( ie the number of weeks on oestrogen only). I was post-menopausal by the time this happened.
Research shows that used vaginally progesterone is more effective at protecting the womb lining and limited research suggests that half the oral dose could be used vaginally ie 100 mg vaginally instead of 200 mg orally. Obviously this is off licence so you would need to monitor your bleeds and your womb lining. Do inform your doctor - she needs educating! On higher oestrogen doses and with heavy bleeding a higher dose even of vaginal progesterone might be needed. Until recently I have been using 200 mg vaginally on a longer cycle but have recently reduced my cycle length and the utro dose to 100 mg. The migraines are tough - I sometimes get one while on the utro phase, and sometimes on withdrawal ( like this time - have just recovered from one) - mine last 3 - 4 days when I get them.
Actually the licensed duration is 12 days per 28 dya cycle, not 14 so at least give 16 days on the oestrogen only. Also if you are very late peri-menopause or post-meno some meno docs suggest stretching the cycle to calendar months so you start the 12 days Utro on a fixed date each month - again giving you a bit longer.
I have a theory - but really only that - that if I plump up the vag tissues before and during the utro phase - less will be absorbed systemically than otherwise, so minimising the side effects. So - I shove up Vagifem alternatie days in the week leading up to the utro. Are you on local oestrogen as well?
This cycle it seemed to work because I felt fine on the prog phase (just a bit more tired than usual), but weirdly as above, terrible on withdrawal implying that it had been absorbed systemically!).
If your flushes have not disappeared then maybe you need a slightly higher dose oestrogen patch - this should be the minimum benefit to expect ie elimination of flushes and sweats.
Hope this helps
Hurdity x
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Topic: utrogestan/estrogel support group (Read 724952 times)