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[KiltedCupid]

Tc - I'm really sorry to hear that, had high hopes your new regime would work for you. I think you mentioned the possibility of an implant? In your shoes, I'd grab it with both hands. You'll be well monitored when using it and the reports I've read from users are all positive. Can your call your consultant and ask to increase gel?

[Hurdity]

Well here I am again. Same old same old.

Switched from patch to sandrena 2mg  and from cycle 200 utro to conti 100.  I felt the eastrogen dip within a week.  Now nearly 3 weeks on the utro and I feel exactly how I did before on it.  It starts off after a few days by crying , then very quickly descends to deep depressive state then anxiety kicks in.  Then it a seems to manifest itself physically, shaking, being sick, chest pains.
So I'm back here again. Cant take utrogestan it makes me realy realy I'll and . Eastrogen isnt high enough to counteract it.  Same old story.

Sorry to hear this Tc - I was wondering how you were.

Thing is 2 mg Sandrena isn't very high and sounds like you are not really absorbing it? 2 pumps of estrogel is 1.5 mg and I know Aandrena is more concentrated but i would increase this definitley. I breifly changed from 62.5 mcg patch (or maybe it was when i was still using 50 mcg?) to Sandrena and doc prescribed 1 sachet per day and my flushes returned. I didn;t bother to try to increase to the equivaloent estargel dose - which would have been 1.5 sachets - as I knew the patches worked but I would have thought you might need 3 mg - but increase in small stages?

Do you rub it in well? It used to take me ages as it's quite sticky and stayed sticky for some time - which is what put me off partly - but worth it if it does the job though. Can you up the dose and stay with it for a bit longer?

You were on cyclical Utro before?

Hurdity x

[Tc]

Thank you ladies.

I was on conti utro but after a couple oc months  I got like this. Switched to 12 days cycle but (migraines aside) each month I seemed to be able to tolerate it for less and less days., and by day 10 I've had to stop..  Obvs on the cycle it twas better after stopping until next time. But on conti it didnt get better just worse and worse til I simply had to stop it.  I feel like that's,happening again.  I guess it was bound to if my eastrogen hasng gone up.  It's like a recurring nightmare.

I've bee rubbing the gel in well. I find it rubs,in better if I keep it to a,smaller aea,  no bigger t my palm size.   The 2 x1mg sachets ae listed as high dose  but when you consider I was on 2 x 100 estradiot it's a big drop  the gynae said I can increase after 6 weeks.

I'm pinning hopes on getting implant but I cant have if til next year. Got to get mirena fitted first. They cant do that until 16th December.

I dont know whether to  keep taking the utro in the hope it will balance if I increase E tommorow  or just stop it. I dont think I can take many more days of it.

[Tc]

I think I need to get in touch with c and w.  If I stop the utro tonight I will have only had nearly 3 weeks on 100. And I've still got nearly 5 weeks til mirena so I guess I will have to fit a 7 day cycle in at least.

I wish she hadnt messed around from cycle to conti but she was going on about my lining being 4.2 and not wanting it any higher. But this change in both E and P at the same time has realy messed me up.

I'm in exactly the position I was in when I was first on conti with low E. I dont know what she thought would happen, why she thought history wouldnt repeat but it is.  Maybe she didnt grasp just how bad it is. Or maybe she didnt realise how long i would have to wait for mirena.

[KiltedCupid]

Tc - before switching from patches to Sandrena, I checked the equivalent dose and found that 1mg Sandrena is roughly a 50 patch so you've essentially halved your dose. You should call c&w tomorrow and explain what's happened, you sound despondent.

[Tc]

Thanks kilted. I'm in despair. I feel absolutely awful. I will call them. Thank you xxx

[KiltedCupid]

Thanks kilted. I'm in despair. I feel absolutely awful. I will call them. Thank you xxx

Chin up, old girl, you'll get there and you've moved on; you now know exactly what causes what and when and you've got a great consultant on your side. Together you'll find your sweet spot. If I were you, I'd stop the Utro tonight, you sound like you're full to brimming with it. You can re-start after you speak to consultant. Your endo won't have changed much on conti and less E, so you're safe.

[Tc]

Thank you kilted. Xxx

[Hurdity]

Hi Tc - the thing is the equivalent doses are only approximate - and as always depends on your absorption which is hugely variable between women and with different methods. These figures are only an average from trials of lots of women. If it's not working for you you need to increase - full stop. Also what's the fuss about 4.2 mm lining? I don't think mine has ever measured that low on any scan I've had since being on (cyclical) HRT!!! That is really nice and thin I would say - but obvs not what your gynae thinks! I can't remember at what point in what cycle ( if any) your lining was 4.2 mm anyway? On cyclical HRT it varies throughout the month.

What did you decide to do in the end?

I would first try to increase the oestrogen to see if that makes you feel any better. Alternatively stop the utro - and you will probably get some sort of bleed maybe small. Then after 3 weeks do another course say of 7 days, by which time it will be amost 16th Dec and hopefully at this point your lining will be nice and thin - ready for an increase in oestrogen to whatever level you need, and without having to contend with too much spotting ( if your lining is thin).

If you don't take any more between now and your Mirena, it won't do any harm of course, but you may well get a fair bit of spotting afyer the Mirena has been inserted as the lining starts to thin so personally I wouldn't do that ie if you've stopped I would do another 7 day stint if you can? However you could always ask your gynae at the clinic to see if this would be OK?

How do you feel today?

Hurdity x

[KiltedCupid]

How are you today Tc?

[Alicess]

Tc, I'm so sorry you're having such a rough time. I hope you've made the call to C&W. Or take Hurdity's advice. xx

[Tc]

Thank you hurdity. Thank you kilted.thank you Alice.  I'm even worse today. I stopped the utro last night so I guess I'm going to have a withdrawal.  I've had to email c and w.

I had thought the same hurdity that I will be able to firt 7 days at 200mg in.

A surgical meno site I found likens the first year or so after BSO to being much more akin to peri menopause than to a post menopausal state. A kind of pseudo peri. The body is adjusting,  the "background" non ovarian hormones and steroids are going haywire. But with natural meno it's a gradual process whereas in surgical it's got to do a lot of catching up. So a sort of "pseudo peri" storm ensues. So even small  HRT changes can have a big impact during this time.

My docs have seemed universally reluctant to prescribe an alternative to utrogestan  (until now)  and so have kept advising me to play around with it. Conti, 12 day, 7 day, back to conti.   It doesnt make for balancing a body already in the middle of a hormonal storm.  Add to that  the way they have handled my E . Chopping and changing. Getting me to the highest dose on something and then with each change making me drop down by a significant amount initially for 6 weeks to see if I absorb better. I havent absorbed better once and have had to increase each time.  So the result is these constant 6 week periods of nosediving , getting back to an ,albeit low, plateau then nosediving again. creating a rollercoaster   in an already unstable environment.  Looking back I've had zero hope of getting any sort of stability like that. So at the end of a year or so I'm in no better position to get a feel for how my body has adjusted itself naturally to ovary removal or of what my real needs are in terms of replacement

Xxxxx

[KiltedCupid]

Tc - maybe you should say what you've just posted to your consultant. I'm not surprised you despair, a year of rollercoaster highs and lows is exhausting. It's really clear you need to find stability and the Mirena might help with that. Do you really need to take any more prog between now and Mirena? The coil will sort out any build up and you'd have some bleeding until it's settled but I'd ask the consultant if you can just work on getting your E levels stable before getting your coil fitting. Did c&w say when they might get back to you?

[Tc]

Kilted. Within 2 days I think  I'm going to up my E.  ".  200 patch gave me 154pmol. Hardly too high. But no, they had to take me off it saying the dose was too high!! and give me something else at half the dose and cause me to plunge into despair again. It's happened so many times.   I'm not having it anymore. 

Thinking about this last year with this new perspective I've been given  that  rather than just fast tracking to post meno my body has been going through a huge period of adjustment, the way my HRT has been handled has been wrong. . Halving a dose in one go causes unnecessary suffering. Then increasing as I try to climb out of the hole,  Never allowing me to settle and adjust to a level of E for long enough to plateau. Not seeing that with an already low e level even a small drop can be significant,  I've had enough .
So You are right  I need to say all this to doc.
Xxxx

[Hurdity]

Hi Tc - yes you will expect a few days of withdrawal after stopping the prog (and maybe a bleed) - I expect you know what this feels like - but bear with it, since as soon as it's left your system you will at least feel better from that.

Yes your body is still in shock as your endocrine balance changes and the adrenal glands come to the fore.

Do let us know what the C and W say - as to what to do between now and 16th Dec and in the meantime hope you  manage to cope - personally I would increase the gel anyway. Also what is it with all these docs saying a particular dose is too high - clearly surgical menopause is totally different, and a dose high in number does not necessarily translate into actually systemic levels.

Hang in there Tc

Hurdity x