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[Smarlo]

Ta Stellajane - dang-blasted postmenopause; hits us all so differently. Just when you think all is chugging along well, a problem rears up. I'm frightened to again try boosting Estrogel to two pumps and increasing progesterone because I blow up and my boobs get very painful. ARgggghhh. And the meno docs seem to have a standard response: "Hmmm, it shouldn't cause that (whatever) to happen"...

[Smarlo]

I've been googling around trying to determine if my switch to putting Estrogel on my inner thighs instead of inner forearms is a factor in my fat growth in my thighs. Found this, written by a naturopath, in an article about cellulite:

Premenopausal women with too much estrogen tend to have the pear-shape body type with more weight at the hips. The reason for this comes down to fat, both the type and the amount. Consider that women have almost nine times the amount of alpha receptors for every one beta receptor in their hip and thigh region. When stimulated, alpha receptors cause fat cells to produce fat, while beta receptors breakdown fat. This is also the area with the most estrogen receptors.

I'm going to revert to application on forearms after a two-week break from Estrogel. Will continue Utrogestan three times a week (I had recently reduced it to two times but think that wasn't enough opposition to oestrogen). Will post again if there's any noticeable difference. You never know, someone else might be accumulating more fat on hips and thighs too by applying the gel to inner thighs.

[Cassie]

I have been applying the gel on my thighs for yrs no extra fat thankfully. Can you explain your hrt regime, you mention a 2 week break and only every few days for utrogestan, do you keep bleed free like that?

[Trufflecat]

Anyone else using four pumps of oestrogel? I upped it due to feeling particularly horrendous mood wise one month and then lowered it back to two, then back up to four permanently as it means I am far less moody. It's also given me a proper period, so I suspect that two pumps wasn't enough to build up my endometrium. Is four pumps a really high dose though?

[Sleepy]

Hi I Would love to join you all.
Apologies for jumping in at the deep end but I've been struggling for 4 years with Peri meno
I'm 47 and had gone 11 months without a period before starting HRT last year.
And haven't found one that suits me yet I've tried 4 now, patches, pills different strengths etc...
I've always had migraines before my period but they've been getting worse so finally the doc refered me to a specialist.

So after seeing him i had to take progesterone tablet for 7 days to induce a bleed if I needed one, which it didn't.
and then use Estrogel and Vagifem upping the dose from 1 pump to 4 if needed every 2 weeks.
I'm not due to see him again till mid September, but he recommended I look at this site!

I'm a week in on 1 pump and I'm feeling worse not better, been no improvement at all in sleep, anxiety, low energy, hot flushes etc.

And after reading here I'm wondering why I haven't been given progesterone also like a lot of you, I'm wondering if it's because I hadn't had a period for 11 months or he's trying to keep my hormones level to help my migraines?
Does anyone remember how long it took to have an effect?
Im also wondering if I should up it to 2, I know it's only a week but I'm desperate to feel some improvement.

[dazned]

Hi there,if you still have your womb then you need progesterone too. Surely the specialist must have perscribe it .
If not you need to get back to him and query this I think.

[Oliver39]

Hello - I'm new to posting ... I've read this site with interest for the last 9 months or so.

At the age of 45 I was diagnosed as being Peri-menopasal after being told by a consultant gynae at the age of 43 he thought I was (due to a low Anit Mulerian test when I was 36).  At 43 I came off my pill had a blood test which was normal - thought he must have been wrong(!) then in November last year was hit like a train with no energy or interest in most things totally exhausted and bloods lead to my diagnosis.

I have an understanding GP and after patches which just didn't stick went onto two various types of tablets that I've just not got there with, I've always struggled with the Progesterone side.  And at first suffered with not enough Oestrogen.  In April I was referred to a Menopause clinic (which was really just a consultation with a rather unhelpful female Consultant who said my energy would slow down naturally as am I getting older!!!) she put me on 4 pumps of Estrogel and 200mg orally of Utrogestan  days 15-26 to have a bleed generally about days 3 days after stopping the prog.  I'm very down and emotional on the progesterone generally and then suffer a massive mood drop after ending the prog.  I feel after 3.5 months of Estorogel my brain fog and ability to function is so much better - I really did lose it for a while.  I do generally feel bloated tho and this isn't ideal - I'm of a slim frame and put the gel on my arms and thighs.

I have previously been diagnosed with endometriosis, I couldn't have children due to low fertility (age 36) and have particularly heavy periods and a small fibroid - diagnosed by scan in 2013.

All of the emotions associated with all of this has just become too much and my GP has suggested Citlapram 20mg - not because she thinks I'm depressed just needing something to aid all the little bits that are overwhelming me.

So ....  I have several questions which I thought you lovely bunch could help me with   Sorry for the long winded intro!

Prior to all of this I was't really a "tablet taker"  I also seemed to be pilling on the weight so I have also given up carbs as I just feel the weight was pilling on and trying to eat healthy.  I take an oral multi vit and also Macca daily.

• Will the hpl reduce my 4 pumps down - I've read that big doses of Oestrogen cause more painful periods - and since being on the gel I have one day of my 5 day cycle where i have horrendous pain - general day 3.
• I read you can use Urogestan vaginally - it's better if it's localised - I know they dont like to tell you to do this but are the benefits/side effects better and should that be the 200mg for 10 days that way? Again, avoiding the liver and it's congestion.
• Do ladies take the HRT and the SSRI's?  I understand some ladies can get by with just the SSRI and as it's lower risk would this be of benefit (my maternal grandmother died of Breast Cancer).  I need something as I was just a former version of myself.  My confidence also took a knock last year.

So there are a few things to be going on with - fortunately I've not suffered any sweats and my sleep is okay after CBT last year.

Look forward to hearing back with any useful advise - and as a thank you to all the ladies that have posted and I've read over the last 9 months  - a huge thanks  ... I wasn't going bonkers - Just having a tough time

Xx[/list]

[Cassie]

The recommended dose is 2 pumps.

[Sleepy]

Hi there,if you still have your womb then you need progesterone too. Surely the specialist must have perscribe it .
If not you need to get back to him and query this I think.

Thanks for the reply dazned, yes I still have my womb so after reading this I'm wondering the same.
Not due to see him till September... Do you think I should call/email him to see what he thinks before then?

[Dancinggirl]

Hi and welcome to MM Oliver39
It would be a good idea to do a separate post with your story and questions so you encourage more ladies to respond and support you.
I must stress that SRRIs  are not an alternative for HRT - you need oestrogen to protect your heart and bones for the longer term.  SRRIs alongside HRT are sometimes necessary if anxiety and low mood are ongoing even when on HRT, so it could be worth trying the Citolapram.

Whilst Utrogestan is hailed as the safest and best option for the progesterone part of HRT it doesn't suit everyone, it is sometimes poor at controlling the bleeds and can make one feel sedated and low.
4 pumps of Oestrogel is a very high dose, particularly in the peri meno stage when your own hormones will be fluctuating and such high dose will make the bleeds heavier and more painful I'm afraid.
As to using Utrogestan vaginally - this could be worth trying as many women find it more effective and get fewer sedative effects when used this way - however for some of us it can irritate the bladder and vaginal area.  Give it a go and see.

If you suffer from endometriosis then I would have thought a Mirena would be a good option for you as you may get fewer progesterone side effects and it might reduce problems with bleeding and cramps - this is worth discussing with the a gynae.
Below is the section on MM about the Mirena:

MIRENA
Mirena is a levonorgestrel (type of progestogen) releasing system which sits inside the womb, gradually releasing the progestogen into the womb. It is licensed in the UK and Ireland as a contraceptive agent, for treatment of heavy periods and, from August 2004, also for the progestogen component of HRT. It can be used in both the perimenopause and postmenopause and it is particularly useful for:

Persistent progestogenic side effects from systemic HRT despite changes in type and route of progestogen.
When contraception is required along with HRT in the perimenopause.
When withdrawal bleeds on sequential HRT are heavy, after investigation if indicated. (see WHEN TO BE REFERRED )
With Mirena in place, systemic estrogen alone can be taken as the Mirena provides adequate protection of the womb lining and the estrogen dose and route can be tailored to meet the individual's needs.

Progestogenic absorption throughout the body is minimal so reducing progestogenic side effects. The effect of Mirena on the womb lining can significantly reduce bleeding and when used as part of an HRT regimen, in time, 30 to 60% of women have no bleeding at all. Although Mirena used for contraception is licensed for 5 years, the license for use for the progestogen part of HRT is currently 4 years.
Price: £88.00


DG x

[dazned]

Yes Sleepy if it were me I would definitely query this now ,although 2 months of estrogen only wont cause the lining to build too much ,I would not have much faith in what you have been told to do unless perhaps you missed something that he explained in his thinking 
It wont hurt to up to two pumps if you getting no relief from one ,see how that goes.

[Sleepy]

Thanks Dazned I think I'll call his secretary to clarify.
Just hope the gel kicks in soon... The exhaustion & anxiety are killing me.

[dazned]

It will take time,just need to try remain positive and patience 

[clare663]

Hi. I have just been to my GP (saw the husband instead of the wife!!!) and he admitted he was not really clued up on HRT so I told him I wanted to change from Everol 50 conti to estrogel and utrogestan 100mg daily. He wasnt sure of the dosage of estrogel and it wasnt in his book so he wioll speak to a female GP to get advise. Could anyone using this method please let me know how many tubes of estrogel they get through in a month (or how many pumps there are to a tube) so that I am not given a too low prescription with the daily utrogestan. Also I enquired about the testim gel as my libido is at zero, and he did inform me that they will prescribe it if my libido does not pick up on the new HRT, which is the opposite of what I thought he would say so there is hope for us woman out there who need a boost!! I also advised that he should take a look at this great forum so he would be more clued up in future!!

[clare663]

Thankyou Stellajane. My GP has just rung and has prescribed me with 60 days of Utrogestan and only 1 cannister!!!!