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[Sunnydays]

Hi,
I've had a lot of reassurance  from ladies on my thread 'from conti hrt to long cycle'. Following my consultation just 2 weeks I've got sorted out down below, plus the tummy discomfort from starting estradot 25 is now easing. Despite all this, I've spent the past  fortnight feeling absolutely frantic about the long cycle I have embarked upon (oestrogen 3 months and then take Provera high dose 14 days)  mostly because I'm so fearful of the side effects that a sudden high dose of progesterone might bring upon me; I'm very sensitive to medications and hormone changes.

I emailed Dr Currie last week for her thoughts. She indicated that the present trend is not to use 3 monthly cycle since the high dose often causes side  effects but also, there is concern that a cycle every 3 months does not provide enough protection of the womb lining. She suggested continous  Utrogestan, either  orally or vaginally - the latter would minimise side effects and get over the problem that I rarely have an empty tummy! I wouldn't want to take it vaginally everyday so am waiting to hear back from her  for clarification of what the dose would be on say a 6 week cycle.
I am due to see my GP on Tuesday and I'm sure she will prescribe what is suggested (even though  I'll feel a complete twit as I only went there 2 weeks ago to get Provera)
Can I ask any ladies who are post meno and use Utrogestan either daily or every  6/8 weeks to just give their doses? I know this info is out there in the forum but so many different threads on it, and I scared myself silly at some peoples side effects looking on the site last night.
 
I have made a decision that after the GPs appointment I shall either give one round of Utrogestan a go and if it seems ok, to continue with a medium  cycle. Or I will simply revert to the Evorel conti patches that I still have in the cupboard from before. I will just have to keep my fingers crossed that two and a half weeks of oestrogen only will somehow just disappear from the womb lining. I know I decided to come off Evorel but on reflection I feel that, yet again, I was experiencing much stress from my teenage children, and that may have been contributing factors to my headaches and  irritability - hrt can't fix everything  unfortunately!

The other alternative was femiston but this only comes in tablets which, according to dr Currie can give headaches due to the spikes in hormones. I guess taking half a dose morning then evening might alleviate.
What a minefield!

Thanks all for your patience to my rambles at the moment. I will get sorted eventually and enjoy the peace of much reduced introspection.

[Cassie]

I use the small tablet, only 100mg vaginally for 12 days per mth, works a treat!

[TheDuchess]

I think you have to accept that there are a variety of opinions on long cycle HRT. I have used it under the guidance of a very good consultant and they are happy with it. I take Utrogestan every 8th week for 10 days. I have dropped back from 10 weeks due to heavier bleeding. I have tried to use it for 21 days out of 28 (100mgs) so almost conti regime, and found I spotted constantly and had a migraine almost daily due to levels falling. I do have scans every 12-18 months to check all is well.

[Night_Owl]

Hi Sunnydays - sorry you're in such a dilemma, I know that feels.

I think we've spoken before - I was likely banging on about progesterone intolerance and medication hyper-sensitivity.

"Can I ask any ladies who are post meno and use Utrogestan either daily or every  6/8 weeks to just give their doses?"

In response to your specific question, I'm now on Estraderm 25 (same as Estradot but larger) and can take Utrogestan 100mg (NB: 100mg not 200mg) x 12 nights, v-route, every 6 weeks.  BUT the meno clinic have said I can try this for 3 months on condition that an endo scan is done at the end of the 3 months.

I can't take Utro orally or monthly as it makes me feel so ghastly - will scrape by on 6 weekly maybe go to 7 weekly if the scan is okay.

I tried longer cycle, 10/12 weeks between taking Utro - when I was on HALF Estraderm 25 - no bleed at all - for some reason I felt MUCH worse when taking Utro than I normally do - it seems the longer gap between taking it created more of a shock to the system, plus my estrogen levels had dropped further.

Maybe have another round of Utro and see how you go? - have to be honest, I wouldn't fancy taking that mega dose of Provera but that's cos I'm off the charts prog intolerant.


Night_Owl
x

[Night_Owl]

ps: just remembered - the other option the meno clinic suggested:  Utro 100mg x 7 every month, days 1 to 7 of the calendar month.  I said I needed a longer gap without any prog in my system so opted for the 6 weekly.

[Dancinggirl]

I have been on one pump on Oestrogel with 100mg of Utrogestan orally every day for the last 5 weeks and I'm feeling great. I tried the longer cycle and even monthly with Utrogestan and was worried about trying Utro continuously but I've been really surprised at how good I feel.  I was getting hormonal headaches with the  sequential regime but so far I only got a headache for 2 days when I first started and since then all fine - it is the first time in many years that I've gone 4 whole weeks without a headache.
I haven't tried using Utro vaginally as I get bladder issues which I don't want to aggravate. I might try it vaginally if I need to - when using orally, it does have to be taken on an empty stomach which can be tricky.
Dg x

[Sunnydays]

Thank you for your replies ladies.  I have just heard back from Dr Currie and in response to how much utrogestan I should take every 6 weeks, she said that we can't be sure it would enough protection to the womb.

Is it the stopping of the utrogestan that causes the womb to shed the built up lining? I just find it strange that whether ladies take it sequentially or continually, it is the same 100mg. Does the utrogestan 'eat away' at the lining if taken continually? Just interesting to know how progesterons work (I know what they have to do but not how!)

Anyway, I think I might just revert to the Evorel conti, wean myself off hrt and look for something else. Every decision is personal and I still feel that the benefits of hrt more than outweigh the slight  risks. In an ideal situation I would be able to take just a bit of oestrogen (which I know my body benefits from) but I used to get raised blood pressure from the pill and can see that happening with the oestrogen from hrt.
I'm spending my waking hours thinking about my health which can't be healthy!

[CLKD]

Why not give it a go?  After all, it doesn't need to be for a long while if you don't get 'on' with the regime.  Quality of Life is important - 1 cycle probably isn't enough particularly if your own hormones are playing along 

Do you keep a diary ……… can be useful!  How *is* your BP?  The Pill is totally different 

Why are you considering HRT?  Think about how symptoms were prior to your going to your GP and see if you want to see how you now feel by stopping all HRT …….. and then decide what regime might suit you should symptoms be difficult to deal with.  Do let us know as all experiences are useful!

[Dancinggirl]

Sunnydays - Utrogestan behaves in the same way as all the progetserones in that it prepares the womb so it can shed - when you stop taking it the drop in progesterone triggers the bleed. When you take progesterones continuously I think it will simply act to keep the womb lining from building up in the first place.  I think one of the problems of Utro is that it is not as stable and easily absorbed as the more synthetic progesterones and can therefore not be as effective.  The usual dose for sequential use is actually 200mg fro 12-14 days.  100mg should be for when you use it continuously though some gynaes will allow you to use just 100mg when used sequentially to see if it is sufficient - we are all different.
It is so easy to over think and build anxiety about using HRT in any form.  CKLD is right - perhaps come off everything and start fresh with the regime as and when you feel you want to. Try the regime your gynae has suggested so you can properly gage how well it works for you. HRT is often blamed for many risks and side effects but you are seeing a specialist/gynae who is giving you sound advice and is monitoring you so I think you have everything to gain and nothing to loose by giving his suggestions a good go. If you wanted to try just 8 weeks of oestrogen and then the Provera phase I'm sure that would be fine - don't worry about the dosage he has suggested, I know it seems high but each progesterone is given in different doses and will have different effects.  I have a strong feeling you will be OK on the Provera - there have a been number of women posting on MM who have done really well with this. Going back to the very small dose of the Evorel you were using is probably not a good way to go as you need to find a regime that works well for you and this is only achieved with trial and error.
Concentrate on a healthy diet, cutting out as much sugar and caffeine as possible. Do lots of brisk walking, take stairs not lifts and perhaps try some Mindful Meditation to keep your mind off your health anxiety.  These things will help your anxiety over your blood pressure.  I don't think HRT is actually blamed for giving high blood pressure but I could be wrong about this - I think high blood pressure is usually caused by other factors e.g  being overweight, too much alcohol and clogged arteries etc - blood pressure can be controlled by beta blockers which could possibly be taken alongside HRT if necessary.
DG x

[CLKD]

   DG: also, many patients suffer from White Coat Syndrome in that their BP is absolutely normal until they get into the Surgery!  My DH is the calmest person you will ever meet but he has WCS  .  He now has a BP machine at home and used to take his every morning B4 breakfast.  He jotted down the results, showed our GP every 3 months and hey presto! no raised BP!

It is unlikely that HRT will cause a sudden raise in BP