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[saffy123]

I am so hoping you guys don't mind me asking yet another question. You have all been so kind, promise I won't keep bothering you all!
As I have said before I'm 42 (mum of 3 young kiddies) and really struggling with VA/bladder frequency. I have taken on lots of your advise and I am working with the vaginal creams as much as possible, despite irritation.

I am currently using the birth control pill, to increase estrogen levels, however my lady bits have become drier and frequency worse (only been using for 2 weeks) and I feel that is due to the progesterone side of it (it is an estrogen dominent pill though!).

My question is what HRT tabs/patches etc would be best suited to my age?? I have shortened cycles, but regular very light periods. The estrogen in the BCP has helped my anxiety and dry eyes, so I need something reasonably high estrogen based and with the least amount progesterone as possible.
Any thoughts greatly received xx

[CLKD]

Speak with a Pharmacist, most have private rooms these days.

[Hurdity]

Hi saffy123

It's difficult to say really and it's whatever suits you best. If you are becoming oestrogen deficient and heading towards menopause then oestrogen levels need to be maintained to protect your future health (bones and heart amongst others).

The contraceptive pills are all high in progestogens - but are better able to control your cycle ie the fluctuations of peri-menopause than conventional HRT better suited for women in peri-menopause where cycles are few and far between. One that would be lower in progesterone would be any form of cyclical HRT whether tablet or transdermal and these are available as combi products ( see Treatments /HRT preparations tab - peri-menopause for all the different types) or as separate oestrogen and progesterone (also under the HRT preps tab as above).

I can't help with the effect of progestogens on vaginal atrophy and dryness and whether excess aggravates this - sorry.

Hurdity x

[saffy123]

Thank you Hurdity. I am curious does HRT take over your cycle (like the pill), or will I have my own cycle and a new cycle going on, how does that work?? My cycles are very constant at around 25 days. However up until my mid 30's my normal cycle was around 45- 50 days. So I am not sure where I am in the whole peri menopause time scale  xx

[Hurdity]

Hi saffy123 - while you are still having fairly regular periods then it is often possible to sync the HRT to your cycle - allthough it doesn't take it over like the Pill (ie does not suppress ovulation), but once your own cycle gets erratic then especially at low doses of HRT it can do its own thing and override your cycle. Eventually as your own cycle gets weaker then the HRT becomes the main driver of your cycle.

Hurdity x

[saffy123]

Thank you Hurdity. I'm going to defo stop this BCP pill at the end of the month, the continuous progesterone is driving my bladder mad. My vagina feels hot and dry despite using as much ovestin as I can stand.

I am tempted to use estogel on its own continuously for 3mths. I have used it in the past and just reduced the dose to allow for my own progesterone to kick in and produce a period. But I feel perhaps no progesterone for a while might give my bladder chance to heal xx