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[MIS71MUM]

Just a quick question, but I have noticed after using both Femoston 1/10 and Evorel Sequi for more than 3 months, that I suffer for 10 days after the withdrawal of the progesterone phase.

Basically Days 1-10 of my cycle are the worst, worst I could feel with awful depression, feeling withdrawn, empty, weepy and despair feelings.  I then improve for a week, until I get racing thoughts, which then stop once I apply the combi patch.  Again all is well until Day 26 - ish, when I then start to feel flat, tired and ratty but I can cope with this.  It's just those 10 days which are so bleak.

Is there any way that I can combat this?  I'll be honest, it's far worse on Evorel than the Femoston. 

I know some may suggest the Mirena, but I am absolutely terrified of having something that could cause depression fitted and that I can't control myself.

I'm having an ablation soon for heavy bleeding and am keen to get a new regime under way after this because I know I can't continue with the 10 days pit of total despair.

My gyny has ruled out both Zoely and Qlaria which has upset me because I feel I need something to knock out my own system. 

I know my issues are hormone related because they happen on the same days in every cycle but it's what to do about them. 

Although I'm paying privately to see this gyny, I feel she'll only offer me the mirena with as much oestrogen as I want or another tablet form of HRT.  I was hoping that she would give me a higher patch, and a really low dose of Utrogestan but it's not been mentioned.

I'm peri and 45!  Any ideas anyone please?

[dahliagirl]

I tried the Norgeston mini pill (contraceptive) which is the same progestogen to see if I would be ok with mirena.  Maybe worth a try?

[Hurdity]

Hi Mis71Mum

We mention progesterone withdrawal almost daily on this forum. If you go to the forum home page and put "progesterone withdrawal" into the search box ( in quotes) you will get 4 pages of posts!

Yes it is a standard phenomenon. Progesterone (in high doses) causes physiological changes to various aspects of our metabolism , gut, muscles etc and when it is reduced the changes are reversed and it is this reversal which seems to cause the horrible pms symptoms we experience either through our normal menstrual cycle (bad pms) or after the progesterone phase of HRT. Some withdrawal stages last for longer than others due to the fact that synthetic progestogens vary in how long they hang about in your system. Progesterone ie utrogestan - is the most unstable compound so the withdrawal from this usually happens fairly quickly. Femoston contains dydrogesterone which is very similar to progesterone but a bit more stable. Norethisterone in the Evorel contains norethisterone - a strong progestogen so i imagine this accounts for the differences you are experiencing.

This is the problem with short HRT cycles - sometimes women only get one good week per month!

Can't remember why the doc is opposed to Qlaira or Zoely - you are under 50 after all? These do contain synthetic progestogens though so maybe they would not suit you, although some women ( eg Bryony on here) overcame the sdie effects after about 3 months.

Hurdity x

[MIS71MUM]

Hi
Thank you both for your replies.

Dahliagirl - has given me any idea of trying Femseven as that is the same progesterone as in the Mirena.

I know I need to come up with a plan to improve things and I need to make the suggestions as my GP thinks I'm a malingerer! And the gyny doesn't seem to offer me much in the way of options.

I'd love to try the pill to see how I am and am prepared to give it go but I think the gyny thought I was over 50 when we discussed it.

I've spoken to Briony by pm a few times. I think her experience on HRT is similar to mine at the moment. I do think I'd prefer zoely to be honest.

Those first 10 days of HRT are horrific...I overthink, become obsessed and withdrawn - then almost what to do cartwheels mid cycle! It's this I'm trying to iron out, the total polar opposites!

After my ablation, I need to ensure I don't become pregnant as it's really really dangerous,so maybe if I visit my nurse practitioner, I could ask for Zoeley. I pay to see my gyny privately and I can't really afford it anymore.