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Author Topic: Progesterone intolerant?  (Read 514 times)

NightNurse

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Progesterone intolerant?
« on: September 13, 2018, 11:14:48 AM »

Dear All,

please could you help me as I'm at a bit of a loss what to do safely and effectively.  I think I'm intolerant to progesterone in HRT but worried it might just be me - being meno or being just me!

On the advice of my very helpful female GP I started on Elleste Duet Conti 2mg 2&half years ago and felt great for a year.  Excellent symptom control, fully functioning emotionally and at work, and no bleeding at all.  Then I started to get hot flushes, night sweats and bad sleep again. After six months of hoping it would settle went back to the GP and asked for more oestrogen.  She changed me to Evorel Conti and Evorel 50 patches.  I was to use two patches at a time, one of each.  She said there were no 100mcg Conti patches available and wasn't sure why I was getting symptoms again but was happy to find something to help me.  In effect we were "having a go" which I was cool about.  Unfortunately, this caused chaotic bleeding.  So after 3-4 months of this and of my own accord I started to use two Evorel Conti at a time, for two weeks, followed by two Evorel 50 at a time for two weeks.  In effect, like Evorel Sequi but double dose.  This has worked well for the last 9 months in terms of flushes, sweats and sleep.  Bleeding is once a month just like being on the pill and totally managable. 

However, my issue is the two weeks I'm on Conti I feel emotionally and psychologically awful - like having PMS and a very similar feeling to when I was on the desogestrel mini pill (Cerelle/Cerazette).  The two weeks I'm on Evorel 50 (using two patches at a time so getting 100mcg oestrogen) I feel fab.  Happy and normal.  Husband and daughter also notice the difference.  When I went on holiday in this summer I did Evorel 50 for three weeks which was even better.  Three weeks of normalness!

My question is this: what evidence is there for long-cycle oestrogen-only use?  I know I can't take Evorel on its own for months on end but how many weeks could I go for?  Also, is there a better way of taking the progesterone element of HRT?  Could I do it orally or vaginally - if so, what dose for 100mcg transdermal oestrogen, and for how many days? 

In other words, what's the least amount of progestogen, for the fewest days, with the minimum of side effects?  I'm 54 years old and very reluctant to have a Mirena.  I know it would be a good way to protect the endometrium but I feel rather squeamish about having one fitted and I wouldn't need it for contraception for much longer.

I'm pretty confident if I went to my GP with some robust evidence or a well-thought-out argument for a change in HRT she would be more than happy to help me.  Appointments at the surgery are tricky to get and I know all the docs there are under pressure and have limited time.  I feel if I can do some of the hoof work this will make better use of both our time.

Thank you all so much for any advice - and just for being here!

 
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dangermouse

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Re: Progesterone intolerant?
« Reply #1 on: September 13, 2018, 05:22:07 PM »

If you felt fine on the progesterone at the smaller dose then itís probably just too high a progesterone dose rather than you being intolerant (although Iím still not completely sure what intolerant means but I suspect youíd have a bad reaction to any dose of external progesterone?).

Could you not have one Conti and one oestrogen only patch for that phase instead of 2 Conti? Then 2 oestrogen only patches for the second phase, as the stop start prog obviously suits your bleeding pattern but is just that much too high prog.

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49, perimenopausal, gastric silent migraines. Prescription Versabase progesterone cream.

Stellajane

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Re: Progesterone intolerant?
« Reply #2 on: September 14, 2018, 11:47:52 AM »

Hi nightnurse - do a search on Utrogestan.

The most effective HRT I've used is Oestrogen gel (patch would be equally effective) with 200mgs x 12 days Utrogestan used vaginally every other month, after which you get a withdrawal bleed. There are other ways to take it, just saying for me, as someone who doesn't get on with progesterone very well (though I wouldn't say I was totally intolerant) this has been the best.
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Trufflecat

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Re: Progesterone intolerant?
« Reply #3 on: September 14, 2018, 12:38:22 PM »

I used Evorel and was fine for a few months and then I stuck a combined patch on and was plunged into a depression. I switched to using utrogestan and, whilst I sometimes get a few PMT days, it's much better.
I've been considering a Mirena but am reluctant since it's not self-removable if it makes me feel awful.
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Stellajane

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Re: Progesterone intolerant?
« Reply #4 on: September 14, 2018, 04:29:40 PM »

I should have added for anyone following the thread, its my understanding that long cycle is not advisable unless you are definitely post menopause. You should always check it out with your doctor.
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LesleyB1964

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Re: Progesterone intolerant?
« Reply #5 on: September 16, 2018, 06:57:02 PM »

This is exactly whatís happening to me. I take two (50) everol patches twice a week for two weeks and the second two weeks take two everol conti patches which contains the progesterone.  Been 2.5 months now and only the flushes have deminished I actually cry for no reason those two weeks. Been to the Dr and she said she was speaking to another Dr who knew more but Iíve heard nothing since. I also bleed a couple of times a month. Itís all getting right on my nerves. Sleep would be nice too. The problem is the Drs arenít up on it as much as some of the ladies on here and when I went in there forearmed she just ignored me. I know she doesnít want to hear some old woman trying to tell her her job but I just explained Iíd been on this forum (which she recommended) and I needed to try something else. I think I need to go private. 😥
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Stellajane

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Re: Progesterone intolerant?
« Reply #6 on: September 17, 2018, 02:22:52 PM »

You shouldn't need to go private.

Explain that you've been doing a lot of reading on this website and you feel you'd like to try Utrogestan.

It shouldn't be too difficult for a doctor with all those brains to look it up in her book and prescribe it. Tell her its called micronized progesterone if she can't find it.

I'm not surprised you feel awful on the progesterone weeks, that's an awfully high dose you're giving yourself.

The dosage for Utrogestan would be 200mgs (2 capsules) at bedtime for 12 days per month. You can swallow the capsules or use them vaginally (like a pessary) as many of us do as we either prefer not to use oral meds or we find there are fewer progesterone side effects used that way.
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LesleyB1964

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Re: Progesterone intolerant?
« Reply #7 on: September 17, 2018, 08:41:15 PM »

Thank you Stella. Youíve helped me make my mind up.  I did ask for the gel and the progesterone in a different form when I went in there as I read a lot about it on here. Iím going to make an appt and be more forceful. I went when I was on the second progesterone patch so burst into tears when I was in there. Oestrogen patches this week so no crying. My husband looks at me in horror as after 30 years together heís not used to me blubbing 😂
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LesleyB1964

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Re: Progesterone intolerant?
« Reply #8 on: September 17, 2018, 09:00:36 PM »

Sorry Stella Jane that should have read:
Everol 50 Monday and Thursday for two weeks
Everol Conti Monday and Thursday for two weeks. Total 8 patches per month.

 :-\
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NightNurse

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Re: Progesterone intolerant?
« Reply #9 on: September 18, 2018, 11:00:53 AM »

Thank you all so very much for this info and for sharing your experiences.  Although I'm sorry to hear others are having simialr experiences, it really helps validate how I'm feeling - it's not my imagination! And to clarify whether being intolerant of progesterone was a "thing".  I'm now 24 hours into the cycle of Evorel 50 patches and already I feel better; less anxious, not so low and generally less miserable.

Thanks also for the advice about long-cycle oestrogen.  I was worried about the safety of this.  I'm guessing based on my age and on what I've read on this site that I'm most likely to be post-menop now as I'm 54 (and a half!) years old.  I was taking either the combined oral contraceptive pill or the mini-pill until I started HRT so I've no clear idea when my last physiological period was.

I'll be seeing my GP soon and asking for the utrogestan.  I'll let you know how I get on  :)
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Stellajane

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Re: Progesterone intolerant?
« Reply #10 on: September 18, 2018, 03:08:44 PM »

Onwards and upwards! Good luck.
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