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[Armadillo]

Hello

This is my first post here.  I am completely lost, emotional and muddled. 

I have chronic health conditions and a large dollop of ptsd linked to health care stuff. 

My Mum started peri around my age, my sister 2 years older than me is in peri and i have a long list of extra symptoms that all correlate to being in peri; my cylcle is present but has gone from predictable to the day to a 2-3 week block.  I have had blood tests that come back 'normal' but my body is known for doing it's own thing despite what it should be doing.   I don't have many ladies to talk too as i'm mostly housebound but books and the few ladies i've asked for support all think i'm peri too.

I've been told so many different things by GP's that i'm lost.  First GP looked at list and said yes that's peri. She wanted to do some research and get back to me about HRT (i have complex interactions to some meds) by the time she replied she stated categorically I am too young (40) and it would pass. I spoke to the 'more senior GP' she suggested who said it was due to my other illness which has been stable for 10 yrs ish. 

I finally saw my normal GP who looked at the list, stated calmy he didn't know what to do but it looks like peri-menopause and that I'm having a rough ride.  He promised to phone hospital gynae during his admin time a few days later then phoned back with a prescription.

The plan from my GP and hospital gynae was to start on oestrogen gel (estrodial) and after 4 weeks report back to see if my body could tolerate it... then add in patches that also contain progesterone. (everol sequi) to see how i coped with that. 

The new patches were lower in oestrogen than the gel so i spoke to a GP who told me to have a pump every other day or daily until i felt right in addition.. then the next gp said i couldnt use the gel at same time when we tried to get a new prescription?

I have been on the patches 3 weeks and am now on the ones containing norestherone (progesterone supplement).. i'm getting really light bleed intermittently.   I am using the gel as otherwise things get unbearable.

I have a follow up phone call tuesday to review.

Every GP is telling me something different.  The chap I trust and who knows me best is very hard to get an appointment with.  I don't know who to believe.

My questions are

When should i expect breakthrough bleed /period?
I usually have horrific heavy cycle (have done since start) is this likely to be the same or could this light bleed now be this months 'event'?
Does anyone else take the oestrogen gel and a patch?
I know i'm triggered by my ptsd at the moment (hospital this week) but can changing between the first 2 weeks oestrogen only patch to the progesterone patch also disrupt mood?
I have to stop for 30 days before an operation and am terrified of all the symptoms piling on again.. any ideas?

Basically i'd like a bit of reassurance and answers from people who know this that 'its all normal', it wont last forever and I will get through this.. as on top of my normal chronic condition i'm lost.

Lost and scared
Armadillo

[wuzzie]

Firstly, if your periods are becoming erratic that is a clear sign of perimenopause and blood tests don't always show this up.  I think the best thing you can do for your health and to get you on the right track would be to see a specialist rather than different GPs who all have a different view.  You need some consistency and expertise.  My periods would alternate in frequency and intensity all the way through peri so throw the rule book out of the window as anything can happen.  But, it all sounds normal and of course you will get through it.  It is such a bewildering and lonely time but it does ebbs and flow in its intensity.  You won't always feel so out of control and frightened.  I can't advise on gel and patch as I am on gel and Utrogestan pill post menopause but I'd find a menopause clinic that can support you through the process.  Try not to worry, you'll be ok.

[CLKD]

>wave< - my periods waxed and waned for a few years, then disappeared.

Some ladies find that they have heavier bleeds or the flow becomes lighter.  It's The Change, does what it says on the tin  so maybe keep a mood/food/symptom diary?

If you have HRT prescribed, put the name of the product into the search box here and see what pops up?  Make notes  . 

30 days seems a long time to stop prior to elective surgery but of course, that depends on what you are in for.  How soon after will you be able to re-start treatment regime?

GPs often don't know much about menopause  . 

[Armadillo]

Thank you both.

OK I didn't realise there were menopause clinics so that's something to ask about. 

My periods have definitely changed from 28-29 days between starting bleeds (menorraghia)  and been like that since the start to being 20-35 days apart.. i'd been chalking the other peri symptoms upto the other health condition but it didnt make sense as this was all new or at least different to the 10+ years of other symptoms. 

Stopping for the op .. the pack leaflet states 4-6 weeks so the 30days i've originally been told may be extended.  I shall ask when i go back in a few weeks for another appointment before op.


Bewildering and lonely sum it up.. my husband is really supportive and is also researching like crazy.. but well i wouldn't want to be him if the HRT stops.

I've read the side effects section of the paper in the box and it does look like the change in mood, diarrhoea, leg/back pain etc could be linked to the noristherone medicine.. sigh.

The 'change' definitly sums up whats going on here.. i don't feel like me at all anymore. 

Thank you for replying

[sheila99]

I'm sorry you're having such a tough time. It isn't normal to prescribe gel and patch, usually if you have gel you will have utrogeston, provera or mirena for progesterone. You keep on gel all the time and add utro for 12 days, not sure about provera but assume similar. If you're on patches you have E only for 2 weeks followed by 2 weeks combined. The bleed on either should come a day or two after finishing prog though in peri your own cycle can put a spanner in the works. Prog is usually the part that causes trouble. If you don't feel well with the one you're on I would ask for utro and take it vaginally. Perhaps ask why they have given you this mix? It seems a bit odd to me. I'd also suggest you ask for a referral to a meno clinic.

[Armadillo]

UPDATE - looks like Noristherone is a problem for me

Took the patch off shortly after writing this yesterday.  I decided to look at side effects list with husband and the week of troubling but minor symptoms had me tempted but it clearly states if your blood pressure is high stop immediately and speak to GP.  Well I had a pre-op screening where they kept worrying about my blood pressure, at home relaxed it was sky high..so i've stopped.

I feel so much better.. i've been very emotional, teary and suicidal this last week.  I've been on the support phone lines and couldnt work out what was going on... now i've stopped i'm thinking more clearly and realise this happened before with noristherone whe i had it to manage periods 15 years ago.

I also managed a day without extra pain meds which for me are pretty heavy duty opiates /prescription drugs..

------------------------------------------------------------------------------
Thanks Sheila
Thank you.. I spent ages googling when to expect bleed and had everything from start of progesterone patch to a few days after.. i had thought the hormone would regulate a 'start' and peri wouldnt still make it a lottery... so that is useful

Yes it is odd.. there are reasons;
  I am allergic to one of the 'packers' in tablets so there wasn't a standard combined HRT tablet and provera is out. 
I tend to have unusual severe reactions to meds so it has to be something that can be stopped instantly.  (rules out implants/coils/injections)
 My GP spoke to Gynae who said patches would be the gentlest, safest and quickest to stop.  I was meant to move off the gel at that point but there wasn't enough estrogen in patch for relief.

------------------------

GP is phoning tonight so back to the drawing board.. bit nervous as the estrogen gel has made sucha  difference but i know that without some progesterone source i can't keep using it

[Ladybt28]

Armadillo - have a look at a thing called Duavive.  It does not use the traditional progesterone and is developed for women who are progesterone intolerant.  It uses another drug entirely.  Not many GP's or meno consultants know about it.  My consultant did know of it, but said "oh I always keep forgetting about that one!"  It is something which has only been licensed in the UK for about 3 years I think so pretty new.

[Armadillo]

Ladybt28

Thank you.  I suspect the phrase 'progesterone intolerant' may apply to me.  I've just excitedly checked it but the tablet contains lactose and that is the ingredient i have a very severe reaction to.... the accumaltive effect of the tablet would make me poorly.. it used to be awful with the quantities in contraceptive pill when i was younger and healthier.

I wonder if there are other non progesterone options.. i shall start searching.

thank you

[sheila99]

You might not be prog intolerant it might just be the one evorel uses. I was fine with this but get tired on utro (had to change as got a rash). It might be that you can't get on with evorel but are OK with utro. Used vaginally it doesn't pass through the liver so the theory is there are fewer side effects though of course it still may not suit you. The usual dose is 200mg for 12 days but it comes in 100mg tablets so you could start with that and see if you can tolerate it. I hope you can find a solution.
There are various threads on progesterone intolerance you could search for but I'm not sure there's always a good solution.

[Ladybt28]

Will save you the trouble Armadillo - there are no other non-progesterone type drugs - sorry. Duavive is unique.
There are different types of progesterone though;
so you don't get on with Norethisterone
There is dydrogesterone, medroxyprogesterone (Provera), levonorgestrel (which is the mirina coil I think) - these come on their own
Mexican Yams produce a natural progesterone not made in lab but what its name is I don't know.
There is Crinone - which says it is a natural progesterone - not sure about this?
Cyclogest - also a natural progesterone used in fertility - this comes on its own I think
Norethindrone - which is in Climesse - but that is a combination treatment.

Some of those are in combo patches or tablets.  You can't get all of them on their own. 
check out if any have packers you cant take but you should be able to research what might suit you from this list. Good Luck x

[Armadillo]

Thanks

I can't explain how comforting it is to actually have people who understand offering ideas and support... thank you.

Spoke to GP last night.. hadn't realised she was a locum so she can't do follow up.. that's frustrating.  She actually asked to hand up and ring back so she could go and do some research and look up options which was again reassuring.

UTROGESTAN - is our next med to try.  I am waiting on the chemist now to order/deliver it.. seems a long wait but phone call was only last night.  It's 'micronised progesterone' and she thinks my last tablet chance. 

After that I can ask about vaginal creams.

The fear is I'll have to deal with the peri-symptoms without HRT and the oestrogen made a huge difference but i cant have that without progesterone.

I have a book on foods for menopause i hope to read soon.

Thanks
-------------------------------------------------

medroxyprogesterone (Provera) - only comes with lactose
dydrogesterone /levonorgestrel tablets - lactose. 
Coil not suitable due to ptsd but also can't be stopped instantly and if severe reaction.
cyclogest - I'll ask about this.

[Ladybt28]

Armadillo - just so you know Utrogestan comes in a pill. It is not a hard pill like asprin or paractamol.  They are round balls with like a rubbery coating (don't let my explanations alarm you in any way I just don't know how else to describe it  ) with like a liquid cream inside.  The prescription will say to take them orally which is the licensed way.  When you take them this way they go through the stomach and are processed by the liver and can cause some women side effects which is the same with any meno medicine.  However, it is possible to insert them vaginally. This is not what the actual prescription license says in the UK but it is licensed in Europe to use this way.  Lots of meno consultants say you can use it that way and I use it that way along with loads of other women.

The thing is that lots of GP's and plenty of consultants have not heard of using it that way but it is perfectly safe and it avoids the side effects of going through the stomach as it is directly absorbed into the vagina and up into the womb - localised if you will.  You have both the options to either take orally or use vaginally.  Tell your GP about the vaginal method - there is plenty of info on the web about it and on here even though the official leaflet says oral use.

Ref vaginal creams - I have not heard or read anything on this forum that suggests that any progesterone cream would be sufficiently strong to trigger the shedding of the womb lining if you used it on a cycle or would be strong enough to stop build up if you used it continuously.  There maybe someone out there who knows different but having investigated just about every form of hrt through my own problems, I don't know of any progesterone creams that work the same as the tablets or pessaries.

Let us know how you get on and ask away if you have any questions about using the utrogestan - there are loads of us on here who use it. x

[Armadillo]

Ladybt28

Giggle.. you have me thinking of tiny 'bath pearls' with bubble bath inside a dissolving membrane, either that or frogs spawn.so i'll stick with the first image ;-).

My chemist didn't have any in stock but is hoping some will come today. I'll start by trying taking as a pill as I have fluctuating problems with mobility, flexibility and dexterity but if that doesn't work will definitly look at inserting vaginally.  Thank you I didn't know that was an option..so will do some research.

these last 3 days without the oestrogen have seen the peri symptoms start to pile back on and i am scared of having to go through that for potentially years.  With my exisiting health condition the extra symptoms leaves me almost bedbound (apart from loo trips).   So everything is crossed this will work

thank you

[Ladybt28]

Yep bath pearls is defo better than frog spawn!