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[Yavina]

Hello all,

I am extremely happy to have found this community. I live in Canada and we seem so behind the times when it comes to sharing perimenopause and menopause information, as well as with healthcare providers understanding our issues and offering medical options.

I'm on my last weeks of being 51, was prescribed many antidepressants and had to go on disability from my job last year over what, I can only see after dozens of tests, was a badly managed perimenopause.

I could not believe no one had ever told me about so many perimenopause symptoms (chills, joint pain, brain fog, memory lapses, heart palpitations, increased anxiety, etc.). Having that information seven years ago, even just 3 years ago, would've saved me so much time and pain. This is why this board is so important.

In doing research, I finally saw a link and realized that in spite of my doctor and the nurse practitioner's constant refusals to have my hormone levels tested "because I was on the pill", there was no issue as I was on a progestin only pill. I finally got tested last January and very low estradiol and FSH at 109 IU/L.

In late March, my GP prescribed Prometrium (Utrogestan) 200mg and 2 pumps of Estrogel. I then found out just before walking out of the pharmacy, that the progesterone contained peanut oil (?!) to which I am allergic, and the estradiol was too much for my body to handle (headaches, nausea, bloating, weight gain and diarrhea of all things!)

In spite of reading everything I could get my hands on, and listening to Dr. Newson's podcasts, the only place I saw that two pumps of estrogel was a lot for someone with very low estradiol, was on this board. I kept thinking I was intolerant to it and the gynecologist told me in August not to try taking it anymore.

I read articles from Dr. Jerilynn C Prior at the Centre for Menstrual Cycle and Ovulation Research and moved to take only 100mg  progesterone (made with sunflower oil this time) orally for three months and validated this course of action with the same gynecologist. As I kept struggling with chills, hot flashes, memory lapses, and most especially a complete lack of endurance, a cardiologist encouraged me to try estrogen again in October and little by little, I'm now up to taking 1.5 pump per day. Creating a "base" with the progesterone helped me handle the Estrogel, and bonus, the gel took away the bad heartburn caused by Prometrium. (P.S. I don't have a heart issue, all my tests came back clean.)

I am still struggling with hot flashes in the early morning hours and the constant lack of endurance. I'm hoping to increase my estrogel dose to 2 pumps next month and will see with my GP tomorrow and the gynecologist in February if it means 200mg of Prometrium which leaves me quite lethargic without more estradiol to compensate. I don't think my doctors will be open to prescribing me any form of testosterone, but they're not too happy with me still being on disability so we'll see.

Thank you so much for sharing your experiences, reading them has helped me tremendously. If there's anything I can do to help anyone out here, I will aim to pay it forward.

[Ladybt28]

Hi Yavina and welcome to our happy little band!!

You talk much about testing in your post but here in the UK (but in general it depends which country you live in) doctors and consultants tend to go "by control of symptoms" rather than testing levels.

Oestrogel and Utrogestan (you call it different) is becoming more popular now here as we are having supply problems with patches and pills.  My meno journey was terrible.  I have been on hrt since age 46 and I am now 58.  In the first instance I got prescribed with one kind which I took for 7 years but it didn't help much primarily because it wasn't the right levels to control my symptoms.  What I have learned about gel and utrogestan (progesterone).

I was prescribed 2 pumps of gel in the first instance but it didn't control the chills, shakes, insomnia, joint pain or acid reflux, so my doctor upped it to 4 pumps.  After 3 months on 4 pumps everything started to subside once I had got my oestrogen levels up high enough.  With oestrogel the number of pumps you can use is quite broad anything from 1-4 and in special circumstances specialist consultants have prescribed up to 6 but this is quite rare. I have a womb so I need progesterone of some kind.  I tried 6 types of hrt before I settle on the current regime which was the only one of the 6 that worked.  I found out I cannot take Utro continuously.  I could not manage 200mg Utrogestan continuously (that's your dose if I read your post correctly?) It would know me out make me depressed and very unwell.

There  are 3 ways they prescribe utrogestan here in the UK - 100mg continuously/200mg 12 days per month and you can take it orally or use it vaginally as a pessary.  If you use it vaginally as a pessary you don't get the sedative side effects if that is what happens to you.

Personally I think you need to up the oestrogen as it appears that it is not combating your symptoms, you still have them.  It is the oestrogen that controls symptoms and the progesterone is really only there to protect the lining of the womb from thickening against unopposed oestrogen.  I worked with 2 pumps for 3 months and it wasn't enough as soon as I upped to 4 things started to move.  I have been on gel for 18 months now and once my levels were up I was able to bring it down to 3 pumps and the symptoms haven't returned.  You may get other symptoms as you describe, weight gain, nausea etc when you up the gel but that is just the body adjusting.  I have learned (well it was my experience anyway) that it takes a minimum of 3 months and in my case 4-6 months before the body adjusts and sometimes it appears to get worse before it suddenly becomes better.  I also have testosterone now twice a week but that only helped with brain fog and libido.

Let me  know what you think?

[Yavina]

Thanks Ladybt28!

I only mentioned hormonal testing because it can be used to guide women like me in making the decision to stay on the mini-pill or stop. It's only a snapshot but still can be of use. Asking for it also made my GP (suddenly) think my issues could be caused by a lack of estrogen and not an immune disease which is where she was going at the time.

I just saw her again today and she's okay with me doing progesterone 100mg every day and 2 pumps of Estrogel. She says I shouldn't need anything else (i.e., testosterone). We'll see.

Sorry to hear you've had such a rough go of it for so long. I feel for all the ladies in the UK right now. I read that the shortage is with older forms of HRT and was due to the NHS wanting to save money on certain medications, is this correct? What a terribly raw deal.

[CLKD]

Welcome to our World, browse round, join in!

Make notes.  Has anyone mentioned vaginal atrophy? Do read the appropriate threads.  Symptoms mimic urinary tract infection-type feelings really well but it is usually due to vaginal dryness.  Forewarned and all that!

We discuss most things - dogs, music, holidays, exercise - as well as menopause  .  Do you have snow yet? 

Educate.  Educate.  Educate.  Sharing experiences can help enormously.

[Yavina]

Thanks CLKD! And thank you for directing me to check out the Off Topic threads.

Snow and ice have definitely arrived in my neck of the woods (sigh) but I'll take them over the Australian fires any day. Well, except for freezing rain which is my nemesis.

I didn't loose vaginal lubrication until very late in the game so I only learned about atrophy through my readings. I did have clear water like discharges for years, which I saw here could be a symptom of atrophy, but my then GP couldn't explain them outside of “it might be an STI”. A swab test came back negative and I didn't mention it again because I suffered from no other symptoms (no pain, no UTIs, etc.)

I also read here that putting Estrogel on your inner thighs can help vaginal dryness more than if you put it on your arms so I'm trying that. A naturopath told me to use vitamin E suppositories but so far the Estrogel has helped.

[CLKD]

Hi!  It's 9.00 p.m. more or less here.  Our burner is lit.  Feet up. 

I hate wet windy weather.  Clear frosty days, even over a thick layer of snow is OK - until the snow thaws  .  Then it is so messy.

Vaginal atrophy can be helped by inserting appropriate : either 'ovestin' or 'vagifem' : in2 the vagina on a regular basis.  Some ladies in the UK use 'yes' or 'sylc' products, maybe look at those sites to see if they or similar are available in your chemist shops.

The idea is to insert the O or V every night for 2 weeks then every 3rd and 5/6th nights to keep the area plumped.  Let us know how you get on!