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[Gingernoggin]

Hi,

I know this gets discussed a lot and I have read up as much as possible across other threads but still a bit confused and would appreciate some advice please. I've been on Evorel 50 patches and 100mg Utrogestan daily for two months. I've just turned 53 and started with HRT mainly to combat fatigue, foggy depression and painful sex. I haven't had a bleed at all since November 2018 so I'm definitely postmenopausal. I felt better at the beginning but now feel tired, slightly hungover and a bit nauseous sometimes during the day. Sex is a bit less uncomfortable but still not brilliant. I also use Vagifem twice a week. I suspect it's the progesterone. I know I can take it orally or vaginally but do I need to see my GP first before I change anything? I've been taking the Utrogestan every day for a couple of months without any breaks. Maybe I've overloaded? I haven't bled at all since November 2018, not even breakthrough bleeding. Do I need to take Utrogestan every day? It feels too much and I think it might be affecting my mood and sex drive now  However, I'm scared (like everyone else!) of letting my womb lining build up too much.

God I can't be bothered with any of it sometimes. Constantly slapping on and poking things up myself  Right now, I couldn't care less if I never had sex again but I don't know if that's progesterone, lockdown, fears over work (I got made redundant earlier this year) or what the hell?? We've had a lot of changes over the past couple of years - changing jobs, three house moves, studying for new careers, getting married. My husband tries very hard to be patient and understanding but we've only been married just over a year and I know it makes him feel unloved and a bit sad.

Anyway sorry to go on. Would welcome any help! Thank you x

[Hurdity]

Hi Gingernoggin

Sorry to hear about your ongoing symptoms.

It could well be the continuous progesterone causing your symptoms. Unfortunately some women are susceptible. if you would prefer to take it vaginally then do so. You don;t need to discuss this with your doctor. it is manufactured for oral and vaginal use but just the 100 mg is not licesned for vaginal use in UK. Research shows it is more effective in protecting the endoetrium at a given dose than taken orally. There are also more metabolic by-products after oral intake and these can cause side effects in some. It has to be taken in high dose because it breaks dwon quickly in the body rather than beng produced continuoulsy as the ovaries do after ovulation when we are fertile. You should start off always by taking the licensed dose and only vary this under medical supervision to ensure your womb lining remains protected. If you want to change to vaginal use then maybe try this for a few weeks although most of us who take it this way take it cyclically for obvious reasons.

Also taken cyclically for example I don't have to endure the foggy head and fatigue!

Progesterone can also depress sex drive  and has a sedative effect. The  fact that you haven't bled is good as it means the endometrium is protected. Decreasing this or increasing oestrogen could upset this balance.

It may also be that your oestrogen dose could be increased? You are still very young and only just past the avergae age of menopause, so you could perhaps try this first ie ask for 75 mcg patches but cut a bit off to give you 62.5 mcg for a few weeks and gradually increase.

Some women find that tesosterone also helps although this is off licence and I wouldn't take it while taking continuous progesterone until I knew whether this is what was causing the fatigue and lack of sex drive?

Hope this helps

Hurdity x

[Jilly62]

Hi Gingernoggin

I posted a similar question a few days ago.  I've been taking Sandrena gel and Utrogestan for 10 weeks, and couldn't work out why I was feeling so tired with no energy all the time.  Convinced I had Covid! (tested negative - twice!) I have been sleeping much better, but waking up feeling exhausted. I was advised to try taking Utrogestan vaginally alternate days (also if you listen to Menopause Doctor, Louise Newson podcast from a week ago, this is also what she recommends.  I felt almost normal after not taking for one day, bit up and down since, but have definitely stopped feeling like a zombie.

I've just got a prescription for Evorel patches, so am going to give them a go ......

Hope you find the right cocktail of medication soon!

xx

[Gingernoggin]

Ah thank you for your reply Hurdity. Your comment that I'm still very young made me smile. Not often I get described as that these days 

If I take Utrogestan cyclically, I presume that will cause bleeding? I'm not keen to go back to having periods having endured endless ones before they eventually stopped. Or does it depend where my body is? I guess I could take the break and see what happens, maybe nothing in terms of bleeding?

So basically my choices are 12 days x 200mg every 28/30 days or 1-25 days x 100mg? And I can do either orally or vaginally? I had wondered if I could take it (either way) on alternate nights? Sorry I know I'm asking the same questions as other women have. I just find the choices a bit confusing and I don't feel confident enough to make a decision on my own.

All help gratefully received.

[Gingernoggin]

Yes Jilly62, that's exactly it! Sleeping well but feeling drugged in the morning! Glad it's not just me although sorry that others have to feel crap. Hmm food for thought ... thank you x

[Jilly62]

You should probably discuss with your GP, but they are not always very well informed. If you take vaginally you need half the dose as it gets straight to your uterus.  So one every 2 days ....... I think.   Look at the resource info. on www.menopausedoctor.co.uk loads of useful stuff.

[Gingernoggin]

Thank you Jilly62. Much appreciated x

[Tinacros]

Hi
I'm sure a lady on here posted that her doctor said at post meno she could get away taking it 3 times a week. I'm sure it was a doctor in France or Spain. I take it alternative nights vaginally, which isn't ideal for me either. I'm waiting for the femseven conti patch to come back in stock. I?ll try that then 😁 x