Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Applepie]

Hi.  I wondered if there's someone out there with experience of this.
I'm post menopausal on Evorel patches continually and Cyclogest for 2 weeks every other month.

I know my last oestrogen use needs to coincide with my last use of progesterone.  But is there a minimum amount of oestrogen that has to be used with the progesterone?  Already been made progesterone dominant three times 

Would be interested to hear of any experience of this.

[discogirl]

Hi Applepie

I'm not sure I have the answer to your question, however I was wondering what dosage of cyclogest you take?

[Hurdity]

Hi Applepie

 

"I know my last oestrogen use needs to coincide with my last use of progesterone"

I'm not sure what you are asking and what you mean by this? Are you stopping HRT completely? If so then yes you would stop both oestrogen and progesterone at the end of the progesterone course.

However as discogirl asks - it would help to say what doses of each you are taking? If too much progesterone relative to oestrogen is taken then the uterus lining can overthin and become atrophied and sometimes ulcerated which can cause spotting. Not sure if this happens unless progesterone is taken alone during post-menopause which is not a good idea. Sometimes the Mirena has this effect too due to the high localised dose of progestogen.

If endometrial atrophy occurred with you then this can be remedied by increasing the oestrogen dose or reducing the progesterone though if you have been taking it every other month it doesn't sound like too much to me unless you are on a minute dose of oestrogen?

Do tell us more and what happened to make you say you have been progesterone dominant and perhaps we can help further?

Hurdity x

[Applepie]

Hi.  Sorry for my late reply.

I was progesterone dominant when the clinic didn't listen when I said I respond fast to progesterone and slow to oestrogen.  I didn't realise they'd prescribed a low dose of oestrogen with full dose of 100mg progesterone daily.

Utrogestan 100mg daily was changed to 100mg cyclogest for 2 weeks every other month after proving allergy to Utrogestan and general progesterone intolerance.

It also retriggered hyperthyroidism. Something that first happened when given progestogens I should not have been given in my 20s.

It got to the stage
I was on 150mg Evorel until a letter from the clinic claimed I knew I was on more than is recommended and would be increasing to 200mg.  My levels had increased at the beginning then reduced as the dose increased.

Withdrawal bleeds were heavy and painful (past endometriosis).  I've been able to leave cyclogest for 3 months at times as I've bled (on time) between cycles anyway.  They have been lighter lately and without the pain.  I don't know if that's because of reducing the dose or because I've bled each month.

I decided to stop hrt because of the hyperthyroidism, the pain, the post-bleed emotional fallout, and because the doctor at the clinic was very blasé when she said any problems could easily be solved with a hysterectomy.  I'd only managed to speak to one sensible doctor there and she left.
Well they all left after one appointment!

I may continue if I find reducing the dose settles the hyperthyroidism etc.  I've been reducing by cutting the patches and atm I'm around 111mg with no difference than when on 150mg re symptoms.  Cyclogest still at 100mg for 2 weeks every other month.

It gets muddly as I know too little oestrogen means the progesterone is working on insufficient womb lining.  And not enough progesterone is also a problem.  As I'm super-sensitive stopping quickly isn't an option.  I find myself worrying every month whether the bleed will happen, and whether it's enough to be ok. 

I had to stop my first hrt attempt with gel due to migraines.  The doctor ghosted me when I asked how, claiming it wasn't to blame (it was) and I was plunged straight in to post menopause age 48.  Again I'm left to work it out myself.   Then I found this website and wondered if any of you have experience.

[Hurdity]

Hi Applepie

My comment would be that it does seem like a high oestrogen dose in relation to the very low progesterone dose you are taking (and I presume you mean 150 mcg patches, not 150 mg?). 100 mg cyclogest does not as I understand equate to 100 mg utrogestan  - it's how they work rather than the total amount in the preparation that counts.

If you are bleeding between taking the cyclogest and are post-menopausal ( are you peri or post?) then this indicates that your lining is too thick or some other reason, and you need more progesterone rather than less - unless you are not absorbing the oestrogen well. So ideally a scan would be needed to have a look at what is causing the bleeding - so you should be referred for abnormal bleeding.

The advice for those with endometriosis also is to take progesterone continuously so your bleeding problems may be due to this.

Hope you manage to sort this out and let us know the outcome. what you decide.

Hurdity x

[Applepie]

Hi Hurdity

Sorry yes mcg.  And post menopausal since age 48 supposedly.  Oestrogen levels dropped as Evorel dose increased.  The clinic claimed I wasn't absorbing.   I think my body thought as it had the patches it needn't bother!

I appreciate what you say about needing more progesterone if one bleeds too often.  That's the usual thing done.  But it never worked that way for me.  Breakthroughs would happen with progesterone and stop when I stopped any progesterone.

Bleeding between Cyclogest hasn't bothered me as it's been at the same time of the month as if I had used the Cyclogest.  As far as I was concerned it was a good thing.  My body was having cycles by itself.  Now you've made me wonder if I should have worried. 

Unfortunately this month there's some breakthrough at the wrong time.  Which makes me think I've reduced the oestrogen too  much as far as that's concerned.

I'd been told it would be continuous hrt so no endometriosis worries.  But my reactions to progesterone stopped that.

Not sure of the best course of action atm, but have stopped reducing the oestrogen further for now as I'm dealing with another health issue.  Consistently failed to get the correct nhs response for that so not hopeful for hrt