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[RebJT]

Hey

Bless you, if you don't mind me saying, you are doing changes too quickly.  Hormones are great, but they are powerful, it's a hare and tortoise situation.  If you are OK on the half and half, then leave it a few weeks, you are not going to make yourself ill in a month (indeed, Prof John Studd put me on E only for the first three months).

With utrogestan I've built tolerance over time - Nick Pannay says this, tolerance can be built - but intially I was so sensitive (also autoimmune and I also have histamine intolerance, almost all histamine intolerant ladies are massively P intolerant) that my current gynae told me to aim for 5 doses a cycle (100g vaginally days apart) and I built up from there (and by over time I mean over about 18 months), I can now do about 12, but can eek it up to 17 x 100 per cycle (with say two days of 200).  I have regular scans - I use those baby scan places, cheap, friendly and send a digital scan I then send to my doctor.

In my opinion, women are not data, we are all individual and whilst studies say this and that, a good gynae, with years of clinical practice knows best in terms of what is safe and what works, because they've seen it in their practice  - provided you are checking in with a competent professional, having scans and monitoring, just take your time to find your level. 

x

[chopsuey]

Reb - can I ask how much you pay for your scans please, just to get a rough idea what is reasonable? When I last discussed this with my gynae, she didn't feel it was necessary, given that I was having a regular bleed and no breakthrough bleeding. Longer term, she wanted me to take Utro continually though but I don't think I could tolerate that.

I'm not being monitored by anyone currently and as I'm using half the recommended dose and vaginally, I think I probably ought to have a scan for ( hopefully) peace of mind.

[RebJT]

Hiya

I've used a couple but the last I used was Ultasound Direct as they are local to me but they have branches nationwide. Mostly used by women trying to get pregnant, or who are pregnant. They offer an endometrial thickness scan, and I think it was £60.  My local one was very nice, lovely friendly people.  Last time, for the first time ever the sonographer was a man (regional lead, happened to be there that day) but I had total choice about that, and a female chaperone who never left the room.  They'll tell you which day of your cycle it's best to go (as obvs lining builds up naturally just before a bleed).

They then email the images, which I just forward to gynae.  I'm due another, as like you, I just like to be on the safe side.

x

[chopsuey]

Many thanks for that Reb. I'll check that out

  x

[Petra]

I'm 62 and have been on HRT for about 10 years. Just under 2 years ago, here in NZ, Utro became funded and my GP switched me from Provera to Utro. I loved how great I slept on it, but my energy levels went down the toilet and I started to get some really bad indigestion on occasion. Tried various doses of estrogen, tried vaginal route for the Utro... Took me a year to suspect it was the Utro, and finally in January this year, I switched back to Provera. Feeling sooo much better in all ways. I had about two weeks of breast tenderness and it took a while for my sleep to settle down, but this has happened partly because of regular meditation, I think. Anyway, I guess Provera isn't the gold standard these days, but in the end, Utro felt like whole body poison to me.

[Anonymous1]

Thank you all for your responses.  Some really helpful info Re: Scans. 

Yes, I am making changes very quickly.  I've hot a difficult decision to make about work life/health balance so I am wanted to get an idea of whether I am going to tolerate a form of Progesterone & how much a difference  HRT is going to make.

I have felt better since I went back on 1/2 Evorel 50 & 1/2 Evorel Conti.

Rebecca, I agree with your comments about the value of a specialist clinical experience.

[Peach8]

Hi Anonymous1. I don't get along with utrogestan either. Had a mirena fitted and didn't get any of the same negative effects.

[Anonymous1]

I'm glad that you found something that suits you.

[Anonymous1]

I went back to Evorel Conti 1/2 path and Evorel 50 1/2 patch and felt fine.

I re-introduced Evorel Conti full patch yesterday.  Within 12 hours I felt very negative, depressed, unmotivated and wiped out.  Today I was finding it diffiult to function with these symptoms so added in a Evorel 50 1/2 patch so I am on the equivalent of Evorel 75 and the recommended progesterone dose.  I feel a bit better but my mood is still very low.  I've headache.  The progesterone has cancelled out the positive effect on my mood of the oestrogen.  The side effects are not as bad as when I was on Utrogestan but still not good at all. 

I am aware that you are meant to try things for 3 months.  However, what can you do if you are having difficulty functioning due the the side effects?

I have had a month now where I have just been on oestrogen only or oestrogen and a lower than recommended dose of progesterone.  The private meno nurse said I could take oestrogen on it's own for a month before re-introducing the recommended dose of progesterone.

I've noticed the effect of taking both oestrogen and progesterone within days of making starting or changing the dose.
 

[Scampidoodle]

I do think often the body takes 3 months to regulate but is also firmly believe when things are very bad you just had to stop. I say this from a place of ploughing on with different meds when in hindsight I needed to have stopped. You just know your own body and mind better than anyone and if the progesterone was making you feel so bad you did the right thing in stopping x

[Anonymous1]

I stopped the Evorel Conti as I could not function on it.  I tried Evorel 50 and Provera 5mg/d early evening.  I got the Provera from a private pharmacy.  I slept very well.  However, this morning I have felt extremely tired, like I am under a bit of sedation and bloated and have increased nasal congestion.

I know that I am making changes too quickly.  I guess, it possible that the side effects might improve in time.  However, so far, I have not tolerated the following and the side effects have excacerbated my underlying health problems and been so bad that I was finding verydifficult to function:

51, 12 months since period. 
Long term mental health e.g. Anxiety, chronic fatigue.  On SSRI, special diet and supplements.
DUTCH plus test showed testosterone level is ok, oestrogen and  progesterone low.  DHEA levels is lower end of normal range.

No HRT - Severe depression, no motivation/joy, aches and pains and dry skin etc.

Evorel 25 - Still getting meno symptoms but a bit better e.g. Low mood, aches & pains
Evorel 50 only - Feel great

Evorel 50 & Utrogestan 100mg/d orally & vaginally - Severe depression, no motivation, anger, increased fatigue, flu like, nausea, headache, sleep disturbance.
Evorel 50 & Cyclogest 100mg/d vaginally - Similar to Utrogestan but a bit better
Evorel Conti - Severe depression, no motivation, anger, increased fatigue, headache.  I added in Evorel 50 1/2 patch and felt a bit better but still felt very depressed.
Evorel 50 with Provera 5mg/d - Reduced mood, irritability, sedation, bloating, headache, mild period type pains.

Therefore, so far I can not tolerate the full recommended dose of progesterone but have been ok on the following:

Evorel conti 1/2 patch Evorel 50 1/2 patch i.e. Half recommended dose of progesterone - Felt fine
Evorel 50 & Provera 2.5mg/day - Mild side effects.

I know you won't believe it but I have ordered a small box of Femseven Conti to try from an independent pharmacy.  I expect it might be the same as the above.

The private meno nurse said I could try oestrogen on it's own for a month to get my levels optimised and then re-introduce progesterone.  I took oestrogen on it's own for 2 weeks and then I tried Evorel Conti and now Provera at half then the full dose.

The Meno GP I origionally saw at my GP practice has left.  Therefore, I think I am going to have to pay for another private meno consultation to see if I could perhaps continue at a reduced dose of progesterone a bit longer.

I could also try Evorel 50 1/2 patch and Provera 2.5mg/d.

I also wondered whether I could be referred to a NHS Meno clinic.  I'm not sure if I meet the criteria for that or whether they can help.
 
So far I have had one month on HRT (Evorel 50 & Utrogestan 100-200mg/d), one month off HRT and one month back on HRT (2 weeks oestrogen only and 2 weeks experimenting with half/full recommended dose of progesterone).  I have not had any bleeding.

I need to make a number of changes; some of which will be difficult which will help my recovery from chronic fatigue.  Therefore, my mood and motivation needs to be good to create a positive spiral etc.

I just wondered what other people have done when they have had side effects that have made it very difficult to function which then creates a negative spriral.  Have you just put up with them to see if they improved?

[SaraUK]

I’ve been on oestrogel and utrogestan cyclic (200mg for 14 days per month) for 2 years. First year was ok. Second year I noticed my anxiety and mood being affected after around 4 days of taking utrogestan.

In January this year the menopause nurse recommended I go on continuous utrogestan at 100mg daily “as it may be better on a lower dose”.

After 6 weeks I was suffering terribly with extreme anxiety, sweating, shaking, heart pounding, night sweats and panics. I was and still am suffering with awful bladder issues and external burning. So not sure if that was the root of my anxiety as I feel nothing is helping me. But, describing this to nurse she said sounds like progesterone intolerance. She said stop the utrogestan and go on a long 11 week cycle then a two week provera at 10mg daily. I’m still on my oestrogen only phase which is worrying but she said it’s ok as a one off, not continuously.

My anxiety has reduced considerably but my bladder issues continue. So I can’t blame utrogestan for that.

To make matters worse, they found 2 fibroids (5cm & 1cm), so not sure if that’s the cause of my bladder problem.

It’s all so worrrying.

[Anonymous1]

Thank you for your reply Sara.  I'm sorry to hear about your bladder issues.  Yes, it is all very worrying; particularly when symptoms are having such a big effect on level of functioning.  Is your menopause nurse private or at NHS menopause clinic or GP? 

The menopause has been a very big shock for me.  Things seem to have got worse since I got closer to 12 months without a period.

[Mogster71]

Anonymous1
I too hated taking Utrogestan.... I was (am) on 100mg patch of Evorel, when the Utrogestan was introduced to my cycle i felt a distinct dip in mood, anxiety and generally feeling boggy in the mornings. Headaches, just bleugh. I asked my GP for Provera and they wouldn't prescribe it, I tried continuous too to see if half the dose meant the symptoms were less but I just felt the same with messed up bleeding patterns.

I decided to have the Mirena fitted last September, it's been a game-changer for me as every other progestogen (apart from Femeston) has been horrible. I had a period straight after for a few days, then some spotting for a couple of weeks but after it settled it's hand on heart been great. The freedom of not having to take daily tablets that make you feel awful is just one huge benefit!

If you don't think the Mirena is for you (and I understand it's a very personal choice) then what about long-cycling? Under supervision you can take your progesterone for one week in every 3 months... it might be easier to tolerate if you know it doesn't come every day/month.

I hope you can find something to suit you and feel well with it.

[merrygoround]

Femseven conti is a good choice to try Anonymous1 because it contains to same progestogen as the mirena coil. If you tolerate one you ought to tolerate the other, although nothing is set in stone, it's good to know where you stand regarding the mirena because I'm sure you'll be offered it soon if not already.

I also cannot tolerate provera (raging zombie with flu), utrogestan (agonising indigestion and insomnia) or cyclogest (suicidal by day three). The mirena wasn't as bad and Evorel Conti wasn't as bad, but both too much to tolerate, I'd rather have menopause symptoms than progesterone poisoning symptoms. Pregnancy was just as bad as taking progesterone for me btw, I was depressed until I gave birth, then got such a huge bounce in energy and happiness, brain chemical happiness as well as event happiness, just as other mums were getting baby blues.

It's not mentioned much, but by far the best menopause medicine I've tried is tibolone.

It doesn't give me any bad side effects except some abdominal pains, but it's nothing like utrogestan indigestion pains (those were off the scale, I was close to going to A&E).

My doctors got cross with me for not liking their gold standard menopause medicines. I tried far too hard to please them. For example by trying provera three months in a row (that or lose HRT completely) and honestly it took months and months afterwards to rebuild my self confidence and damaged relationships that were a direct result of that blind testing no matter how bad things get for the patient. I was phoning my GP to say I was suicidal, physically ill and unable to go to work, only to be told HRT doesn't do that, it makes women feel better, not worse (i.e. go away you silly woman).

Another thing they wouldn't believe me on was the way taking utrogestan completely wipes away the benefits of taking oestrogen for me.

Don't persevere with something that is making you feel awful, in my experience none have ever become beneficial after starting out awful. Only the ones that started out with minimal side effects became worth taking in the end.