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[Girlinabox]

Hello

I’ve been on HRT a number of years however I recently saw a consultant at the menopause clinic as wanted testosterone.  She convinced me to stop my cyclical progesterone and try continuous. I am post menopause and but had been taking it cyclically due to side effects.

Over time the cyclical side effects lessened and as I felt I was tolerating it well decided to give the continuous a try. I was finding with the cyclical regimen that I was having a big dip in mood when getting the withdrawal bleed.

I’ve been on continuous for a month now, 100mg utrogestan vaginally. I had some initial side effects like bloating but they seem to go. However this last 7 days I’ve felt dreadful. So, so tired despite sleeping well and my mood is very low. I feel angry at the world, have no motivation, want to leave my job, I just feel awful. I want to go to bed and shut the world out. I’m really health conscious and do a lot of exercise but this week have done nothing. I just don’t feel like myself at all.

I know it’s maybe the sunken cost fallacy but I’ve got this far and I’m desperately hopeful things will settle down.

Does anyone know if increasing my estrogen (2 pumps daily currently) may help counteract the progesterone?

[CLKD]

Morning.  How were your moods during your menstruating years?  I would sob the night B4 a bleed began, even when a period wasn't due.

Hopefully some1 will be along with advice.   

[Girlinabox]

Thanks for your reply CLK. My moods weren’t great. Always struggled to tolerate the pill, mirena in the past. Prior to a period would be awful. Also have a history of PND.

Everything had been quite good the last few years though and I was finding month on month the utrogestan got easier hence why I though going to continuous would be ok.

However I just feel dreadful and just not sure what to do

[bombsh3ll]

Anecdotally being on a therapeutic dose of estrogen and having testosterone on board can help make progesterone more tolerable.

However it is likely that if you increased your estrogen, your specialist would want you to increase the progesterone as well, based on recent guidance.

Remember that you are the expert on you, and if cyclical was working for you, then a good specialist would be prepared to support you with this including monitoring the endometrium with regular scans if necessary.

Cyclical progesterone long term is associated with a slightly higher risk of endometrial hyperplasia and cancer, however many other outcomes are better Vs continuous eg cardiovascular, breast, brain health and of course your quality of life matters too.

Therefore I believe people should have the autonomy to make an informed choice regarding this, rather than be bullied into algorithm based, non-individualised treatment.

This will not be available on the NHS however as they don't have the resources to provide monitoring scans, so pragmatically they have to err on the side of caution and overtreat many women with progesterone in order to protect everyone.

[CLKD]

I would be inclined to go back to the regime which worked for you.  Let us know how you get on.

[Aubrey]

Hi girlinabox,

I'm sorry to hear you're struggling, it is so hard to get this right and feel OK, isn't it? I've been feeling like you for years, can't be bothered to engage with anything unless I have to. Angry, sad, insomnia. I used to be such a go-getter. I've also used the cyclical regime for years because like you I don't tolerate progesterone. I've tried testosterone and didn't tolerate that well either, bloating, sweaty, spotty and ANGRY!

I had an endo' scan recently, because I take quite a lot of Sandren gel, 3mg daily, and 100mg Utrogestan virginally days 15 - 27, my endo' is fine, I bleed every month. So, if you felt better on the original regime, had regular withdrawal bleeds, maybe stick to that?

I hope this gets better for you.

[joziel]

Do you know what your serum estradiol levels are, on those 2 pumps of gel? It is a very low starter dose really, so increasing would be a good starting point.

If your serum estradiol levels are not high, I can't see why you'd need to increase the P. Because after all, we should go by serum levels and how well you absorb - the amount you apply to your skin isn't the same as what you absorb from it...