Print

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

[SunnyG]

Hi everyone

I'm so pleased to have found this website.

I'm 51, still having irregular periods so GP prescribed Elleste 1mg, which was then changed to Femeston 2/10, after reading horror stories about the progesterone in Elleste on this forum. Like many ladies, I found the estrogen phase very helpful, especially the higher dose. However, the progesterone is making me feel awful, I feel sick, really exhausted, grumpy (to the extent that colleagues are looking at my face and asking what's happened to me). I also have 'fatty sacks' which have appeared under my eyes.

I started taking HRT as I'm in the last stages of a PhD and the brain fog and hot flushes were stopping me from working. However, with the exhaustion I feel like I'm back to square 1 almost.

It seems that I'm progesterone intolerant (I had problems with the mini-pill when I was younger). Reading around the forum and internet, I think it's possible to take estrogen as a tablet and progesterone as a pessary/gel. Does this help the symptoms? Can I take progesterone for a shorter time - I'm not sure I'm going to last the 2 weeks at the moment? I saw that was possible too. What should I ask my GP for?

Any advice would be gratefully received. 

[MicheleMaBelle]

Hi SunnyG- yes you can take oestrogen in the form of a gel or patch and progesterone separately- you can get either utrogestan ( bio identical) or another one( sorry don't know it's name )
You can take the utrogestan vaginally which can help with some of the side effects but if you're intolerant you may still find them unpleasant to deal with ( but maybe it's worth a try- different things work for different folk and I don't want to put words into your mouth )
Less progesterone than the recommended guidelines? Yes, it is possible, should only be done under medical supervision, it MAY carry a higher risk of endometrial cancer and you then need annual scans. I'm not sure if your GP would go along with this- some are ok with it, others won't even go there and you may need to go private.
I've now been offered this option ( private consultant) but given where I am, I'm going to try coming off HRT to see how I react. I've struggled for 20 months to get something that suits no have felt very bad indeed on HRT- my brain tog, confusion seems to be worse on it than off!

Discuss the options with your doc, be aware of any additional risks in taking less than the guideline dose of progesterone- it works beautifully for some women but don't self prescribe whatever you do.

Hope you find something that works for you and good luck with your PhD x

[MicheleMaBelle]

And I can't even spell! X

[SunnyG]

Thank you for your advice, Michelemabelle.

[Freckles]

Hi SunnyG
I am also progesterone intolerant. I am prescribed daily Estrogel  gel  (it's safer and more effective than oestrogen patches, as well as more practical IMO), a tiny amount of Testim (testosterone) gel daily and Ultrogestan tablets at 100 mg for 7 days.  I use these vaginally, although they are designed for oral use.  You still get the same effects but it significantly reduces the horrible side effects.
I got mine prescribed privately initially by Prof Studd as I gave up on the inadequacies of my NHS GP and not het my prescription on the NHS after he wrote to my GP.
Initially I was advised to take Ultrogestan orally but it didn't work for me in that method  and following discussion with Studd, was advised that many of his patients take the oral tablets vaginally.  By passes the liver and is more effective vaginally.
I hated Femoston!  Took me two years to realise (for me) it made me feel worse and just wasn't effective. I put my house plants on the left over tablets and they really perked up! Unlike me.
I can't see an issue re the *method* of application personally, as it still works vaginally, although clearly some posters on MM prefer to adhere to their GP's advice or NHS guidelines. Their choice of course.
Studd tends to prescribe this dose of Ultrogestan to the majority of his patients
Of course every one varies, and obviously GP's vary in their knowledge of current HRT and anxieties about varying from the NHS "guidelines".
I know there is no way I could tolerate 200 mg for 14 days a month!
The NHS advise that as they won't pay out for possible uterine scans at a lower dosage, which from what I can gather, isn't necessary at 100mg for 7 days each month.
Minimal risk of uterine cancer using that prescription.
I'd give up HRT altogether if that was the case, as many women do, due to the excessive amount of progesterone prescribed and the horrible side effects on the NHS generally.   
As for self medication- I'd argue it's not- it's prescribed for me by a world renown expert in HRT, so I accept his diagnosis, funnily enough, rather than my  female 12 year old GP who suggested that in my mid 50s, I needed to be "weaned off" HRT and go on anti-depressants for the last third of my life.
To hell with that suggestion.
Plus like many women, I do self medicate in that I reduce very slightly sometimes the amounts of the prescription- I am an "expert" in my own body, so if I feel I am getting too much of excessive symptoms of oestrogen or testosterone, just  for a few days. Which works for me.
No doubt I'll be flamed by some MM posters for daring to take to take clinically informed flexible decisions about HRT into my own hands , but I have my big knickers pulled up and still able to read *current* clinical research papers. 
IMO a lot of the NICE NHS "guidelines" are over cautious, clinically misleading and now rather outdated.
GP's are NOT an oracle when it comes to HRT issues. Far from it.
My current prescription has really worked for me- lifted "brain fog", low mood, anxiety etc. It's been life changing for me.

So lots of different  opinions about HRT about.
I'd suggest you read some older posts and make up your own mind.
Good luck!
Freckles x
 

[SunnyG]

Hi Freckles

Thank you for your very helpful reply. 

Re the doses and self-medicating , this is exactly what I've been thinking. No one knows how you feel apart from yourself. The NICE doses are generic and cannot possibly suit everyone. I'm tiny (5' 0" and weigh under 8 stone), there are women who are much taller and weigh a lot more than me. I can't see how the dose can be right for us all.

I'm going back to my GP, this week, she's in her 30s but not unsympathetic, I'll ask about the gels and vaginally taking the Ultrogestan and show her this forum. I wonder if she would refer me to Prof. Studd? It's probably too early in the treatment as it's still my first 3 months, but the clock is ticking on my PhD so need things sorted asap.

Glad things have been sorted out for you.

Sunny x

[Freckles]

Hi Sunny

Your GP won't refer you to Studd- too expensive for the NHS as the first consultation is about £350!
Then you have one follow up after three months and then yearly after that with him.
Your GP may refer you on to someone on the NHS, who may, or may not, be helpful.
I think the Estrogel gel  for oestrogen is far more practical, not to mention safer and more effective than patches and certainly pills.
Patches sticking to my big girl knickers, falling off, etc, isn't practical, but regardless transdermal oestrogen (gel or patches) is certainly safer and more effective than pill versions.
Taking Ultrogestan vaginally for some reason in the UK is restricted to 200 mg vaginal pessary (usually for fertility problems) but I use the oral 100mg vaginally with a pessary dispenser and that works fine for me . Taken last thing at night (after using the loo) , they absorb well internally, with no yucky residue.  You simply pee any the casing, if any left,  in the morning. 
If it's of any comfort, I was on Femoston tablets which were awful, after a couple of years, for me.
Got a lot of primarily psychological symptoms: brain fog, anxiety for no reason, low mood (ditto), etc. 
After being advised by the 12 year patronising GP to go on AD's, I found my oestrogen levels (as I suspected) on Femoston were confirmed by NHS blood tests as being lower than most men's (in very low double rather than triple figures) !!
No wonder I felt like crap and looked a middle aged man  going through a gender identity transition crisis
Got off my depressed backside, gave up the cost of a weekend away to see Studd, started his Oestrogel/Testim/Ultrogestan regime.
Within two weeks I felt so much better psychologically (mainly I think as my oestrogen levels were so chronically low).
Usually they advise about three months to see a difference, but I was so low on oestrogen to begin with, I really noticed a difference quickly
Also saw a huge difference in my crepey skin, loss of head hair, big  reduction in the "beard", eye bags, etc.
Your GP may not advise taking Ultrogestan *vaginally* at 100 mg but plenty of women do on MM, so I would treat it as "advice" if that's the case
But DO ask about changing to Estrogel gel instead of a tablet.
It's only marginally a bit more in cost than the usual tablets but much safer and more effective, so cost shouldn't be an issue on the NHS.
Studd has some helpful reader friendly papers on HRT on his web site that might be useful information to consider, even if you don't see him.
Always good to be informed on current clinical thinking IMO.
Quick Google should bring the web site up.

Good luck!
Freckles x

[Hurdity]

Hi SunnyG

  from me too.

I use an very small oestrogen patch - Estradot - and it never sticks to my knickers ( I don't wear big ones anyway  ). This comes in a variety of doses from 25 mcg per day to 100 mcg (this is the daily delivery rate not the total amount contained in the patch). Choosing between gel and patch is a matter of personal preference and also the differences in absorption experienced by different women - with gel this can vary with application method/technique, and also skin properties and products used, as well as fat layers under the skin and application site (ie part of the body)!

Re the amount of UTROGESTAN - as you can see the licensed dose is 200 mg x 12 days orally but as discussed women may be prescribed less than this under medical supervision since lower doses are associated with increased risk of endometrial hyperplasia in trials from populations of women. An individualised approach is obviously ideal but really does need to be done under medical supervision so that you can arrive at the minimum dose which you can tolerate, and which at the same time protects the uterus - since there is an established casual relationship between oestrogen dose and endometrial hyperplasia - hence potentially endometrial cancer (albeit low risk).

I am post-menopausal and use Estradot 62.5 mcg with utrogestan 200 mg x 12 vaginally every 6-8 weeks which gives me a small-ish bleed - approved by my GP.

Hope this helps

Hurdity x