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[Hurdity]

How much oestrogen are you using Tinkerbellj? Your feelings could partly be due to the drop in oestrogen which occurs in the second half of the cycle and starts to rise as the bleed begins - so many women feel low at least week before and a week after their period starts - in addition to any effect they might feel on the progesterone - or even just due to the oestrogen levels. if you are peri-menopausal there are so many variables going on it's difficult to pinpoint exactly why you are feeling as you are.

Hurdity x

[Mary G]

Tinkerbellj, I would start the Utrogestan on day 15 if that is a month after the last lot. 

Cassie, don't worry, that happened to me a few times while trying to do a long cycle.  How long is it since you last used Utrogestan?

I use two pumps of gel but can't go much more than 5 weeks without shedding automatically.  I have tried two things, leaving it to take its course but the downside of that is that is turned into an elongated period that lasted for 2 weeks and then completely stopped.  Alternatively, you can start the Utrogestan immediately which will delay things until you stop and then you should have a normal type of bleed.  I have tried both and had a scan afterwards and all was absolutely fine. 

I spoke to my gynaecologist about this and she said that some women have good womb receptors which shed without the use of progesterone - I shed without progesterone at about 7mm.  Obviously she does not recommend going without progesterone but did say that I don't need anything like as much progesterone as some of her other patients. 

So it's all about finding your own personal threshold and then sticking with it. 

[Cassie]

Thanks for that info Mary, I seem to shed just on 5 weeks automatically and have really been pushing my  luck. When this happened before, I also carried on hoping it would stop but it didnt so am going to use the Utrogestan to sort things out and try and get back into a cycle. I envy ladies who can push past the 4 week mark, but I just cannot. I think my womb would shed automatically on 4 weeks without the progesterone. Perhaps I can try and tone down, using it for less days, what dose do you take?

[Mary G]

Cassie, I take 100mg Utrogestan (always vaginally) for 7 days every 5 weeks but to be honest, I have cheated like mad in the past!  One month I only took 1 capsule because of a migraine (just couldn't face taking any more) and it was still enough to give me a regular bleed 6 days later.  Others will disagree with me but I think the progesterone part of HRT is way over-prescribed and only you will know how much you need is by trial and error and having a scan to make sure you are shedding properly.  I would never encourage anyone to take unnecesary risks.

I know what you mean when you say you think you would shed automatically without progesterone, I probably would too but the downside of that is the very long period (classic sign of low progesterone) and my gynaecologist said some of the lining can get left behind.  Still, it is good to know that you can take less and not ruin what is otherwise a magic formula.

[Cassie]

Thats a lovely dose, I have been on 12 x 100mg for ages, but after my next scan I am going to see if I cannot come down to perhaps a few less days and see if it still keeps the lining thin, am sure it will.

[Tinkerbellj]

I was using two pumps and upped it to three during period but am going to keep it at three mow two in morning one at night.  Feel much better today still emotional bit mot so uncontrollably angry

[Mary G]

Stellajane, it just shows how some women react well to low doses of Utrogestan and others don't.  I'm glad your new regime is going well, 200mg was obviously too much for you hence the better bladder and fewer overall side effects.  I have found that Utrogestan is very powerful when used vaginally and not very effective when used orally.  I also found it gave me far too many unpleasant side effects when used orally.

Tinkerbellj, I'm glad you are feeling better and I hope it continues - the effects of the Utrogestan must have worn off. 

[Cassie]

Mary G.....was your bleed, am meaning the one you  had when you were being naughty and not taking the Utrogestan 4 weekly, also very much heavier? Wow....this is awful, the flood gates have literally opened! Were out with friends last night and had to keep dashing to the ladies room for damage control, really unpleasant. Day 3 of the Utrogestan, doesn't seem to be stalling the flow yet but am keeping everything crossed.... forgotten what its like to have such a heavy bleed as the usual post Utro one is a few days but not nearly as heavy as this....

[Mary G]

Cassie, when I didn't take ANY Utrogestan while trying to go for the long cycle, it was the same volume of blood but it took 2 weeks to come out, what I would call a slow burner! 

When I took just ONE capsule of Utrogestan vaginally (having ditched it because of a migraine) it was a normal period for the normal length of time with the same volume of blood.

I have only started having lighter periods since I dropped from 3 pumps of gel to 2.

It doesn't sounds like you are going to have much lining left after this.  Hope that helps. 

[Cassie]

Yes I cannot go long cycle this has happened before and I was silly enough to push it again. Will def have to stay on my 4 weekly Utrogestan x 12 days and see what the scan shows when I have one later this year, thx ladies, its a real schlepp.

[Cassie]

Phew the flood seems to be tapering off now on day 4 of the Utrogestan, am hoping we are back on track now after this little blip

[Trufflecat]

How many people use 4 pumps of oestrogel? I upped it a week or do ago when I was feeling horrible (peri so my own progesterone I think) and am now on the Utrogestan phase and feeling good instead of low and paranoid. 

[Hurdity]

Just to add that if you do not take progesterone as part of HRT and you are post-menopausal and you start to bleed - this is likely to be oestrogen breakthrough bleeding (amongst other possible reasons such as fibroids or polyps) rather than progesterone withdrawal bleeding. If so, this is abnormal uterine bleeding (whereas prog withdrawal bleeding is normal), and could be an indication of a thickened lining whereby the endometrium builds up and spontaneously sheds after thickening too much. This is why it takes longer and there is no guarantee that it will all be shed as it won't have been converted from proliferative to secretory endometrium (as happens when you take progestogens). It is the proliferative - growing - endometrium stimulated by oestrogen that can lead to endometrial hyperplasia which can sometimes lead to cancer - so is a greater risk in some women.

There not taking progesterone or taking it on a longer cycle, or for a shorter time than recommended should not be attempted without proper medical supervision and with regular scans to check the uterus lining.

Hurdity x

[Dancinggirl]

Excellent post Hurdity.  A clear outline of the consequences of not using progesterone properly.  Professional advice and supervision is absolutely crucial if you want to experiment with HRT doses. DG x

[Chikabee]

Hello,

I'm a newbie and been poring over these boards for the last three months re my hrt regime.

I was initially put on 1mg of estradiol gel and 100mg x2 of Utrogestan starting mid April. I've perservered with the horrible bloating and increased 1 dress size to 16, and it seemed to be levelling out. Since I started I increased to 1.5mg of oestradiol. In last week or so Ive experienced night sweats and low mood and yesterday increased to 2mg. I will be seeing gp about this but is this safe to do.

My other questions are:

1. Should I go on antidepressants as I still feel low moods, and I do not feel like a 'new woman' or back to my old self, as my youngish female GP suggested I would experience.

2. Should I have blood tests and scan now that it's been over 3 months?

3. When does day 1 start? On day 1 of start of breakthrough bleed or after day 28. I asked my GP but she wasn't sure and said to take Utrogestan around same time each month. But won't that mean more estradiol days if a month has 5 weeks - really confused.

4. Are there any seminars or real- time support networks available in London.

5. And a random one, I was an amitious, creative woman before all this started, and now my life has come to a complete halt. I look at the TV and see these older women at the top of their game in politics and business, and wonder how they do it. I don't hv children, and not currently working. I don't know what to say to people when they ask about what I've been up to, especially younger people or acquaintances. Anybody relate to this?

I hope to hear from someone soon. Thank you in advance for any responses.

Chikabee