Print

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

[jedigirl]

Is there a reason why you can't go onto a conti HRT if you are still haing periods (slight)? I'm struggling with the estrogen only part of Femoston Sequi and wondered if it was possible for me to take the conti version with continuous progesterone, which I feel better on. I'm currently on Femoston 1/10 but when moving back onto estrogen stage feeling nauseous and overly anxious.

[Dancinggirl]

Hi jedigirl
It would depend on your age and what stage you are in your menopause.  If you are over 54-55 then they may well let you change to the conti version. Perhaps you are actually needing to go onto a high dose of the Femoston - 2/10? You are currently on the low dose and perhaps a bit more oestrogen may help the dip after finishing the progesterone stage.  If you are peri menopausal your own hormones will be gradually falling and this could be resulting in your negative response to the oestrogen phase.
I must add, that your are describing the withdrawal bleed you get with Femoston as a period - this is not strictly true. I am not an expert by any means but many women think they are having periods with sequi HRt when in fact it is just the HRT doing it's job of keeping the lining of your uterus thin. You don't know whether your own periods have stopped or not because the HRT is controlling this. The only way to know whether your own periods have stopped is by coming off HRT for a couple of months and then having a blood test to see where you are in your menopause journey.
I think you are just experiencing normal PMT type symptoms when you finish the progesterone stage - do you feel better once the bleed starts?  DG x

[Millykin]

Hope you get some good replies here Jedigirl as you know I'm on 1/10 and feel much better on prog part, and slight anxiety in oestrogen only, I rarely have a withdrawal bleed though.
X

[jedigirl]

Hi dancinggirl, I was on 2/10 Femoston until two weeks ago but i felt the estrogen stage was too high for me. I had horrible facial rash, sudden anxiety that came on like a wave just before New Year and is only just subsiding on progesterone stage.
I feel better when my period starts in that my head feels clearer and I'm not so dizzy but then once back on estrogen feel so sick and anxiety is awful. I'm 45 and not keen to come off hrt yet as only been on 6 months.
I think I'm being a bit dense but is there a danger being on conti hrt if you are peri? Why do you have to wait till you're post menopausal?
Thanks for reply 
Hey Millykin, we'll get there in the end!!   

[GypsyRoseLee]

Hi Jedigirl

The locum gynaecologist I saw last week prescribed me Evorel Conti. I queried it at the time, explaining I definitely still had periods. He insisted it would be fine. Once home I queried it on here, was told it was definitely the wrong preparation for anyone who was still only peri menopausal. So I rang the locum and expressed my concerns and he STILL insisted I could take it 

But I am the opposite of you in that my body seems to really love the oestrogen stage of my cycle (feel relaxed and happy, almost dreamy) but can't cope with the rise in progesterone. Though like you, I have had a couple of REALLY nasty nasty dips just as my period finishes on roughly Days 7-9 of my cycle.

I hope you get a really nice, clear answer and this HRT maze is really frustrating.

[Dancinggirl]

jedigirl
At 45 you do need the HRT for a few years. You are too young to use conti HRt at the moment unless they can confirm you are definitely post meno - which would be difficult unless you come off HRt for a time. I'm no expert but if you are still in peri menopause you are still producing some of your own hormones so using conti HRt might result in some odd breakthrough bleeding. It is better to stick with sequi and many women opt to stay on sequi through post meno.  I am 58 and post meno but I'm on a sequi regime.
I'm wondering if you need to try a different HRT regime.  I have used Oestrogel with separate progesterone for many years. You could use Utrogestan(micronised progesterone) as it is bio identical and very similar to the progesterone in Femoston so should suit you.  By using oestrogen in gel or patch form it is not going through your digestive system and could solve your nausea issues. Look under HRT preparations for info.
If anxiety becomes a real issue then many women find they need a SSRI alongside the HRT to control all their symptoms.  My gynae recommends Citalopram and I have a colleague at work who is on both HRT and Citalopram and she is feeling really good on this combo.
Dg x

[jedigirl]

Thanks dancinggirl, am at the doctors next week so will have a chat with them though they seem a bit clueless about this so far.
Am i right in thinking you use Utrogestan for part of the month only? I think my problem is not having enough progesterone in relation to my estrogen which is why when i come off the progesterone stage i almost have a double issue of my progesterone levels dropping and estrogen rising.

[Dancinggirl]

Yes the withdrawal of progesterone will often cause these PMT type symptoms on any sequi HRt preparation. However, I think it's the nausea which you are getting on the oestrogen that could be helped by using oestrogen in gel or patch form instead of orally.  The transdermal route by patch or gel means it won't go throughout the digestive system and will therefore give less side effects - the feeling of nausea could be triggering your anxiety?!!.
I must stress I am not an expert by any means I am just putting forward a logical solution that might be worth trying.
If your GPs are clueless then this can be tricky to handle as they are unlikely to know about Utrogestan.  Do print off the info from this site to show them.  Don't let them put you on a combined HRT as the progesterone will be different.
Out of interest, do you feel nausea and anxiety for the whole 2 weeks of the oestrogen phase? DG x
DG x

[jedigirl]

Thanks DG, yes the nausea hits about two days after going onto estrogen and stayed for a good 10 days this month. The anxiety also peaks then. I cant say i feel fantastic on progesterone, still anxious but less so, and rashes have cleared. I just feel better on this stage than on estrogen.
Am wondering if mini pill is another route i could ask about as well as Utrogestan.
I also had the nausea before starting hrt, it's the symptom that sent me to the doctors at the beginning of all this. It was so severe then, like bad morning sickness.
Thanks for your help, i appreciate you taking the time 

[Hurdity]

Hi jedigirl

I have posted about the cycle on your other thread.

Just to say - firstly there is no danger of being on conti HRT when you are not post-menopausal - but as has already been said ( I think!) you will likely get irregular bleeding as your cycle breaks through which is inconvenient.

HRT provides a constant amount oestrogen so you will no longer experience the dips.

Ah - you were experiencing nausea before you started HRT. Then most definitely I would change from tablet HRT which can aggravate nausea. This is what it says on this site about route ( ie tablet vs transdermal):

 Indications for non-tablet route.

    Individual preference.
    Poor symptom control with tablet HRT.
    Side effects such as nausea with tablet.
    Bowel disorder which may affect absorption of tablet therapy.
    History of migraine (when steadier hormone levels which may be achieved with a patch may be beneficial).
    Lactose sensitivity (all tablet preparations of HRT contain lactose).
    History of gallstones.
    Current use of medications such as anti-epileptic medication which may interfere with the break-down of tablet HRT.
 Variable blood pressure.
    High triglyceride levels.
    Risk factors, family history or past history of deep vein thrombosis or pulmonary embolus, after full discussion and specialist advice when necessary.

http://www.menopausematters.co.uk/route.php

I wouldn't take the mini pill in your position.

Have you thought about the Mirena coil (which women seem either to love or hate) - because it delivers progestogen directly to the uterus with minimal systemic absorption, provides contraception, and enables women to take the dose of oestrogen that suits them. You would then use oestrogen only patch or gel alongside this coil.

Personally I would not go down the SSRI route if your anxiety is hormone induced and you did not suffer it before.

Here is some information on using diet to help with peri-menopausal nausea it is American but the same principles apply):
http://www.patient.co.uk/forums/discuss/menopause-perimenopause-and-nausea-258199
https://suite.io/deanna-lynn-sletten/2zxy21w

Hope this helps!

Hurdity x

[jedigirl]

Thank you Hurdity for both posts, I'm trying to take it all in despite my bad head and brain fog! So much to consider and I don't want to rush into anything that might make me feel worse. I'm not currently having flushes, bit sweaty at night. I tried patches before and they were fine but so itchy underneath and problems keeping them on. Might consider the gel though

[Kittyjay]

Hi Jedigirl
I'm 43 and have been on the conti regime for 2 months having been on sequi for 18 months before that. (Previously no period for 6 months and blood test showed menopausal). I take estradot 50 patch and utrogestan 100mg on day 1-25, allowing for a bleed days 25-28 if 'there is going to be one' (my docs words!) I have had a bleed both months but at roughly the expected time, whereas on sequi I bled every 2 weeks for some reason.

I feel soooo much better with constant progesterone and utrogestan seems to suit me really well - in fact Ive never felt better since starting hrt! (Only 3 months ago I was in total despair and suffering debilitating anxiety) My gp is v happy to prescribe continuous progesterone despite my age and certainly did not say there was any reason not to have it at 43. If it suits you (as it does me) to take constant progesterone then why not do it? As Hurdity says, there are no dangerous health reasons why you can't. My gp said it will simply keep the endometrium lining thinner continuously.  Kittyjayx

[Dancinggirl]

kittyjay - I expect you have already gone into post menopause - this is possible at your age.  I had premature menopause and was probably post meno by the age of 41-42.  I expect you blood tests may have shown this. If someone is still in peri - in other words still producing quite a bit of your own hormones, then taking Utrogestan in the continuous regime can produce some odd breakthrough bleeding.
Hurdty is right, you could use this regime if still in peri but must expect to get some random bleeding until your own hormones have dropped. DG x

[Kittyjay]

Hi Dancinggirl- yes my gp did say I was post meno at the time but as I'd only not had periods for 6 months i didn't think I could be classified as post meno until no period for 12. I know my bloods showed v high FSH/LH. looking back I think I was peri for a good few years before periods stopped and recognise now so many of the symptoms I had when reading others posts, but due to age didn't think about meno! X

[Dancinggirl]

I think early ovarian failure is more common than we think and sadly many GPs are not good at picking this up and giving appropriate treatment.  I was lucky as I had a good GP at the time and when results came back showing I was peri meno at the age of 36 I was at first reluctant to take HRT but my GP simply said "If I was her daughter she would insist I take HRT"  - I'm so pleased I followed her advice.
Now 58, I recently went to see a gynae privately for advice; I wrote my menopause story down on paper for him to read and his comment to me after reading it was "You've had good advice and treatment for your menopause".
DG x