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[Dancinggirl]

Had a dreadful night of cramps - took some Cocodamol at 3.30am and in the morning the cramps were better. Over this morning the cramps have got progressive worse again. This is getting to be a real pain in every sense of the word.  I'm not bleeding excessively and I've still got 2 days of Utro to take!!!! I really don't think I will be able to stick with sequi HRT if the cramps are going to be this bad and for so many days. I fear that Utro is triggering these nasty cramps but I also had some mild cramps over the last few weeks while just using Oestrogel - so I am actually a bit concerned that my uterus is just rebelling.
Whether things would be better on conti Utro it's difficult to know - I think I will have to try this first before throwing in the towel.  I'll probably go back to my gynae once I'm back on Oestrogen only, if things don't settle .
Back in my 40s when I was using Oestrogel with Dydrogesterone for 10 days each month, the bleed often started on day 9 and I got nasty cramps for a few hours but these would subside quickly and the bleed only lasted 3-4 days and wasn't heavy. I found the dydrogesterone gave me slight PMT symptoms and the odd headache but nothing too bad.  It's shame that this type of progesterone is only available in Femoston these days and not separately as it once was.
I would be devastated to stop HRT as it has made me feel so much better in many ways - during the year without HRT I did feel I was leading a half life.
To be honest, if my gynae suggested a hysterectomy I would probably seriously consider it - although I know this is not ideal.
I do appreciate all your support everyone.  DGx

[honeybun]

Sorry to read this DG. It's exactly what Utrogestan did to me and I just couldn't cope with it. I had terribly painful cramps as a teenager that improved as I got older and had my children. I was so surprised to end up curled up in bed with a hot water bottle suffering cramp in my 50s. I tried for a good few months but it just got worse. I think Utrogestan is far too strong for me.

Perhaps having gone so long without any periods at all is not helping your situation.

Are patches not even something you would consider trying....I use a scant half as I'm getting a bit older. It's just enough to keep the flushes at bay and help me sleep.

Hope you feel better soon.


Honeybun
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[Dancinggirl]

Thanks honeybun - it's interesting to know you suffered the same way. Unfortunately both the combined patches, Evorel and Femseven,  have synthetic progesterone which gives me nasty PMT so I would be very wary of using these.  I did have a Mirena for 4 years in my 50s which was OK but I think I absorbed too much of the progesterone (again synthetic) in the first year or so and felt sedated/sleepy quite a bit.
As I mentioned, it's a shame that Dydrogesterone isn't available on it's own, so it can be used alongside Oestrogel.  I haven't tried MPA (Provera) so this might be an option as it isn't as testosterone based as Norgestrel, Norethisterone acetate and Levonorgestrel.
I don't need a high dose of oestrogen either - I'm feeling good on just 1.25 pumps of Oestrogel, which I think would only be about 1mg in pill form, so really quite low.
I'm going to have to be persistent and try different options. DG x

[Briony]

As I mentioned, it's a shame that Dydrogesterone isn't available on it's own, so it can be used alongside Oestrogel.  I haven't tried MPA (Provera) so this might be an option as it isn't as testosterone based as Norgestrel, Norethisterone acetate and Levonorgestrel.
. DG x

Interesting you say this as I searched everywhere to see if there was a combined contraceptive pill using Dydrogesterone that I could take rather than the Dienogest in Qlaira. I found an article saying it was in the research stages. Wonder why it's not available separately when it seems to well tolerated?

[Dancinggirl]

Briony - it baffles me!! Maybe there is only one pharmaceutical company that has the rights to dydrogesterone?
It used to be available in pill form on it's own (that's what I used to use back in my 40s) and I think it is still available in other countries. Why it was taken off license in the UK seems odd when it is clearly a kinder type of progesterone.  It would be great if it was in a patch but maybe it doesn't work in that format - for some reason they only use synthetic progesterone in patches. 
I'm sure in time that newer and better tolerated HRTs will emerge as the demand grows.  Now women are getting more informed and demanding treatment for the debilitating meno symptoms the pharmaceutical companies will surely meet this demand - after all there are so many different contraceptive pills out there now. My daughter uses 'The Ring', which she just replaces monthly - it contains oestrogen and progesterone that prevent pregnancy and it would seem to me that a similar thing could be ideal for meno symptoms. DG x

[andius]

My struggles with HRT made me wish for a hysterectomy at times.

After 5 years since my periods stopped, I think I have now reached a level of comfort.  Natural progesterone was a big problem for me. Even with a 1mg estrogen patch, the continuous progesterone at 100mg caused constant bladder/urethral burning and occult blood in urine. It also burned my vulva when urinating.  Going off HRT I would improve for several months, then low estrogen symptoms kicked in and vagifem alone was not able to keep VA in check. Hot flashes were mildly there, but the VA was much worse. Back on HRT, I would be fine until the progesterone levels built up (about a mo), then the unremitting bladder burning began. It took a while to realize it was the progesterone....almost 2 yrs!!

I am now on the US version of what I think is Evorel Conti in UK.  In the past, I could never tolerate BCPs due to the PMT with norethisterone/norethindrone which made me depressed, fat, etc.  I tried the COMBIPATCH (US version) with trepidation, expecting issues and have found none to my surprise after 2 1/2 mo!! The combined tablets did not work for me.  I had hot flashes every night and persistent VA even combined with vagifem after a 3 mo trial but NO bladder pain.  I researched the blood levels of estrogen and NE in the two available combined patches in US and found that the highest blood levels for estrogen and lowest NE levels are with the combipatch 50/.14 dose and my doctor agreed to prescribe it. Since the NE dose is lower in this one (the other one has .25 NE), there is some propensity for spotting but I have had none of that.  The patch sticks very well and I change it twice a week.  I have tried it on stomach and hip/buttock, the later of which gives slightly higher blood levels.  I like the hip/buttock application better as I think the levels seem more even as I get closer to patch change day.  I also leave old patch on for about 6 hrs after applying new patch before removing it.  So far I have still been using vagifem also, but I may start to taper off it as it does irritate my parts mildly the day after using it. I also tried 1/2 combipatch with the vagifem and it wasn't enough to keep VA symptoms away.

If you haven't tried this after being post-menopausal for a while, I suggest you give it a go....as I am very glad I did so far.  It might just work : )

Andius

[honeybun]

My Evorel Conti patch made me feel very flat, little enthusiasm for anything much. I also was pretty bad tempered off and on.  Since I have gone down to a half patch my mood has improved.
I suspect at 55 (just) I am post meno. My period had been absent for seven months for the second time before I started HRT and I was 49 then.

I feel as if the half patch plus Vagifem just keeps things ticking over.

Andius is right...what have you got to loose because it really sounds as if Utrogestan is far too strong for you and despite chocolate cake    the side effects are debilitating. I know they were for me and I decided I was way too old for period cramps.

Honeybun
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[Dancinggirl]

Thank you andius and HB - very interesting feedback.  As you both may remember, I have suffered badly with burning urethra.  Vagifem aggravated the burning and I used the Estring for a few months when not on systemic HRT with some success - however I did get a couple of bouts of thrush which was very unpleasant. I think one can be more prone to thrush when having lots of flushes - naturally much more hot and sweaty around that area!!!
Since being on the Oestrogel and even when taking the Utrogestan, the burn gin has gradually improved - I haven't had this discomfort for some time now so I think the oestrogen is doing it's job. I wouldn't use Utro vaginally in case that aggravated things again.
When I was young and on BCP I tolerated this very well.  After having my babies they put me on the newer type of BCP and it made me feel really ill !!!!  I think the older types suited me better or I was already going into peri meno!!!!

I did try patches back in my 40s and found them far too strong(I felt really spaced out and sweaty on them) - I know I could cut them up but it seems strange to me that they don't come in different strengths.
For me it's the idea of using progesterone continually that is the issue - particularly if they are synthetic - because I've had such bad experiences with PMT, headaches and fatigue.  I do feel OK on Utro - it's just these wretched cramps and erratic bleeding.  DG x

[andius]

fwiw.....i am almost 60 and my baseline estradiol level is 5 pg/ml or  18.35 pmol/L and that is while using vagifem but no systemic HRT for 5 mo. My progesterone level is less than the tests can pick up without HRT, so the lowest level they can test for is always reported. No woman on either side of my family has ever had breast cancer or endometrial cancer whether they took HRT or not, so this may be a genetic type thing. All have lived past 80 for at least 2 and some for 3 generations back (the ones I know of) and mostly died from strokes.

If your baseline estradiol or progesterone levels are higher, then I think that might dictate what hormones and what doses you might be able to tolerate.....of course, you would probably have to go off hormones for a while to get the baseline levels done. Some women never develop VA, and I think this means they must have higher natural levels of estrogen or their receptors (for estrogen) down below are maybe less sensitive to depletion?

In my case, since my baseline estrogen is low in full menopause, I think the natural progesterone that is currently available to take other than the creams is just too strong for me or builds up too high in my system.  Most doctors fail to feel confident that creams or low doses of progesterone (less than 100,200mg) are protective for the endometrium without exhaustive studies or protocols saying so, of which there are NONE. As the lower urinary tract forms with the vagina in an embryo, estrogen depletion can affect both as we ladies know too well. I think the progesterone may have actually blocked the effect (in myself) of the estrogen I was taking, if that makes any sense.  Why the norethindrone/norethisterone doesn't do the same thing....I have no clue. except that it is not the natural kind of progesterone.

[Dancinggirl]

I will be 60 in 6 months time, Ahhhh!!!!!
Very interesting andius - I had a premature meno and I think my hormone levels without HRT are very low.  I developed VA and the burning urethra in my mid 40s when I was on HRT - I was on quite a low dose and I think it wasn't enough to keep everything plumped up in this area.
I continued using some Vagifem when I started with my current systemic HRT but it still tends to irritate so I've stopped using it now - urethra really much better and sex is definitely better - so happy hubby.
Naturally I don't want to disrupt all the benefits - I'm hoping I can find a good compromise that I can sustain for a few years yet.
I think we tend to get really excited about the notion that Utrogestan is natural and potentially safer but it clearly is not always ideal. As we keep saying, "we are all different".  DG x

[honeybun]

Utrogestan has been said to be....on this forum anyway ...by some ...to be the best that you can use.

Unfortunately this is not always the case at all. It was originally used for fertility treatement and now there is a crossover to HRT.

Most of us at one time in our lives have been on the pill for birth control reasons.

Synthetic progesterone.....did we question it....well I know I didn't.

Maybe we should just open our minds to whatever preparation works best and stop getting over enthusiastic and perhaps unrealistic over bio identical and use whatever suits is best.


Honeybun
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