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[Tindia]

Hello everyone, have been a long term reader and have learnt so much and taken comfort over the past few years by knowing Im not going crazy and what I was experiencing was real. Im 48, have been severely sensitive to progesterone and for that reason have put off taking HRT, however I begun oestrogel and Utrogestan 14 days ago as was hoping that bio and vaginal route would be a different experience from the pill and Mirena misery of my past. I am taking one pump of gel in the morning and felt good for 5 days, when I added the 100mg Utrogestan on day 15 of my cycle it took 4 days before I was having rage, irritability, sweats, massive adrenaline whooshes and could basically cry all day. I was on night 10 of 12 and couldn't face it so stopped last night.
I wondered if someone could explain what the 7 day cycle often advised by Proff Studd entails and if its safe for everyone? I am also confused about the 'take 7 days Utrogestan on the first day of the calendar month' aspect and wondered whether I could now just keep on the gel until March 1st and then give myself 7 days of progesterone and if this would be a solution to the emotional and physical side effects which are making me so tired and panicky again?
Hope that makes sense? thank you all in advance

[Hurdity]

Hi Tindia

 

Sorry to hear you are progesterone intolerant. The 7 day regime is the minimum prescribed by Prof Studd for women such as yourself who are his patients and under supervision only. It is not sufficient to ensure the endometrial lining is completely shed during each cycle for all women so should not be attempted unless you are seeing a specialist gynaecologist. If you are in UK please ask for a referral to a menopause clinic so that you can have this specialist help.

With a low dose of oestrogen, 7 days of vaginal utrogestan may well be sufficient but you can't assume this - not least because women vary enormously in how much oestrogen they absorb into the bloodstream from the gel, and on other factors including their own womb eg the presence of small fibroids etc.

Whereabouts are you in menopause and what have your periods been doing over the past year or so? What are the symptoms you are hoping to relieve? Women who are ovulating regularly seem to be able to get away with less progesterone because they are producing quite a lot of thier own - so for women prescribed oestrogen for depression/pms it might not be such an issue.

The universally recommended safe dose is the licensed one - but this is taken orally (ie 12 days per 28 days) and does not vary with the oestrogen dose so to a certain extent its guesswork and even so may not ensure complete shedding on high doses of oestrogen.

Please go along and get specialist help rathere than do your own thing at this point. The women who take it for 7 days are mostly under Prof Studd and have regular scans.

Hurdity x

[Tindia]

Thank you for your reply and advice. I think im about 6 years in to perimeno: still having heavy irregular periods and have recently had polyps removed. My  reason for going on to hrt was for help with low mood, crying, feelings of dread, etc and physical symptoms after ovulation, mostly dizziness, sweats, fatigue and horrible adrenaline rushes that leave me panicked. In fact these are exactly the symptoms Ive had (but worse) over the last 5 days of the 12 days of utrogestan.
Was hoping for relief but am feeling dissapointed, tired and confused!
I suppose im just trying to assess whether to give it another cycle or accept defeat on the progesterone front, or to give myself the shortest possible time to suffer the irritability and depressed mood. I refer to Proff Studd because he seems to give this a generic dose on his website and I have read his patients discussions and most say he suggests 7 days only.
I will ask for a referral to a meno clinic when I go back to the gp for the 2 month review in March. I feel more human and less isolated knowing there are others struggling and succeeding out there, thanks again

[Kate50]

Hi Tindia
You are having exactly the same re action as me on Progesterone.  I started having the palps bf I took any hrt and went on it to stop them.  What I found was with just the oestrogen they stopped if it was enough and then if I tried to take progesterone they started again. I tried 3 different types of progesterone in pills and patches and all did the same. Went to see Professor Studd yesterday after being on oestrogen only since September he didn't seem too worried and he said 2 pumps at least to start as my bloods showed the oestrogen had been taking wasn't working but I knew that!  I've got to take another 2 months of oestrogel bf taking progesterone and then only 7 days. Hurdity is right about getting checked out as I have not had bleeding or any problems internally.  Hurdity what are the scans you refer to I just had a small internal which surprised me and I actually think I will still ask my GP for a full one at our local hospital.

[Hurdity]

Tindia - it's tricky if you are having heavy bleeding and don't get on with the Mirena and are progesterone intolerant. The thing is if you add in extra oestrogen for the symptoms, without the progesterone they can be even heavier - depending on whethet you are ovulating and producing a normal amount of progesterone. It is all so unpredictable in peri-menopause.

You might want to consider one of the treatments for bleeding such as an ablation - which I think means you can take less progesterone although you do still need it.
http://www.menopausematters.co.uk/periodtreatments.php

The patients who go to Prof Studd will be able to ask for scans as needed but anyone who decides to do this regime for themselves ( 7 days progesterone only) could be risking endometrial thickening. If you can I would try to take it for 10 days - how much oestrogen are you adding in with the gel - and then ask for a referral if you are still finding it difficult. Are you feeling this even with the vaginal route of utrogestan?

Kate50 - scans can either be external ultrasound on the surface of your abdomen ( like when you're pregnant) or more accurately a transvaginal scan -  a probe thing is instered into your vagina and takes u/s measurements of the uterus thickness from the inside. That can also give a view of the inside of the womb and see if there appear to be any abnormalities. If there is anything suspicious then a hysteroscopy would be ordered where a probe and camera goes into the uterus through the cervix. Sounds like you had the right thing there! Hopefully you will get a report back about thickness etc - well you should ask for it anyway as you paid for it presumably!

Hurdity x