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[Jooju2004]

Hello
I'm new to all this! I like to think I'm the 'Queen of Googling' lol but for some reason this topic sees me failing! The more I google a symptom,the more confused I get!
So ... My story is basically that I've just turned 42, about 4 months ago I went to my GP and convinced her I wasn't 'just depressed' and to test my hormones as I thought (thanks to google of course!) that I might be perimenopausal. Turns out my hormone levels were so low I should be post menopausal, although I still get a light bleed. So, she started me off on Prempaq-C. Dear god that stuff has some side effects!! 6 weeks later I armed myself with more info and she happily switched me to Evorel 50 with Utrogestan 200mg for 12 days a month. I LOVE IT! I sleep, I'm not moody, my joints don't ache and I'm like a normal person! No side effects other than giant lumpy sore boobs  and some ankle swelling the first 2 months but better so far this month (month 3).
My only issue is I don't think my dose is quite right and I can't work out what I need to do to sort it ... And I know my GP won't know either so will go with what I (you!) suggest!
I am still having a bleed but it's timed to my original cycle, pretty much 2 days before the progesterone phase starts... It's a bit heavier than it used to be but still 'light' by most people's standards. So far I haven't had a bleed after the progesterone stage... Although I feel a bit like I'm going to.
The other issue this month is for the last 2 days of progesterone and 2 days since I've been coughing and I think getting reflux... Particularly at night. I already take omeprazole (looking back this started when the peri symptoms started) but it doesn't touch it. Obviously I have now decided I have some terrible disease Does this mean I'm taking too much progesterone or too little estrogen do you think? I'm not sure if I should be shortening the number of progesterone days or reducing the dose or some other fine-tuning?
The one thing I don't want to do is swap to a different HRT ... I really want to make this one work as it is so nice compared to Prempaq-C!
I would be so grateful if anyone has any advice ... I really don't have any peers with any experience of this, my mum died a couple of years ago and I'm all out when it comes to knowing any menopause experts lol!
This forum is amazing ... So supportive and friendly and so much shared knowledge! Makes me feel a lot less lost while I try to get my head round this! Xx

[Dancinggirl]

Jooju2004 - Hi and welcome to MM
The regime you are using is great but when in the peri meno stage all HRT types can take time to settle. Utrogestan isn't as strong as the synthetic progesterones so is not as good at controlling the cycle.  You may be one of those that needs to use Utro vaginally !!!?? It delivers the progesterone more directly so controls things better.  The vaginal route is recommended in other countries though, strangely, not licensed to be used in this way in the UK. Using Utro vaginally would reduce the problems of reflux as well.
You would also have the option of having a Mirena fitted as, though it has a synthetic progesterone, it delivers the progesterone more locally so will reduce side effects and the other benefit of the Mirena is it often results in no bleeding at all after the first 3-6 months and you can use as little or as much oestrogen as you wish!!!
It isn't wise to alter the amount of days or strength of the Utro as this could resulting the womb lining building up with erratic and problematic bleeding emerging - I had this and it's a real nuisance.
Hopefully Hurdity and others who use Utro vaginally will be along with advice as I think this could be the answer to your problems. Dg x

[Kathleen]

Hello Jooju2004.

I am not one of the expert ladies but I did want to welcome you to the forum.

I know you'll find all the help and support you need here on MM.


Take care.

K.

[Jooju2004]

Thank you both for the welcome ... It's so lovely to know that this community is here - I can't believe what a complex subject it is considering we all go through it!
Eek Dancinggirl!!  I was kind of hoping to avoid the vaginal route lol ... But worth a shot I guess?!
I thought though that the vaginal route would mean I got a bigger dose as it's not being digested ... And my concern is that I'm getting a bit much of it? ... The last 2 days of the progesterone stage sees my chest tighten, sleep quality reduce, stress/anxiety  increase, ability to hold my wee severely compromised (!!!) plus the reflux (continuing for 2 days after the progesterone phase, so far).

Or... Am I just overthinking be everything and should I give it a few more months to just see what happens ... ?!sorry for the many questions ... I think I just want someone to tell me to stick doing what I'm doing and not mess with it lol ...it has so many positives I'm scared to change! Xx

[Taz2]

Hi Jooju

Taz x 

[Dancinggirl]

Jooju2004 - my suggestions about using Utro vaginally is to actually reduce the problems you are getting. As the Utro would be absorbed more locally, the 200mg dose would help to control the bleeds better - also, fewer mood and sleep problems because less will be absorbed systemically and because it isn't going through stomach it won't cause the reflux. If you are having incontinence problems then this should be dealt with at a special urinary clinic where they will teach you how to do the pelvic exercises - do talk to your GP or a practise nurse about this.
The reflux could be to do a with a hiatus hernia so I'd discuss this with your GP - sleeping propped up and taking anti acids at bedtime can help but you wouldn't be able to take the Utrogestan orally at the same time - hence using Utro vaginally as a better option. It's all trial and error I'm afraid but HRT cannot cure everything and there will always be compromises. It's about finding a balance to get as many benefits as possible with minimal negative side effects. Dg x

[Mary G]

Jooju2004, welcome to MM!

I use the oestrogen gel and take 100mg of Utrogestan vaginally for 7 days each month.  I can't take any more than that because I am severely progesterone intolerant but I've had uterine scans which confirm that I can safely take that amount.

I have found that all synthetic progestins and Utrogestan taken orally always give me digestive problems and swollen, painful breasts.  It is better to use it vaginally if you can because it works better (about 50% gets lost in your digestive system when you take it orally) and it has fewer side effects when used in that way.

Hope that helps.

[Lizab]

Hi Jujoo2004! I'm going to have to find the link to the info that supports this, but I think first you should try to get your hrt in line with your period by starting the next course of Utrogestan 14 days after the day your period starts. I think by what you've said that'll put you about 2 weeks longer on only the patches for one round, but hopefully that one time shift will line you up. I'll be back with a link about that.

Also, I had a little reflux my first couple months on it. I now follow mine with a whole glass of water and sit up for about 15 minutes before lying down. I'm not sure if that helped or the reflux subsided on its own, but it went away.

Oh, and I'm on the American version of the same hrt 

Ok, here is the link with some info on timing the progesterone. I think with a little tuning you can line it up with your natural cycle.

http://www.cemcor.ubc.ca/resources/cyclic-progesterone-therapy

[Hurdity]

Hi Jooju2004

 

What I'm puzzled about is, if you are still having regular periods (before you stared HRT - were you?), why you didn't time the start of HRT to fit in with your cycle so that the bleed would coincide? This is normally done by counting the first day of the bleed as Day 1 - start to take oestrogen only, and then on the last 12 days of the cycle ie Days 17 -28 - you would add the utrogestan. This should sync your cycle approximately until it started going haywire as you got further into peri - might need a couple of days adjustment here or there. It's also fine to take a day or two more or less some months to try and sync it as long as it is not consistently less.

As Dancinggirl says there are fewer side effects from vaginal use but this is not to everyone's taste and especially at your young age  - if you have a partner and hopefully an active sex life. However with your stomach problems you probably aren't absorbing it as well as you might - although if you are still ovulating you will be producing your own progesterone anyway.

Sorry I can't be of more help.

Hurdity x

[Jooju2004]

Thank you everyone... You all talk so much sense
As for why I didn't work out my cycle from the start ... I suddenly feel really dumb for not thinking of this LOL! By the time I had my hormones tested I wasn't in the best state of mind and I wasn't really doing much thinking at all!   ... But Hurdity you're right - I was still pretty regular... Ovaries working, brain cells, not so much!!
I think I'll try to sync for next month and see what happens!
What I'm getting too is that I should probably give it a bit longer before I change route/type ... As overall I honestly can't say enough how amazing I feel compared to before! Who knew that hormones could be the make or break of me!
The first couple of months I had really bad hip pain and that's almost completely gone now so I guess if I see what happens with the reflux next time and maybe try 'the alternative route' after that if I still get it. Meanwhile I will deffo try the 'glass of water and sitting up' trick too - thank you!
I'm off to do sums and work out when to start my next progesterone
Thank you all so much for the advice ... Honestly can't thank you enough! Xx
(PS no incontinence ... Thank the Lord! I was finding myself needing the loo a LOT before I started HRT but now I even go through the night ... (Proud moment!!!) ... Apart from at end of progesterone phase