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[Katia]

Do you think it's the cost of actually getting the licence that is prohibiting these products?  I think if the are manufatured they should be available.  There's lot of new progestegens in the pipeline and our choice in the UK seems so limited.

[Mary G]

Katia, I wish I knew the answer to that because I really don't get it.  I can understand that there are financial constraints within the NHS but so many of these new products are inexpensive so it doesn't make sense.  Could it be the cost of the licence as you suggest or is it that the NHS don't want to have too many different products knocking about? 

I completely agree with you, freedom of choice is the name of the game.  In the context of HRT this is particularly important for progesterone intolerant women to have immediate access to all new HRT preparations that could help them and if these products are manufactured legally and approved by the EMA, then everyone should have the right to use them even if they have to obtain them privately and/or buy it themselves. 

[Katia]

I was just reading about Osphena.  It's a tablet that acts like estrogen in the vagina, but not in the body.  It seems to be available in the US.  Is it available in Spain/Europe too?  It sounds ideal for those of us who are taking estrogen mainly for VA.  Again, it's not available in the UK 

[Mary G]

Katia, Osphena sounds like an interesting product.  I will ask about it and let you know.

[Katia]

It's available in the States.  It came out in 2013.  It does indeed sound interesting.

I have a private prescription for gel, but it's not really working out for me

[Katia]

Mary G, sorry I've just seen your reply. I have some fond memories of good times in Gibraltar.  I'm not entirely progesterone intolerant, it just seems that I only need a tiny bit otherwise I get a rash. At first I thought it was an allergy, but I ink it's the progesterone/progestegen raising the basal body temperature and causing a ****ly heat rash. I'm having a hard time finding one that works for my skin and hair.  They seem to make my hair fall out. I'm also finding estradiol doesn't agree with me too well. Provera made my hair shed, Utrogestan just makes my mood too low and makes me so groggy I cannot function.  I like the P in Angeliq, but the Angeliq dries my vagina and I don't think that P is available on its own.  I'm scared of cerazette mini pill because of Mav's experience with her hair and eyebrows coming out. That leave duavive or dydrogesterone.  Femoston made me feel odd and blow up like a ballon, but I'm not sure if it was because I still had the Utrogestan in my system and estradiol goes too quickly into my system and for some reason I think it causes the burning vagina.  Premarin is much slower released.  I believe dydrogesterone is available in Spain as a stand alone?  I'm wondering whether to give it a go with the Premarin and then I think I only have duavive left. 

[Mary G]

Katia, Duavive is indeed available OTC in Spain and it costs nearly €35.00 so not cheap.  Does anyone know how much it costs with a private prescription in the UK? 

Sorry to hear you are having problems finding the right combination.  I will ask about dydrogesterone and let you know. 

[Katia]

Mary G, please would you enquiry about drosperinone that's in Angeliq too?  I really like that one and it's antiandrogenic  but the estradiol in it is causing me problems. I'm struggling to find something to go with the Premarin. At this point I'm even wondering if utro isn't the lesser of the evils, but it makes me so groggy I can barely function.  My consultant charges £50 for a private prescription and them there would be the product costs, so it would certainly be more in the UK

[Katia]

Mary G, at this point I'm wondering if there much difference between Angeliq and half a Yasmin at least the Yasmin doesn't have estradiol 

[Mary G]

Katia, I will certainly ask about the drosperinone.  The progesterone in Angeliq is well tolerated by many and even I got on better with it than many of them but I am severely intolerant so I'm not a very good example!

£50.00 plus cost of medication is very expensive so buying it yourself in Spain would definitely be a good saving.  Perhaps you could get a significant discount if you just had the consultation and bought it yourself?

[Katia]

Mary G, i e been looking at duavive, the estrogen in it is on the low side.  Do you know if it's possible to take two of them? It's called Duavee in America.

[Mary G]

Katia, I suppose there is nothing stopping you taking 2 Duavive tablets but it would get very expensive.  Hopefully they will come up with different doses as it gains popularity.

[Katia]

Maybe it's possible to add a premarin with it ??

[Mary G]

Katia, the PIL states that you should not add any extra oestrogen in case of womb lining build up but if you do it with the supervision of regular scans, you might be able to do it.

[Katia]

Mary G, I'll ask my consultant about it. We've determined Premarin works.  I'll ask him about duavive.  I did see a study based on a group on 0.425mg and one on 0.625mg so I'm assuming it's ok, or it may be OK to take two?  I'll ask him. It's new so he may have to check into it.