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[Ljp]

Hi,
I've been on one and a half to two pumps of oestrogel since December, with Mirena coil for progestogen, and estring for overactive bladder, and urgency.
All has been pretty good most of the time. Anxiety much improved, flushes, gone, bladder better, although urgency is still an issue.

After a chat with my (new) GP, my previous GP retired in May 😩, we decided for me to try without estring to see how things go, she did give me prescription so I have one in case, and also said if I want to try twice weekly vagifem instead, I can call for a prescription.

So I've been without estring for almost two weeks, bladder has been ok (normal issues if I drink coffee etc, or am stressed) but ok I guess. However I have noticed that burning, internal soreness returning after sex again, so today I have put estring back in.

I feel crap to be honest, like why do I need all this stuff? Why can't I just cope without it? Will I EVER cope without it? What risk am I taking using all this? ( oh maybe my anxiety is also returning?  all this overthinking? But surely estring wouldn't have made that much difference?)

There are so many pros and cons, hate how the HRT has made me crave sweet foods and carbohydrates, which has resulted in a 10 pound weight increase, another issue to address!

Just feeling rubbish today, and question if it's all worth it 😟

[babyjane]

Hello, I can't comment on the HRT questions because I don't use it but I do use Vagifem and I know that if I forget one (I use it alternate nights) I know about it the next day so you could well miss the effects of the estring after 2 weeks without it I would think.

Like you I don't really like taking stuff either and I don't take a lot - just Vagifem and a low dose antidepressant and beta blocker.  However my quality of life is better with than without and that's the main thing.  I will never be young again and if I need a bit of help then I have accepted it now but I did fight it a lot at first.

[Dancinggirl]

Ljp - You clearly need the local oestrogen so it's good to use the Estring again. I personally always use some lubricant when having sex - even with systemic and local oestrogen I find the lubrication makes things far more enjoyable and fewer post sex problems.
From the outset you have been very ambivalent towards HRT in general - you felt you were bulldozed into it all - you seem so worried about the possible negatives, whereas, if you concentrated on the positive effects I think you would relax more and enjoy the benefits.  It's a compromise either way - be it with HRT or without  - and the only con you are experiencing is some weight gain which I'm sure you can conquer.
I actually loose weight when on HRT - when I'm off HRT, I'm so tired I tend to eat more, particularly carbs and sugary stuff and I seem to gain round my hips and waist and loose muscle structure everywhere else.  Weight gain is not usually down to HRT (one can feel a bit more bloated on HRT) but I'm afraid it's about eating less overall, as we get older, to help maintain a reasonable weight.
Do try to remind yourself what you felt like before you started the HRT - I do think you are feeling a failure for needing the HRT and this is really not the way to look at it.  Life is short, you probably have family, friends and work that all need you to be on form - don't forget that your bones, heart and bladder will be better in the long term by using HRT now.  You are not alone in needing HRT and there are loads of women out there, not getting on with life, who won't seek help for the meno problems because they feel they should do without HRT.
The risks??? Well if you are over 60 there is a small risk of developing breast cancer, a very small risk of stroke and a very, very small risk of getting ovarian cancer but under 60 the benefits for your health overall far outweigh any risks. So stop thinking about the risks.
It's sounds to me as though you just need to make a concerted effort to get your diet under control and I'm sure you will feel happier. I understand you need to offload your frustration but it sounds to me as though you are doing generally better.
DG xxx

[Ljp]

Thanks babyjane, I was originally just on estriol cream twice weekly, no other HRT, then I had a post meno bleed, which resulted in hysteroscopy, mirena coil to protect uterus, and estring to help bladder etc.

It was suggested I use oestrogel or a patch for systemic help too, but I do question if I could stop the oestrogel at some point, but continue using mirena with estring or vagifem.

It was explained by gynae, that most women don't need progesterone to oppose effects of vsgunal oestrogen, but some women do find using it can cause a slight buil up of uterus lining, resulting in a bleed. She said it could have been a one off, as my lining was thin, however, should I get another bleed, then I would have to have another hysteroscopy, so the mirena, protects from that possibility.

[Ljp]

Thanks DG, you are no doubt right.
I'm probably feeling sorry for myself and lacking confidence in what's too much or not enough when it comes to this HRT lark.
Still unsure if it necessary to have it all, even though it obviously I helping!

New GP hasn't helped, I had a great relationship with my previous one. This new one, said " you have to weigh up quality of life, and helping debilitating symptoms, with possible risk, and of course you would kick yourself for taking HRT in the event that you developed breast cancer'
Not something that helped my anxious mind!

[Dancinggirl]

Ljp  - I have to say I would not be happy to have a Mirena in place without some oestrogen alongside in post meno.  If you were peri meno and still producing some oestrogen yourself then the Mirena alone would possibly be fine.  I had a Mirena post meno and used Oestrogel - when the Mirena came to the end of it's life after 4 years I gradually tapered off the oestrogel till I wasn't using anything except Vagifem and ended up getting truly horrid cramps and had to have the Mirena removed very quickly - I think my womb lining was becoming too atrophied. 
If you really want to do without systemic HRT and just use local oestrogen, then you could possibly just have a course of progesterone as pills for 10-12 days once a year to make sure the lining remains thin.  I suspect the spotting you experienced was possibly a one off or your hormones having a final gasp - I have not heard of any women needing a Mirena with local oestrogen as this is such a low dose.  I do think that by using systemic oestrogen you may experience more improvements with you VA and bladder problems over the next few months -  it can take some time for the full benefits to be felt and local oestrogen is often not sufficient.   If you were getting nasty side effects like headaches, cramps, erratic bleeding or bad PMT, then I'd suggest you have the Mirena removed and try a different route but you have listed so many improvements overall and only sited a bit of weight gain as a negative, I really think you should give things a few more months before making a decision to abandon what you are doing.  Dg x

[Ljp]

Thanks DG

Ljp  - I have to say I would not be happy to have a Mirena in place without some oestrogen alongside in post meno. 

By that, do you mean systemic as well as the estring? As in what I'm currently doing?

I think for me, I want to find lowest dose to control my symptoms, which is why I hoped just the oestrogel might do it, but seems the estring was helping as I had the internal soreness following sex, and I do use astroglide
lubricant, I find it's the best one for me.
So I hope that the one and a half pumps of oestrogel, and the estring, aren't considered a high dose.

Thanks again Ljp xx

[Dancinggirl]

Ljp - sorry if I wasn't clear.  I mean that having the Mirena without the oestrogel might give problems, as the Estring alone possibly wouldn't give enough oestrogen to counter the progesterone in the Mirena. In your case having both the Estring and the Oesrogel is the best option as this will give a far better outcome overall. The Estring is still a very low dose of oestrogen and isn't absorbed systemically so using both systemic and local oestrogen is not increasing any risks.  Unless you are over 60 I really wouldn't worry about any cancer risks - in fact I believe 5 years of systemic HRT in your 50s can actually give better quality of life in the long term and may even give you a longer life as well!
I am hoping that in future women will be encouraged to use HRT for a few years in their 50s to give these long term benefits - it would save the NHS a fortune. There has been so much emphasis on the possible risks and so little info about the benefits it's no wonder that women fear HRT.   
I can't remember how old you are?? or how post meno you are either??  Dg x

[Ljp]

Thanks again DG 😘
I'm 51 and will be two years post meno in August

[saffy123]

Hi Ljp
Was just reading this thread and was wondering if you would be able to let me know how long the estring took to work and how you found it comfort wise. My worst symptoms are bladder related - frequency and burning. Another member has commented how good it has been, so its something I defo plan to try.

And just to say I also hate having to use all this HRT stuff, I'm 42 so it feels so wrong. However I do feel quality of life is so important, no point having a long miserable one! One of the doctors I see also has the ' think about the risks' chat, but as I always say to him, give me a better alternative and I will try it, needless to say he just writes the prescription.
I would say if you have found a combo that works for you, just keep using it xx

[Ljp]

Hi Saffy, thanks for the repmy, horrible all this meno rubbish isn't it!
The estring took effect very quickly, within a week, although I had been using estriol with cream prior to it.
The gynae inserted the first one for me, but I find it easy to remove and reinsert as required (washing it etc)
Comfort wise, I dont even know it's there, no mess unlike with cream or less arise, and really don't think about.
Hope this helps.
The only thing I have found, is I have to be sure to request new one about a week before it expires, as chemist has to order it in xx

[saffy123]

Thank you so much Ljp, you have given me hope. My bladder problems are really getting me down and the ovestin cream hasn't really helped. If this works, I will be so  xx

[Maryjane]

I have to have everything for my VA/bladder also. The Estring / ovestin and sandrena 1mg. I have seen Dr Annie Evans and she said she has many ladies who need the whole lot just for VA I am 49. It really is about quality of life also.

[Dancinggirl]

saffy123 - you are far too young to be without oestrogen - to be oestrogen deficient so young could well bring many long term problems so HRT is actually essential for you. For you, not being HRT would be VERY WRONG.

Ljp - you are also young to be oestrogen deficient.  The average age to enter post meno is between 52-55  so if you have been post meno for 2 years you will be giving yourself some long term protection by having the Mirena and the oestrogen for the next 4-5 years.

These retched GPs  frightening young women about the risks of HRT when in fact the risks of being oestrogen deficient too young are almost worse.   I know someone in my village who went into post meno in her 30s, had HRT for 5 years and was then told to come off HRT in her early 40s and was put onto ADs - when I told my gynae about this he was really concerned to hear GPs were still doing this - he is one of the specialist gynaes giving talks and lectures to GPs about the new menopause treatment guidelines and he is very worried that GPs are taking young women off HRT when they really need to be using it.
Do look at the new guidelines - they put things into better perspective.  DG x

[Ljp]

Thank you Mary Jane, and keep us posted Saffy xx