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[Dediva Ann]

Ladies I'd love your advice / wisdom / experience.  I was on Elleste Duet for three months and apart from a wonderful boost in only the very first two weeks (and never since) didn't get on with it - terrible digestion problems in particular. Was then switched to Femoston 1mg which seemed to have zero benefit but also no ill effects. So after 3 months on that my GP changed it to Femoston 2mg which so far has caused terrible breast tenderness, often inverted nipples, migraine type headaches and constipation. Am still getting occasional hot flushes, crashing fatigue in the afternoon (with no choice but to nap) crazy mood swings, plus low energy and no libido. Have just finished the first month.  GP has kindly let me try Estrogel and Utrogestan and I can switch tomorrow (she says it's my choice.) Do you think I have given Femoston 2mg a fair trial after one month or should I persevere with it? It feels like such a big decision! Most of all I would love some energy and my libido back! (Really hoping I might be able to try Testem if I still get no joy with the latter but that's for another post...)

Also is there less risk with the Estrogel / Utrogestan combination? I am concerned about breast cancer and especially stroke risk.

And finally if I do switch is my understanding correct that I use 4 pumps of the gel daily on my inner thighs?! And one Utrogestan intravaginally for the first 21 days? Do you do this at the same time of day as using the gel? And do you still use it if you're bleeding? (I am expecting to bleed next week.) And presumably you use the Estrogel for all 28 days but the Utrogestan for just the first 21 days?

I need to decide whether to switch and if now is the right time to do so (and will factor in if it will be lower risk) and then if I do decide to go for it to understand HOW to use it. I usually take my HRT at 8.30am so if I can't make my mind up by that time tomorrow I'll be stuck on Femoston 2mg for another month!

I am 49 and have been perimenopausal for about a year and am still having reasonably regular periods (though skipped some pre HRT.)

Look forward to any help you can offer.  Thank you.

[clare663]

Hi Dediva Ann. I started on 2 pumps a day after coming off from Everol conti patches as they were no longer stopping my hot flushes. 4 is pretty high to start with. I know pretty quickly if a form of HRT suits me or not ansd have only got worse the longer I have stayed on it! I dont think there is any higher risk of using this form of HRT but someone may come along with some evidence that it is or not!I tend to use the gel in the morning and the utrogestan virginally in the evening at bed time so it stays in. Are you peri or post menopausal? If post, you use the utrogestan from day 1-25. Not sure on the peri but there is a thread called estrogel /utrogestan support which is purely about this form of HRT. Good luck though!

[Dancinggirl]

Dediva Ann
Please don't start on such high dose!!!   I would start with 2 pumps per day.  Here is the link about how to use Utrogestan on a sequential regime:  http://www.menopausematters.co.uk/to_progestogens.php
Many women use the Utrogestan vaginally with success but you should use 2 capsules each day for the 12 days to ensure you get a proper bleed.  As you get deeper into menopause you may be able to use just one capsule daily for the 12 days each month.
I would wait till after your bleed if you do start the Gel + Utro regime - you would start with 2 weeks of just Oestrogel and the Utro needs to be used just before bed at night as it can make you feel sedated.
You will experience tender breasts and headaches with any HRT regime but it's about allowing the body to settle over 3-6 months. Energy and libido may return once you have given any regime time to do it's magic - nothing will be instant.
You might like to give the Femoston 2/10 another month just to see if things settle more?  DG x

[Dediva Ann]

Thanks so much for your words of wisdom clare663 and Dancinggirl and the very helpful link I am going to go with what you said DG and stick with the Femoston 2 /10 for one more month.  As it turned out I have been given the wrong Utrogestan (apparently what I have is for IVF!) so it's lucky I got to speak to the GP just before the weekend and she caught this in time!  She is the GP who is really in charge of my HRT but when I was really struggling on the Femoston 2 / 10 she was on leave so I spoke to a different GP and rather pestered for the Gel + Utro regime. However now the other GP is back she said although it is up to me she wouldn't be happy to put her name as the clinician to it as she doesn't currently know enough about it and has reservations on its efficacy and because of it not being proven to build up adequate endometrial lining (paraphrasing her here.)
Whichever way I can't start anything new tomorrow anyway now so by default, by what DG said and also what the doctor said I'll stick with Femoston 2 / 10 for at least one more month and will then have an HRT review with her.  She kindly said she'll read up some more on the Gel + Utro in the meantime, as will I on here, and she also wants me to think about having a Mirena coil fitted.  My instant response to that is 'NO' (never had anything like that before!) but I will do her the justice of reading up some more on it and maybe it could be the HRT for me.

Totally with you on having to be more patient DG! It's just I never really had a sex life until I was 46 (having been a full time carer until then) and it was so short lived.  So much catching up to do but just not feeling it now.  Everything crossed we'll get there!

Thank you both so much for replying.  The support on this site is invaluable X

[Dancinggirl]

Hi again Dediva Ann
I think that Utrogestan in the capsule form is the same whether used for IVF or HRT use - it is usually under micronised progesterone in their prescribing book and not necessarily under HRT preparations so many GPs can't find it!!!!.  You would need to print off the info from this site for the GP to look at as it explains everything really well.

I think you are wise to keep with Femoston for now - it can take at least 3 months to do it's magic - chopping and changing regimes can actually cause more problems in my experience.

Do consider having a Mirena - it does have many advantages - usually bleeding stops altogether over the first few months and it does allow you use as little or as much oestrogen alongside as you need.  Any negative progesterone effects usually subside after the first few weeks and then you don't need to worry about the progesterone fluctuations after that.  You can use oestrogen as pills, patch or gel if you have the Mirena.

As for libido - I think it is a difficult one.  In my experience there are several factors that effect libido and adding in Testosterone can, for some, help with this.  However, I find that keeping healthy, keeping my weight under control, getting enough rest and relaxation are all really helpful.  Our mental state is very important - so feeling good about oneself and actually feeling desirable in the first place is terribly important - you partner needs to make you feel desirable and loved. Lots of extra lubrication for sex is also essential - if it starts to hurt this is a real turn off.

It is trial and error - patience is the key.  DG x

[Dediva Ann]

Thanks so much DG; all very useful food for thought and am following your advice on the HRT.

As for libido - I am feeling dangerously depressed about this today (having caught up on many posts about it this morning) and for the first time ever having really quite painful sex last night (despite lots of lube) and being unable to orgasm, which has never been an issue until the peri, and this was on the only day in the entire month when I felt any desire at all!

I know it's early days for me yet but I was under the impression that once you got the HRT regime right after possibly lots of trial and error, everything would get 'back to normal' and this was the hope which was keeping me going, but it seems this is not the case for many even when the HRT settles their other symptoms? I think I might struggle to get Testosterone from my GP (one partner in the practice has already said an emphatic 'no.')  Your advice about other ways to keep it going is mainly redundant on me: I have lots of ongoing mental health issues and have always used sex (with or without someone else!) as a way to give myself a boost rather than vice versa! I don't have a regular partner and am really reclusive, not looking for a relationship and have never been loved (not an issue.) Although I fully appreciate it may not be acceptable to many of the ladies on here, dictated by a healthy libido at certain times of the month I really enjoyed occasional casual sex; in fact it helped me to manage my depression and was rather a raison d'etre. I absolutely cannot imagine life without it.  I know it sounds extreme but I wouldn't want to be here without it so it's vital to me to find a way to get it back! We'll see I guess.  Once again your input is massively appreciated DG x

[dazned]

I had utrogeston prescribed 200mg per capsule which came with its own applicator,this is what they use for IVF,its exactly the same just only need to use the one so its easier ! 

[Dediva Ann]

Yes Dazned - these have their own applicator. I was impressed as had read on this site about some ladies having difficulty inserting them and thought I'd struck lucky! Have been asked to return them though - I guess because it's the wrong packaging and there are 21 in the box! X

[dazned]

Same as mine ! Pity that it was spotted as this is exactly the same as you will be given just in a different form