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[Liz]

Hi ladies.  Well, I'm 48 (and a half!), been on Oestrogel for a couple of years with Utrogestan on nights 15-26 (although I must admit to cutting short some of the Utro phase as it affects my mood badly - this month I only managed 7 nights).  Herein lies the problem.... the Utrogestan phase makes me feel very low, depressed and sedated.  I take it orally as when I tried it vaginally it irritated my bladder and brought thrush on, also played havoc with any bedroom activities.

Anyway, I don't know what my own cycle is up to, I decided a few days ago that I'd stop the HRT for a while and see what's going on, but I'm not sure this is the sensible thing to do.  Today, whilst driving, I noticed that I felt a bit "jittery" and didn't feel I was as alert and concentrating as well as I usually do - could this be due to the drop in Oestrogen?  I was on a low dose anyway - 1 and a half pumps gel per day.

I'm just dithering.  Part of me wants a break and to see what my own cycle is doing, but I'm afraid that if I come off for a while it will take me several weeks to get my levels back up if the symptoms come back.

Decisions are not my strong point and this feels like a big one, especially when some ladies find it very difficult to get hold of Oestrogel/Utrogestan and I've been lucky enough to be prescribed it.

Can anyone offer any words of wisdom?

Thank you. x

[Ms Saucy]

Hi there.
No words of advice from me I'm afraid. I just have up Oestrogen meds and have only a mirena and feel more alert, brighter and weight is slowly reducing .
Hugs
Ms Saucy x

[walking the dog]

Sorry to hijack thread glad to hear weight loss with mirena ms saucy and that you feel good on it I had one fitted Tue and been worried about weight gain and if it would make my mood worse xx

[Tinkerbell]

Walkingthedog...I have had no weight gain or mood swings with the Mirena.....in fact I am the only one in my house who isn't moody or grumpy 

[walking the dog]

Great to hear tinker bell 😊

[Tinkerbell]

I would imagine it wouldn't be a problem getting your prescription reinstated if you wanted to go back on it again.
Are you against having a Mirena fitted?

[Hurdity]

Hi Liz

What was you cycle doing when you started HRT -do you think you were in early (skipping the odd period but still getting them fairly regularly) or late peri ( periods few and far between - going several months between them)? If the later for example  you could well be post-menopausal by now. If the former - you may be in the late transition.

Do you really need to know what your cycle is doing? If you are feeling generally well (apart from on the prog phase) then at your relatively young age I don't see the need to stop - you need the oestrogen and as you say you are on less than the standard dose of 2 pumps! Do you take 200 mg Utrogestan? I have never taken it orally but I know this dose causes side effects for some women.  Also is it for the whole of the Utro phase that you feel bad? I tend to be OK (if a bit sleepy and foggy headed) for the first five days or so and then these symptoms get worse later on and sometimes get migraine. However because I am on a long cycle I can cope with this - as it's really only a  few days every few weeks that I feel rough from the progesterone.

Could you go back to your GP and discuss taking it (200 mg Utro) on a slightly longer cycle (you would then soon know if your cycle was still apparent as you would get bleeding at the "wrong" time!) or for slightly fewer days per month - or a mixture of both - say 10 days per calendar month. Although this would be slightly less than the recommended dose, it should still give good endometrial protection especially as you dose of oestrogen is not high and if you are post-meno or heading that way. You might be able to persuade your doc to scan your uterus after 12 months to check that all is well on this regime.

Hope this helps

Hurdity x

[Liz]

Thank you Hurdity! Just popped on to see if anyone had replied and there you were!  I'm not sure exactly where I am - when I started the HRT I hadn't skipped any periods, but my cycles were becoming shorter and I had a couple of cycles that were only two weeks apart, I had always been quite regular before.  My main symptoms were general sweating, low mood, sensitivity to noise and after I lost my Dad (traumatically), my GP seems to think it pushed me into the perimenopause.  This was about 3 years ago.

I'm starting to wonder if my low dose of gel isn't enough?  Could the fact that I then use 200mg Utro make me "off balance"?

I'm sitting here wondering whether to continue with a plan of a break/stopping or to carry on?  I did experience quite a bit of hair loss before the HRT, which has certainly slowed down, my hair is much better now.  Also, I used to get monthly thrush, which I haven't on HRT (apart from when I tried the Utro vaginally).

I actually have a heavy bleed at the moment (which came after just 7 x 200mg Utro over 7 nights).  I got to the stage where I decided I couldn't face another dose this month.

Thanks for your help.

[Liz]

I have taken regular breaks during my 8 years on HRT Liz.  I think its a good idea to assess how you feel when not taking it.  Of course you do have to accept that if symptoms such as hot flushes return it may take a good few weeks to get your oestrogen levels up again and I do recall sitting dripping in sweat cursing the day I ever stopped, however this may not be the case for you!

What I would say is that at 48 you're still quite young and if you could possibly manage to remain on oestrogen for just a few more years you'd be giving your bones, heart etc a few more years of beneficial protection. I do understand the issues with Utrogestan though!

Thanks Stellajane.  How long do you take breaks for on average?  Do you find your symptoms return pretty quickly after stopping each time?

[Hurdity]

I also had a break from HRT for 3 months because the doc suggested I start conti HRT as I was 58 and had been on cyclical since I started. Well I reacted to the patch so ripped it off in disgust and in a hissy fit decided to stop HRT altogether! Symptoms ( and new ones) came back so 3 months later went back on - to lower dose - but then back up to the same dose as previously because the lower dose only worked for so long.

If your periods had become closer together then you were technically not yet in peri-menopause but in late reproductive stage - when cycles get shorter and hormone changes have begun to occur, but ovaries still working. (http://www.imsociety.org/downloads/email_downloads/2012_02_16_1773491/straw10.pdf).  The progesterone doesn't make you off balance as such - this is needed to protect the endometrium from getting too thick. However if your periods are still regular then some gynaes allow shorter progesterone doses ( eg 7 days) because you may still be producing large amounts of your own from ovulation. On the other hand you may get some endometrial build-up if you don't take enough and don't ovulate some months. As I probably said below large amounts of progesterone taken orally can lead to side effects in some women.

If you are having a heavy bleed on only 1 and a half pumps of oestrogel then this implies to me you still have plenty of your own oestrogen - if your womb is otherwise healthy ie no fibroids or polyps which could cause heavier bleeding than otherwise.

If you did try a long cycle - as I said you would soon know what your own cycle was doing if you carried on bleeding in between months - so say your cycle was 6 weeks long and you bled after 4 weeks without the prog - then your own cycle is still happening regularly. Good idea to chat this over with your doc if s/he is receptive and knows something about HRT?

Hurdity x

[Liz]

Thanks Hurdity - see, this is what concerns me. If I'm not right in the throes yet, perhaps the HRT is not helping things?  Gawd, it's a minefield, isn't it?  Anyway, I've not used the gel for a few days now so if I can stick with this, I think I'll see if I get a period, etc.  Of course, the best laid plans, etc......... if I start feeling rough, I'll be straight back on the gel.
Will bear your suggestion in mind re. the longer cycle etc.

Really appreciate your thoughts and help - thank you. x

[Hurdity]

If you were feeling generally well and better on HRT than off it (apart from the utrogestan) then it is helping and you needn't worry about exactly where you are!

Keep us updated anyway as to how you feel and what happens - and hope you don't feel too rough!

Hurdity x