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[Peacegirl]

   I am sorry, my head's full of fog possibly because I've changed hrt a few times. I've had so much great advice on here the past two weeks but have now confused myself with too much info.
I'm seeing the nice GP on Tuesday to discuss where I'm at (I.e am I post memo yet according to blood tests I had) and should I bother seeing the specialist. I have been on femoston conti 1/5 for 3 weeks now but would it be better for me to go the utrogestan, estrogen route? I'm not feeling great on the femoston- I realise it's a low dose but I feel drowsy and like I permanently have a cold virus ( although maybe that just is a cold virus!). I have also been woken in the middle of the night by killer headaches, although I can get back to sleep. Im grateful to be getting more sleep now. Also, I'm very susceptible to all drugs, so although it's a low dose, it may be having a strong effect. Sorry to be askin again, Ive been trawling back through threads but have lost track of what's good progesterone/estrogen wise. I'm also wondering why the ratio of progesterone to estrogen is so different than before as I kind of feel I need more estrogen? I'm going to write all this down at the weekend!

[ancient runner]

An expert will be along in a minute but 3 weeks doesn't sound enough to really know what a particular HRT is doing for you. Unless you've got real problems constantly changing your medication is going to be very confusing and inconclusive. I think I've read on here that you need to give an HRT regime 3 months to know what's going on.
If your Femoston is one which produces a bleed, that's not even a full cycle.

[Hurdity]

Hi Peacegirl - yes it is confusing when you first start reading about it.

First - a blood test cannot be used to determine if you are post-menopausal or not, and anyway if you take HRT it won't give a true reading of your hormone levels anyway, which also vary according to time of day and from day to day - so I suggest you don't have these.

Second you cannot compare the amount of progesterone from one type of HRT to another if they are different types - there is absolutely no comparison. The  doses of synthetic progestogens are much smaller firstly because they are more effective in keeping the womb lining thin and also because they are more stable in the body. Progesterone is unstable and has to be taken in large doses to have an effect (since we can't mimic the ovary which pumps it out continuously when required).

If you are age 54 then it is deemed OK to try continuous combined HRT since 80% of women have reached menopause by this time according to stats. If you are younger and went onto HRT before having 12 months without a period ( when you would be considered post-menopausal), then it's a question of suck it and see ie try out a conti HRT and see if it suppresses bleeding.

Having said that some women do not like the sedating effect of continuous progestogens or some of the side effects and choose to remain on a cycle. I agree 3 weeks is a very short time to give it to work. The dose you are on is low dose and if you are still in you 40's or early 50's you might want to think about a slightly higher dose. It is easier to tweak doses with transdermal HRT ( patch or gel) with separate progestogen, than with tablets.

Your oestrogen level is adequate if flushes and sweats are eliminated, but some women prefer to go higher than the minimum needed to give a better "feel-good" factor. The downside is the higher the oestrogen dose you take, the higher progesterone dose you need to keep thew womb lining thin.

All the HRT preparation are found under treatments/HRT preparations in green banner tabs above.

Hope this helps

Hurdity x

[Peacegirl]

An expert will be along in a minute but 3 weeks doesn't sound enough to really know what a particular HRT is doing for you. Unless you've got real problems constantly changing your medication is going to be very confusing and inconclusive. I think I've read on here that you need to give an HRT regime 3 months to know what's going on.
If your Femoston is one which produces a bleed, that's not even a full cycle.

Hi and thanks, for support. yes I've had some great expert advice on here already but have just got myself confused now! I couldn't have stayed on my previous hrt for 3 months as I was averaging 3 hours sleep a night and sometimes none at all- I was feeling suicidal, a new experience I don't want to repeat. I'm on the continuous femoston and will give it longer but I'd still like to discuss with my GP options for 'better' forms of hrt and/ or if to bother with a specialist. 

[Peacegirl]

Hi Peacegirl - yes it is confusing when you first start reading about it.

First - a blood test cannot be used to determine if you are post-menopausal or not, and anyway if you take HRT it won't give a true reading of your hormone levels anyway, which also vary according to time of day and from day to day - so I suggest you don't have these.

Second you cannot compare the amount of progesterone from one type of HRT to another if they are different types - there is absolutely no comparison. The  doses of synthetic progestogens are much smaller firstly because they are more effective in keeping the womb lining thin and also because they are more stable in the body. Progesterone is unstable and has to be taken in large doses to have an effect (since we can't mimic the ovary which pumps it out continuously when required).

If you are age 54 then it is deemed OK to try continuous combined HRT since 80% of women have reached menopause by this time according to stats. If you are younger and went onto HRT before having 12 months without a period ( when you would be considered post-menopausal), then it's a question of suck it and see ie try out a conti HRT and see if it suppresses bleeding.

Having said that some women do not like the sedating effect of continuous progestogens or some of the side effects and choose to remain on a cycle. I agree 3 weeks is a very short time to give it to work. The dose you are on is low dose and if you are still in you 40's or early 50's you might want to think about a slightly higher dose. It is easier to tweak doses with transdermal HRT ( patch or gel) with separate progestogen, than with tablets.

Your oestrogen level is adequate if flushes and sweats are eliminated, but some women prefer to go higher than the minimum needed to give a better "feel-good" factor. The downside is the higher the oestrogen dose you take, the higher progesterone dose you need to keep thew womb lining thin.

All the HRT preparation are found under treatments/HRT preparations in green banner tabs above.

Hope this helps

Hurdity x

Thanks, I'm getting mild night sweats which I can bear. Something I'm realising is that I've always felt flat in my 7 years on hrt (prempak) but after reading that it aids rather than causes depression I put it down to getting older. Since having fluctuations in hrt, I've felt more highs and lows which has been interesting and which I prefer I think. I am 56 and started hrt when still having periods. I will discuss with GP, perhaps tell him I'll persevere with femoston conti or but may want to discuss trying cyclical or utrogestan and estrogel before consulting any specialists. Thanks I've got it all a bit clearer again now! X

[Mary G]

Peacegirl, I would go ahead with the blood tests because it would be useful to know how much oestrogen you are absorbing and how much you have in your system at the moment.  I found that my levels were far too low when taking Angeliq (oral combined HRT with only 1mg oestrogen) and realised that was why I felt flat and half baked while on that regime.  So it's important to know your level in terms of how much oestrogen you need to aim for in order to feel good. 

I felt like I had low level flu when taking the BCP (Eugynon 30) in my 20s and I also had a constant nasal drip and I have since heard that some women react in this way of synthetic progesterone so that could explain the virus type symptoms.

My advice would be have a good run of 4 weeks on 2 pumps Oestrogel only to see how much better you feel without progesterone and how much your mood lifts.  That way, you can gauge how well the gel is working for you and also decide how much of an effect the progesterone has been having on your moods. 

[Peacegirl]

Quick update - Finally had successful appointment with my amazing GP (after turning up a week too early last week!). He offered me testosterone without me mentioning it and has given me exactly what I wanted. I've persevered (as recommended) with femoston conti 1/5 and I'm doing ok (some headaches and feeling a bit flat and sleepy at times which is tolerable compared to some symptoms I've had previously). Only issue was, that as suspected oestrogen wasn't enough (mild hot flushes returning, itching madly at night, dry 'hanging' skin, joint aches) so I topped it up myself with my leftover evorel 50 patches cut in half. He's also up for my trying anything I want.  I'm feeling very lucky and have decided not to go the specialist route as yet - if it aint broke don't fix it  . I was literally clutching my prescription with glee when I left the surgery.  I didn't go with the testosterone this time but maybe I will try it - though worried about more hair loss as lost a lot on the evorel conti!