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[EmmaHG]

Hi all,

So glad to have found this forum. I'm 40 and have known I've had PCOS since I was 15. In that time I've had 2 children through infertility treatment and 3 miscarriages. I've always been low in progesterone and have suffered for years on and off with hormone problems. I have been considered peri menopausal for a number of years.

Amongst my myriad of complaints i also get really bad headaches everyday, sometimes worse than others and usual accompanied by chronic muscle pain in my neck. The gyny suggested that this could be lack of pregastarone and has recommended started bio-identical hormones.  I agreed but now I'm
not sure. I'm not big on taking meds.

She has prescribed pregastan 100mg vaginally once a day except when I have my period. Progestel rubbed on breast twice a week and estraiol 0.5mg vaginally twice a week.

I'm an expat in a foreign country and this gyny is the only one that prescribes bio-identical hormones. Does this prescription sound right to you?  I don't know.

I'm also concerned about the estriol and wonder if i need it as I have no vaginal dryness etc..

Sorry if this isn't the right thread to put this in but I wasn't sure where to put it.

Feeling quite low and confused about it all.

Em

[Cazikins]

 
A big welcome to the forum EmmaHG,

Sorry I can't help with your query but there are plenty of very knowledgeable ladies on here who will no doubt drop by later this evening to help you out.

And you can start a topic wherever you like but NEW MEMBERS is probably the best place till you have got a few answers 

Cazikins

[Hurdity]

Hi EmmaHG

 

Which country are you in? That does sound like a bit weird combo I must say - but then most of us on here are in UK with members also scattered across the globe - from US, Oz, NZ mainly but some other countries too including English speaking expats!

The thing about bio-identical hormones is that in most English speaking countries ( mentioned above) they are available through NHS or regular doctors. You do not have to have them from expensive compounding pharmacies.

I can't imagine rubbing progesterone cream on your breasts - this would not be prescribed here! What are your periods doing - really sorry but I don't know anything about PCOS so would have to look it up. If you have a thickened womb lining then progesterone can be prescribed to thin it but it would usually be taken as a capsule orally or vaginally (known as Utrogestan in UK/Aus and Prometrium in US).

Also re the estriol? Yes this would be local oestrogen to help with vaginal atrophy or dryness/irritation down there, combined with bladder problems. if you don't have this at all then I'm not sure why it has been prescribed.

Sorry I can't really help in detail.

Hurdity x

[EmmaHG]

Thanks so much for both your responses, I really appreciate it.

Essentially PCOS means im estrogen dominant, always have been. I was put on synthetic progesterone about 2 years ago because my periods had stopped. I came off it after 6 months and although my periods came back apparantely I don't ovulate.

The progesterone for my breasts is a gel,  I thought it was a bit weird to suggest putting it there! Where do others topically apply theirs?

I am so confused, I feel like I've wandered into another world I don't understand! I'm back in the UK for a week in a couple of weeks, when you say you get bio-identical hormones o the NHS is that through a GP?  I could book in and see one while I'm there.

Em

[Dancinggirl]

EmmaHG - Where do you live most of the time?  Are you registered with a UK GP?
Here in the UK most of the oestrogen's available these days on prescription are bio identical.  Bio identical progesterone is also becoming a popular type of progesterone in most of Europe. There are many types of progesterone available because we all respond differently to the various types - bio identical progesterone doesn't suit every women - I found it very problematic. It is thought that bio identical progesterone is slightly safer but it can bring more side effects than other synthetic progesterones - it is trial and error.  You say you had a synthetic progesterone for 2 years - did you feel OK on this? 
A UK GP is unlikely to prescribe HRT without investigations. If you are only here for a week then you could make a private appointment with a UK gynae who specialises in the meno for better advice .
The idea of being 'oestrogen dominant' tends to come from the 'alternative therapy' world and is a simple way of describing what tends to happen in the peri meno phase when ovulation is sporadic.  Some women, like yourself, do get hormonal problems from a young age and this is usually treated with regular hormonal treatment.
Not sure whether one gets periods without ovulation though? Maybe your lining builds up and spontaneously sheds - either way, things can be controlled and regulated with proper hormonal treatment. Hurdity would understand this better as she is a biologist.

I agree with Hurdity - she is very knowledgable about bio identicals.  The treatment you have been offered sounds very unusual and I suspect is what is often termed as ‘compounded' bio identical hormones. Here in the UK many are very sceptical about this type of HRT treatment as it is not regulated, so could potentially have more risks.  Having said this, you say you are seeing a qualified gynaecologist and I assume you will be regularly monitored and scanned?

If I were you I would be seeking another opinion - see a gynae to reassess your hormonal needs - blood tests etc done to fully assess the situation and probably a more standard HRT regime put in place to prevent oestrogen deficiency.  The headaches etc could well be due to oestrogen deficiency.  Oestrogel or oestrogen patches with Utrogestan(Prometrium) alongside would be a good HRT regime to try.
Please don't rub anything hormonal on your breasts 

Do read up all the info on this site - look under TREATMENTS at the top of this page to get clued up about all the HRT options available and seek advice from another gynae before doing anything. DG x

[EmmaHG]

Hi,

Bizarrely she said to run the progesterone gel in to breasts to stop breast cancer.... not really sure what she was going on about!

I'm in Qatar most of the time but do travel back to the uk in school holidays. I still pay national insurance so I think I could still see my GP. If I can't where would I get a recommendation for a private appt from?

I saw my GP yesterday and she said that maybe I should just try the progesterone suppository is like the one prescribed in the UK utrogestan. Given that my chief complaint is headaches that can't be made better with anything else and believe me I've tried and I have a history of progesterone deficiency she is suggesting just try the 100mg progesterone and see if it helps and forget about the rest for now.

I'm so confused 😩😩😩

Em x
 

[Dancinggirl]

I still think you need a proper assessment. Getting an appointment to see a GP in the UK is not easy - it can take up to 3 weeks to get a appointment. There some good private gynaes e.g. Nick Panay or Prof Studd - both London based.
I used to go to a menopause clinic run at the Amarant Centre when I lived in London but I don't know if it is still running this type of clinic now - worth looking into this though.
To have a proper specialist look at your needs would be advice able - you seem to have been told some strange things over the years and the treatment you were offered by that gynae is very odd!!!!
If headaches are your main issue then progesterone may not help this.  However if you are menopausal and low in oestrogen then this could cause headaches and it could be oestrogen you need most, with some progesterone for a few days each month.  Without a proper assessment of your needs this would be difficult to tell.
DG x

[Hurdity]

OO-er - I would suggest that adding progesterone is more likely to give you headaches not less. Yes progesterone is decreased during peri-menopause but that is due to lack of ovulation. It is not thought that lack of progesterone (from ovulation) will give rise to any adverse menopausal symptoms other than possible thickening of the womb lining. Many gynaecologists suggest that headaches can be caused by low oestrogen - as Dancgingril says - and even testosterone.

And - I agree I would not put any hormones onto my breasts. There is some evidence that some progestogens may be associated with increased risk of breast cancer - although not necessarily natural (bio-identical) progesterone.

I would definitely try to get a proper conventional assessment as per NHS UK if you can!

Hurdity x