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[Vikkiod]

Thank goodness for this wonderful forum and the amazing supportive members. I've already learned lots and everyday really is a school day on here.

I am 48 and peri-menopausal. In November 2016 I requested estradot 25mg and utrogestan 200mg after picking up this info from here. Am i right in thinking this is bioidentical HRT? The doc had never prescribed it before but is supportive. After 3 months I have upped the patch to 50mg as I didn't really feel anything on 25.

So...I do love the progesterone & it's sedative effects - if i have it on an empty stomach I literally pass out! I am quite a good sleeper anyway. I think that I do, however, have progesterone withdrawal as I feel terrible for a few days after I've finished taking it which makes me wonder....

if it's possible that I may be taking too much progesterone? I obviously want to take the least amount of hormones in order to feel well. I'm wondering if I should reduce the Utro down to 100? Do you think it makes any difference if we take it orally or vaginally? (I believe it is exactly the same tablets for both methods?).

I am also ridiculously tired at the moment and over the last few days have developed a fuzzy headache. Wondering if maybe this is too much estrogen? I am on day 10 of my cycle. Is 50mg quite a substantial dose? Should I drop it back to 25 along with the reduced Utro?

How do we know if we are on the right does or not? I have spoken to the doctor and they won't test hormones. Does any body have any  private blood tests done & are the results helpful .

Apologies - i feel like I have asked so many questions and maybe I should have started a new topic with each question? I'm sure I will learn!

[Hurdity]

Hi Vikkiod

 

I am 48 and peri-menopausal. In November 2016 I requested estradot 25mg and utrogestan 200mg after picking up this info from here. Am i right in thinking this is bioidentical HRT? The doc had never prescribed it before but is supportive. After 3 months I have upped the patch to 50mg as I didn't really feel anything on 25.

Yes it's bio-identical ie the hormones are the same structure as those made in our own bodies. 25 mcg is a low dose but some women only need a low dose during early peri-menopause. It depends where you are in terms of your cycle - how frequent your periods are and whether they have changed in length/flow etc

So...I do love the progesterone & it's sedative effects - if i have it on an empty stomach I literally pass out! I am quite a good sleeper anyway. I think that I do, however, have progesterone withdrawal as I feel terrible for a few days after I've finished taking it which makes me wonder....

Most women get some form of progesterone withdrawal - as part of their natural menstrual cycle. A component of pms symptoms is progesterone withdrawal. The symptoms pass once the progesterone has left the system and you return to your normal physiology. Utrogestan has to be given at high doses and also oral progesterone creates metabolites which bind to different receptors so when you stop it is a bit like drug withdrawal - a kind of unnatural dependency.

if it's possible that I may be taking too much progesterone? I obviously want to take the least amount of hormones in order to feel well. I'm wondering if I should reduce the Utro down to 100? Do you think it makes any difference if we take it orally or vaginally? (I believe it is exactly the same tablets for both methods?).

This is the licensed dose - but would be quite a lot for 25 mcg oestrogen. Unfortunately the licensed dose is non variable and probably designed for medium dose oestrogen. However if you are peri-menopausal - it depends how often your periods are and whether you are ovulating regularly. If so then you will likely produce a reasonable amount of your own progesterone. If your periods were few and far between then regular doses of progesterone are important to protect the uterus.  yes it makes a difference - vaginal oestrogen goes straight to the uterus  and doesn't produce the same side effects as when taken orally as explained above. Off licence many gynaes prescribe lower amounts for vaginal use but it is important not to experiment without medical supervision to ensure your uterus is protected.

I am also ridiculously tired at the moment and over the last few days have developed a fuzzy headache. Wondering if maybe this is too much estrogen? I am on day 10 of my cycle. Is 50mg quite a substantial dose? Should I drop it back to 25 along with the reduced Utro?

By Day 10 I presume you mean Day 10 of pure oestrogen? Sometimes women get a headache when they first increase the oestrogen dose but this should settle. Many women experience this (fuzzy headache and exhaustion) with the utrogestan! It could also be your cycle coming into play? Have you had bloods tested eg thyroid etc and is your diet good - re vitamins and minerals? Some sub-optimal levels can cause fatigue

How do we know if we are on the right does or not? I have spoken to the doctor and they won't test hormones. Does any body have any  private blood tests done & are the results helpful .

It is not really necessary to have hormone blood tests most of the time. Also they vary so much during the menstrual cycle that they don't really mean a lot. The correct dose is the amount which eliminates most of your troublesome symptoms (usually flushes and sweats as the most obvious, but a whole host of others too). Reduced testosterone can cause fatigue, low libido/response and fatigue, also muscle pain especially after exercise, and sometimes lethargy or depression. Doctors will not usually measure this - but your libido/response is the main indicator here. The NICE Guidelines make provision for T to be prescribed off licence but not many GPs are on board with this. Referral to menopause clinic may help but gynaes are of mixed opinion about prescribing this.

Hope this helps

Hurdity x