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[sweetie222]

Hello ladies, I am 48 yrs old, definitely been peri on/off since my early 40's suffering from anxiety on/off, depression, palpitations and more recently insomnia and mood swings. I still have a regular cycle. I tried Oestrogel (1 pump) with Mirena in Feb, then swapped to patches Estradot 0.25 in March before deciding that something was not right and stopping a few weeks ago (felt permanently on edge and was told it could be that Mirena was not providing enough progesterone to balance the oestrogen. As I was not happy with the Mirena after 10 months, I decided to remove it yesterday (first ever hormonal control in my life).

I have been advised by a UK Menopause expert to try Oestrogel (inially 2 pumps building up to 4!) as she said she did not think my initial dose was high enough and Utrogestan (100mg throughout the month).  I noticed many posts about intolerance to Utrogestan and also advice to use it every other day rather than every day. Are any of you on a similar protocol and how are you finding it, are you happy and also how long did it take for you to notice improvement. I am a worrier and read too much so any advice would appreciated. I noticed flushing around my neck today which of course I connected to my first day on Oestrogel but the Dr said I should try not to worry so much. Current symptoms include bad insomnia, hot flushes at night and mood swings.

Thanks in advance, am happy to share any info I have!

[MicheleMaBelle]

Hi Sweetie22- I was put on same regime by consultant 5 weeks ago. Didn't get on with synthetic progesterones.

It's not been ideal so far- although I've been told to give it 3 months, I couldn't last til then so he has suggested either taking utrogestan 14- 28 at 200 mg i.e. Sequential. He also said he would be relaxed about me taking 100mg alternate days which I've been doing this week. On this regime I've been feeling jittery and not sleeping well. It may take time to settle.

I took the utrogestan orally for a week then had to switch to taking it vaginally but when I take it every day, my mood is very very low and I've also had insomnia and itching/ skin rashes although that's settling. On the positive side I'm not getting headaches but I do feel wired and jittery so I'm not sure the balance is right. I'm seeing him again in June so he'll review then.

You'll just need to try it and see how it goes and accept that it might take some tweaking. I thought it would be a magic bullet compared to the previous 3 regimes I'd been on, but so far I'm struggling a bit on it. I'm sure many women get on fine with it though. Good luck and keep us posted x

[sweetie222]

Thank you Michelemabelle, sorry to hear that it has not been plain sailing and this is also my concern. I did read a post from someone abroad that said she only takes the Progesterone once every 3 days and she feels much better. If you want to speak to Menopause Dr on skype with any questions I can recommend a couple of them. I know that wired feeling, are you on 2 pumps of oestrogel as well?

Maybe we can keep in touch and keep each other posted on progress. Which progesterone were you on before? Have you ever tried the bioidentical creams?

[Cassie]

I tried the bio identical creams they were no good, my Dr also said that the progesterone is not safe to use if using a conventional Estrogen as it will not be strong enough to oppose it. I went over onto Oestrogel 2 pumps about 10 yrs ago with 10 days of Utrogestan 100mg this has worked very well for me, I have now reduced to just 1 pump of the gel, one can up and down it, according to symptoms, which is the beauty of it.

[MicheleMaBelle]

Hi sweetie- I'm on 2 pumps but not sure if it's enough but don't know how it's fitting with less utrogestan. Just need to wait and see what consultant says ( I had to go private)
I've not been on bio-identical progesterone before. Was on Elleste Duet ( 2 strengths) on a sequential basis. Felt crap all the time but especially on the progesterone part. Then switched to cyclical progesterone ( every day) via Kliovance ( felt unbelievably bad) and then Everol Conti ( ditto but ended up halving the patches and my mood improved but the flushes came back) . All pointing to progesterone intolerance.
I was at end of oestrogel bottle today and probably had equivalent of 2.5 pumps but the jittery heart racing stuff started soon after, so again not sure if it was the extra oestrogen that caused this or the fact that I didn't have the oestrogen last night. Confused.com.
Yes let's keep in touch to see how we get on x

[sweetie222]

Hi Cassie, thank you for that positive feedback. I like that you only use 100mg for 10 days, sounds more balanced. Do you remember how long it took to settle down and feel better. I am hoping the progesterone will help with my sleep.

Michelemabelle, I would maybe try and speak to your Consultant by telephone for peace of mind, maybe you only need one pump.

Thanks again ladies, great to have some stories and experiences!!

[Hurdity]

Hi sweetie222

 

I can't think why someone would say that the Mirena wasn't enough to balance the oestrogen - this is utter rubbish! Estradot 25 is an extremely low dose whereas the Mirena is a very high progestogen dose which can even stop periods! It is more likely that it was either too much progestogen causing your symptoms or too little oestrogen!

If you use 4 pumps of oestrogel it is unlikely that alternate day utrogestan 100 mg would be sufficient to keep the lining thin although you would have more of a chance if it were used vaginally. Any variation of the standard protocol  should be done under medical supervision and with regular endometrial scans. On the other hand if you are still ovulating then you will be prducing plenty of your own progesterone each month as well. It may well be that this dose of gel could suppress your cycle if you absorb it well? I understand this is a possibility. Otherwise it would seem a high dose if you are still having regular periods and therefore not really at peri-menopause if ovulation is also still regular. 

Like Cassie I have opted to remain on a cycle well into my 60's because of not wanting to have progesterone every day. I use Estradot 50 mcg patches (well I now have 62.5 unofficially!) with utrogestan 200 mg x 12 vaginally every alternate month. My GP says this is fine but I did have a private scan last year as I was worried, and there was no medical reason why i should need one (ie no bleeding, bleeds not heavy etc) - but all was OK.

In small doses some women find that the sedative effect of progesterone is helpful - if they have sleep problems, but all too easily this can descend into foggy-headedness, fatigue and depression not to mention migraines etc, for some.

Hurdity x

[sweetie222]

Thanks Hurdity, that is definitely food for thought and agree on many things. Because mirena supresses ovulation and our own supply progesterone/oestrogen (explained by 2 specialists) and dose is local we are not necessarily getting enough progesterone to other receptor sites.

I am dubious about going up to 4 pumps and will see how things go on 2 pumps. I think my symptoms improved on the gel and got worse on the patch, prob too low a dose as you mentioned. I am hoping I will react well to progesterone.....I need some sleep. Def still want a bleed and time off progesterone so thank you for that advice!

[sweetie222]

Cassie since when are you doing 100mg for 10 days? Since menopause or all the time?

[Hurdity]

Hi sweetie

The Mirena does not necessarily suppress ovulation, and also the progesterone produced by the ovary after ovulation is only needed in those large quantities to support a pregnancy. Sufficient is produced for other purposes via the adrenals (I think!). In fact Mirena does release systemic progestogens (into the blood stream) - just not as much as the Pill. It is a myth that it is not absorbed. The amounts are approx comparable with Femseven sequi patch - give or take....

I hope your new regime works for you anyway and you get some sleep!

Hurdity x

[Cassie]

Hi I have been using that protocol for over 10 yrs went into early meno in my late 30s I never had any issues on it, settled straight in and will stay on it as long as I possibly can.