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[Annie0710]

Tempest we were the same as each other

I never had ups/downs during the month, I would've remembered something like that. I do recall women saying they can feel they're due on.  I never did, I just knew it'd come @35 days each month.  Felt good pregnant too, really good.  And had pnd once out of 3 live births and I think that was because of my loss 13 months earlier

You know, I have a good feeling for you :-) xx

[Rhiner]

Hi again Tempest,
Yes I am BSO but have uterus. I am on estrodot 75mcg and alternate day dosing of 100mg Ultro, orally. When I first started to take the ultro it did take a couple of weeks to get used to it, felt a bit odd and a little nauseous at first, but that wore off pretty quick. I did find that adding the Ultro did lift my mood a little, but after a couple of weeks of taking. I guess you could introduce it slowly to your system, say alternate day and then escalate to daily, so that your body can adjust as you get used to it, as 200mg per day may be a lot to take at the start?

I had a dip in oestrogen around Xmas, and it started when I had a bit of a virus/cold, the virus went after a few days, but it took me about 6 to 8 weeks to 'recover' what I think was depleted oestrogen levels. That really worried me, my consultant said that sickness can effect oestrogen levels and if you have ovaries they will ramp up the oestrogen level to compensate, but for BSO ladies, obviously we do not have that luxury anymore I am dreading the next time I am ill!

Rxx

[Tempest]

Aha! I knew we were so alike, Annie! It just goes to show too that HRT should be an invidualised thing. I'm so very sorry always for the loss of your wee precious one, you're such a brave lady, you know? xxxxx

Rhiner, you're on the same dosing as Diane Danzbrink, the lady who runs Menopause Support that I've mentioned recently who has had TAH/BSO. It seems to be pretty ideal for both of you! She also has testosterone too - have you ever considered adding it in at all? It might be worth a go. My aim would be to adjust to roughly this dosing regime if I can tolerate the Utro. over the next 4 months. Increasing estrogen first really does go disastrously for me, so I am a bit of a reverse work in progress!

I can understand why Professor Lumsden is going for 200mg as she is hoping to control my flushes to some degree as I'm getting very exhausted! I feel the same as you in that it would be best to start alternate day dosing at first. I'm continuing with 1 pump of Estrogel just for the next week before I make the switch as I would like to get to a couple of essential appointments before I start in case I'm out of the game when I first start it (and it takes my infernal GP an age to sort out prescriptions despite me handing in Professor Lumsden's letter today)! xxxxx

[dangermouse]

Good to see more specialists are seeing the value of using progesterone only when oestrogen is too over stimulating.

I think you can also use it vaginally if any problems occur with the oral route. My endo thinks it will be converted to oestrogen in me (as my own oestrogen is too high) so prefers me to have the transdermal progesterone, however, I've not tried it and still may do, particularly if you do well on it.

I've not in the hot flush stage yet but have also heard progesterone is as effective as ERT in stopping them. No one seems to understand the mechanism.

Good luck!

[CLKD]

  Girls - lives and learns I does ;-)

[Annie0710]

You and me both CLKD

today I've learned that Replens isn't as good (prob the wrong word) as I once thought plus that progesterone can stop flushes, I knew it can help as it did me but just shows it really should be more widely available for hysterectomised (is that a word?) ladies

[CLKD]

How does progesterone help if 1 no longer has a womb - maybe a separate thread?

[Annie0710]

Even most Drs think it's not needed without a womb

When I tried it it just seemed to ..., balance me, maybe mildly sedate me

The negative I found was vivid dreams but not every night but then (again supports my theory) back in womb days I had very vivid dreams

[Hurdity]

Thanks for the update Tempest - you asked for our thoughts!

It has been established that progestogens used in pharmaceutical quantities can be used to prevent hot flushes. There is information on this on this website:

HIGH DOSE PROGESTOGENS (MPA) Medroxyprogesterone Acetate and Megestrol Acetate (Megace) are synthetic forms of progesterone which sometimes reduce hot flushes and sweats. They also offer a degree of bone protection. They have been prescribed to women who cannot take estrogen after breast cancer treatment but concern currently exists about the possible effect of progestogen on the breast and so are now used less often. The side effects of these drugs can sometimes outweigh the benefits. In particular there is known to be an increased risk of clotting with higher doses of progestogens.

https://www.menopausematters.co.uk/prescribed.php

In this case they are being used as a drug rather than as part of HRT - because they are given in such high doses. I presume this is what Prof Lumsden is attempting for you?

Also Elisabeth Vliet (of screaming ovaries fame) does acknowledge that there is a small minority of women for whom progesterone is preferable (in terms of well being) in peri-menopause although for the majority of women oestrogen replacement provides the essential ingredient - both for feeling well and for optimising future health.

Surgical menopause is clearly a special case and sounds like more work is needed on researching hormone replacement in such women, and also Tempest your situation is different with your other issues too - is it you that has allergies and potential anaphyllaxis (sp!) which must affect how you react to hormones generally, so your treatment is of necessity individualised but wouldn't necessarily be advised for other women?

Stellajane - if oestrogen is over-stimulating then to me it suggests levels are too high. It often seems odd to me that some gynaes talk about women achieving oestrogen levels of 6-800 pmol/l all the time when they would never be this high in our menstrual cycle. To me this is all the more reason why one should aim for a level at which your symptoms are eliminated but not so that you are feeling like you do at ovulation all the time! I have never experienced this on oestrogen (ie too much) so I can't imagine what it's like! However if this level is needed to eliminate flushes then I can see that has to be given....

I hope the progesterone works for you without too many side effects - as I write I am on Day 4 of current utrogestan cycle - at that dose (200 mg vaginally - so I don't have the same metabolites as from oral use and liver metabolism) - and I feel totally whacked, tired and foggy - can't wake-up in the morning! The sedative effects of it are enormous!

Are you taking it orally? Hopefully you will get used to it after a week or so? Then I presume if it does work you will re-introduce oestrogen as is recommended?

Interested to hear how you get on and wishing you all the best - you have tried so many things!

Hurdity x

[edelweiss]

Tempest I so hope this is the one that works for you. xxx

[Wrensong]

Good luck with the Utrogestan Tempest.  I really hope it works well for you.

[Tempest]

Hi, Hurdity! Thank you for your kind, considered thoughts.

The study you linked to was centred around using synthetic Progestogens which have higher incidence and range of side effects and are less effectual than the bio-identical Utrogestan (most probably due to intolerance of side effects at doses needed to achieve symptom relief). This is where Professor Lumsden is coming from with her thinking.

My prior allergies and anaphylaxis doesn't play a part at all in the decision to use Progesterone only in my case.

The decision has been purely based
on the fact that if I use enough estrogen only to relieve my vasomotor symptoms, I experience tachycardia, abnormal electrical rhythm in my heart upon exertion and vastly increased anxiety, as well as severe bloating. The anxiety and palpitations seem to be a common feature I am seeing in other women who are using estrogen only over at our surgical menopause thread once their levels are high enough to alleviate vasomotor symptoms (and has also been well written about by Diane Danzbrink. Apparently Dr. Nick Panay may be doing a podcast in the near future about this phenomenon with Diane in women who experience surgical menopause on estrogen only HRT).

We are learning more and more now about hormone replacement and it's role in surgical (and natural) menopause as HRT has been proven to be safe and more women are confident using it.

This is going to be somewhat of an experiment in my case from my point of view, but I noted with interest that a former member of MM was treated by her specialist with Utrogestan only and achieved favourable results (I'm not sure if she was actually in Canada).

https://www.menopausematters.co.uk/forum/index.php/topic,24460.15.html

I'm sad that she's no longer active here as it would have been good to see if she is still using this regime, and how she is now.

I'll certainly be posting about my experiences when I start the Utrogestan regime next week.

Thank you again! xxxx

[Tempest]

Hello, Edelweiss! How are you today? xxxxx

[Tempest]

Just a wee update. Hubby and I have been discussing this and given my black mood which developed on Tibolone and the possible culprit being the Progesteronergic effect as I continued on it, I have decided NOT to proceed until I have spoken with my psychiatrist next Monday. I don't think I can afford to take the risk without discussing it thoroughly with him first. xxxxx

[dazned]

Think that this is a wise move as progesterone does have a tendency towards a sedating  effect and /or a bit of a depressor in some people. Better to have discussed all possible angles.