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[Jo06]

After 2 years of trying natural alternatives to the Menopause, I have finally given up and gone on HRT (Sandrena) I did try the patches at first, but these kept falling off. I'm not happy about taking HRT, but the lack of sleep, hot flashes, lack of energy and foggy brain etc, just became too much. I asked my Doctor about the Gel, he advised me that I could get this via the NHS. I thought happy days as I heard Certain celebs rate this highly! My doctor informed me that I wouldn't need to take any of the Hormone tablets to protect my womb, as this HRT method had it built in, but once I had picked my prescription up and read the leaflet enclosed, I became concerned as it mentions about taking another hormone tablet as well if you still have a womb! The next day I was flying on my holiday and needed to start taking this as I didn't want my holiday ruined by hot flashes.  Can anyone reassure me that what my Doctor told me is in fact true? And how do they feel about taking this form of HRT?! Jo06

[Freckles]

Hello there and welcome!
First Sandrena is an oestrogen only gel.
If you still have a womb you need a progesterone input each month to get an artificial "period" i.e. to get a small bleed each month to basically discard your womb lining. This is to avoid the possibility of getting uterine diseases, such as cancer.
Clinical debate continues as to the appropriateness of current NHS "guidelines" as to the dosage and frequency of progesterone each month (indeed as it does here on MM!). 
This is to prevent a build up of your womb lining that could (potentially) cause cancer.
Trans-dermal (i.e. gels or patch) applications of oestrogen are considered clinically to be the safest and most effective application
It's usually the horrible side effects of excessive progesterone that make many women give up  HRT- PMS type symptoms
I  had crap treatment/advice on the NHS and saw an eminent private Professor of Gynaecology (Prof Studd) and luckily got a treatment regime that was effective for me and far less progesterone than the NHS "guidelines" suggest
Anyway the summary of this is to say your  GP doesn't (at best) seem that informed re the right the HRT treatment for you.
Gel forms of oestrogen is great- if you still have a womb, you need monthly progesterone as well at the least.
I despair of crap GP  giving crap  advice sometimes!!
Spend a couple of hours reading previous posts/threads on her?.
Initially I found some of the information confusing and contradictory, especially from some posters, but posts from Mary G were really clinically helpful.
Read around a lot so you feel more confident about going back to talk to your GP about having progesterone prescribed too ( if you still have a womb)
Accurate knowledge is power!
Good luck Freckles  xx

[Maryjane]

Just saying I started on sandrena takes along time to dry , I now use oestrogel and dries in 5mins.


Are you in the U.K. ? REALLY worrying that you are told you don't need progesterone, gosh we really do have to keep on the ball ourselves with all of this.

[Hurdity]

Hi Jo06

 

Aaarrgghh! Yet another ignorant doctor! As the others have said - your doctor is wrong and as you thought from reading the leaflet - of course you need a progestogen to protect the womb as Freckles said!! It's not clear from your post whether you went on holiday and started the gel or not, nor where you are in menopause ie what your periods have been doing, or whether you are post-menopausal etc?  Also how old are you? I presume you are in UK as you mention the NHS - so you do need to go back to your doc and educate him! Point out what it says in the leaflet and also print-off or show him the information on this website (the main site -  top tabs - treatments, HRT preparations).

Sadly this is being reported regularly on this forum so heaven knows how often it is happening in reality. It is so important that your doctor knows that he is wrong to prevent him doing this to other women.

There is a choice of two progestogens - well three really:
https://www.menopausematters.co.uk/to_progestogens.php

These are - Utrogestan (progesterone), Provera (MPA) and the Mirena ( Levonorgestrel). This latter is a coil which is inserted into the vagina and releases the progestogen directly to the uterus with less systemic absorption than when taken orally (eg as the POP).

Hope this helps

Hurdity x

PS Maryjane that's interesting about Sandrena, as it is the more concentrated gel.

[MicheleMaBelle]

Hi Jo06- you must go back to your GP. If you have a womb you need to take progesterone- no question about it.
If you a peri menopausal you can generally take it sequentially so for approx 12-14 days each month.
If you are menopausal the recommended dosage is every day ( or 25 out of 28 ) but some women prefer to take it sequentially ( you take a higher dose but for only part of the month as shown above) as progeston can cause some unpleasant side effects ( lessened to an extent if it's via a coil or utrogestan taken vaginally)

This now leads me onto the point made by Freckles- many women are ok with the progesterone part of HRT treatment but it can cause some very unpleasant side effects in some women ( me included) who are intolerant or sensitive to it. Some doctors are prepared to prescribe much lower doses of progesterone than the NHS recommended guidelines. If you do take less than those guidelines ,then you need to be aware that you MAY have additional risks and you must absolutely do this under medical supervision and have back up annual scans and tests ( you may have to pay privately for these as they are not routinely offered under the NHS ) . Please do not self medicate.

You haven't yet started the progesterone part so you'll not know at this stage how you get on with it. Knowledge is key but so is caution. If you've only been taking the oestrogen for a short while you'll be ok but get back to your doc pronto and get a script for progesterone- see how you get on first with the recommended dose but you'll know pretty quickly if it's giving you any problems. One other thing- you should give it a few months to see how it's working/ let you get used to it.

Let us know how you get on x