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[Aggie]

Hi Ladies,

I posted back in June and hopefully this links to my original thread (Is this the best way to link back or just to reserect the original thread?)

https://www.menopausematters.co.uk/forum/index.php/topic,36371.0/topicseen.html

So just to recap, was very angry, extreme brain fog, quite a few other symptoms and was given 0.5 estradiol and 200 mg utrogestan for 12 days.

So I'm just starting my third month of Estradiol and just finished the second lot of utrogestan, and overall it's all good.  It's taken the edge of my extreme anger and I feel much more like my old self, although still no return of libido and although I've had a hair loss issue for years and years this seems a bit worse.

I had DCIS (non invasive breast cancer) in 2012 so don't think they're gonna give me a higher dose of estradiol for this reason, and I probably wouldn't want it anyway for that reason BUT....

My question is this.  On Friday I'm having a polip removed under general and the doctor suggested they could fit a Mirena coil at the same time, which would replace the utrogestan.  It's easy enough to remove if I didn't want it afterwards for any reason.  I went straight to 'shoving it up there' with the Utrogestan and other than wondering if I'm getting it far enough I don't really have any side effects or problems (which I'm thankful for) other than remembering when to do it and a bit of discharge (which seems to be the casing of the tablets coming out) the next day.  Do you think I should stick with - 'if it ain't broke don't fix it' or are there any reasons I should be trying the Mirena other than convenience?   

Really appreciate your thoughts on this xx

[Tinkerbell]

I have the Mirena coil because I couldn't tolerate the utrogeston and it suits me well so far, had it fitted 16 months ago but there are a few ladies who don't get on with it.
To be honest I don't think I would risk changing if you get on with the utrogeston, did they suggest it for any other reason apart from that they would be poking around in the same area anyway!
The majority of Mirena fittings are done at GP surgeries so you could do that if you change your mind in the future.

[Aggie]

Hi Tinkerbell - I think you are correct in that they might have only suggested it because they were gonna be poking around up there as you so aptly put it! 

My only real concern is I don't know what's making the hair loss worse but then I've been dealing with hair loss for 20 odd years now and never really found the cause.  I think she may have suggested Mirena because the periods I was having were heavy and since I've started the HRT any bleeds I have had are much lighter. 

I'm a bit nervous about the whole HRT thing tbh because I've had the breast issue, but I couldn't have carried on as I was - I was SOOOOO angry most of the time for absolutely no reason. Bloody hormones. 😬

[CLKD]

Indeed!  However, Quality of Life Girl, Quality of Life  .   Something else might 'get you' long B4 the breast disease is triggered, which of course, it might not be.

Let us know how you get on.

[Fee]

I had my Mirena coil fitted 7 years ago when I was in hospital having some fibroids removed.  I wish I had been given a week to decide, I was lucky to get 15 minutes to think about it. 😗.   On saying that I went ahead and, for me, it was the best decision I ever made.  I am currently on my 2nd coil and still have a couple of years before it needs replacing again.  I also use a low dosage Estraderm patch and am happy with the combination.   Vagifem has also been my lifesaver.

You can always have the coil removed if the side effects get too much.

[Hurdity]

I would keep with what you are doing. In terms of breast cancer - although the causal relationships have yet to be determined, evidence is accumulating that progesterone ( and of the synthetic progestogens - only dydrogesterone) are associated with the lowest breast cancer risk - sorry don't have the stats to hand but can look it all up at some point if you want. Progesterone - as in Utrogestan - has been described as "breast friendly". Although Mirena coil has minimal systemic absorption compared to the contraceptive pills contains the same progestogen that it is often compared with, nevertheless there is still systemic absorption (and when I looked it up - if I understand correctly, it was approx the same order of magnitude as say transdermal HRT like Femseven conti and sequi).

Even if you were experiencing some side effects from the utro - on this basis alone I would stay with the progesterone, as long as you are not getting the heavy bleeds that you were experiencing before. You could always do a quick e-mail consultation with Dr Currie (£25) and see what she says - if there is time for her to reply). Eventually you might even be able to reduce the prog dose as your oestrogen dose is so low and you are using it vaginally - under medical supervision.

Incidentally when you say 0.5  - do you mean 0.5 mg estradiol and that you are cutting a 1 mg tablet?

All the best for your operation on Friday

Hurdity x

[CLKD]

My breast disease was oestrogen dominant

[Aggie]

OMG - I just typed a long reply and the system had logged me out 😩  That's how I know the HRT is working - I probably would have thrown the iPad up the garden in rage without it!!! 😩😳😜

Thanks for your replies I will try to respond properly later 😄

[Aggie]

Ok I'm trying again - I was trying to say...

CLKD - Im sorry to hear you've also had to deal with BC.  As mine was caught very early i don't think they even check for Oestrogen dominance but I might be wrong on that 😬

Fee - I've actually had three months to decide but only just started to think about it!  I wouldn't cope with just 15 minutes - I like to have a Google first before I decide on anything!  Glad it's working out for you 👍

Hurdity - Thank you for the reassurance re BC.  I have indeed decided to keep doing what I'm doing - that was my gut instinct- thanks for backing it up with science!  My only concern is that either the Estradiol (my prescription is one sachet of Sandrena 0.5mg gel a day in a small sachet rubbed into my inner thigh) or the Utrogestan 2 x 100mg for 12 days ( I went straight to taking it vaginally) is accelerating my existing hair loss problem.  Is this a common side effect with either of these?  Another reason I've decided against Mirena is it does seem to cause weight gain in some people?  Not risking THAT!  The GP prescribed me with just 10mg of levothyroxine in an attempt to stop the hair loss (my thyroid has shown to be very slightly off for a long time but not enough to warrant meds really) I went up half a stone in a week 😩 So stopped that straight away!

Love this forum  - you're all so supportive 😄  I'm very conscious that there are lots of ladies really suffering with intolerable symptoms and feel grateful that overall mine don't seem to be too desperate at the moment.  I'm grateful for the quality of life I've got now I no longer feel I want to beat the whole world up for no reason 😳😄 xx

[CLKD]

My lump was sent for histology and I think breast lumps are automatically checked for what might be the causation - your GP could probably let you know Aggie

[Hurdity]

Hope your op went well today Aggie?

Re your HRT. That dose of estrogel is quite low and especially for that high dose of progesterone so maybe that has something to do with hair loss? There seems to be conflicting information about the role of progesterone and hair! Mostly sites that sell it say it helps with hair loss - but certainly the androgenic progestogens can cause hair loss, and maybe excess progesterone too if not enough oestrogen ( prob talking through my hat here!)?? I presume you are just taking the lowest dose you can because of your BC? I am wondering if the doc would allow a slightly lower dose of Utrogestan in view of this and is prepared to scan you to check all is well? Many women use this amount of Utro with 2 pumps of oestrogel which is 1.5 mg estradiol so it might be possible for you to try a lower dose eg 100 mg daily for 12 days under supervision to see if it helps with hair loss?

I thought levothyroxine would help with hair loss (and lead to weight loss rather than gain) - because one of the symptoms of low thyroid function is dry brittle hair which falls out? Sounds like it had the reverse effect than intended? However I only know the very basics about thyroid function.....

When you're up to it, do let us know how you feel?

Hurdity x

[Aggie]

Hi Ladies,

I got my Polyp done yesterday.  All went well and was home by 3.30ish despite having had a general anaesthetic (I was very lucky to have been first on the list ) Was rather bothered by the fact that they are sending it to histology - they had previously said it was definitely 'just a polyp' and didn't even need to be removed, so I now have the slightly nerve wracking wait for the results of that    CKLD - my BC was just calcification- not even an actual lump - they checked for clear margins but don't know if by its very nature, as it's so early maybe it doesn't have the risk of being estrogen dominant - I think I will have to investigate 🤔

Hurdity thank you for that suggestion - I have been wondering if it might be possible to have just 100mg of the Utrogestan if I'm allowed to - I have an appointment next month so will ask.  Do you know if they offer the scan or am I going to have to beg for it?  They didn't have time to come and see me after my op (they had loads of ladies on the list). I really wanted to ask what it was looking like 'up there' but I guess you can't have everything 😬  Yes I think you are correct in that they are keeping the Estradiol low because of the risk of the BC recurrence.  I'm sure I would benefit from more but don't wanna push my luck.  Really needed to get rid of the feeling of constant rage, and although it hasn't helped with everything, my mood is better. 👍 Xx

[Tinkerbell]

Every lump and bump is sent to histology when removed during medical procedures..so please don't worry about that it is normal practice.

[Katia]

CLKD sorry to hear that. Are you able to take any HRT.

I think I'm having a few e issues since switching the HRT.  Somehow for me e seems to cause heat.  The gel caused flushes, night sweats and fever like feeling. The Premarin is causing a hit face. Yasmin did that years ago too. No problems with any other pill.  The progesterone seems to call my body.  It seems very odd that it's the opposite way around. Would you have any ideas?

Angie, my hair loss got worse on HRT too.  It seems to be a bit better since I stopped the gel. I'm peri and for me the gel had every possible side effect it could have. I think the dermal trasnsmission was just too much.

[Aggie]

Tinkerbell thanks for the reassurance re everything being sent to histology - I wasn't worried at all prior to them telling me that, but due to my history I did have a moment after hearing that from them.  I think BRAC1 connects breast and ovarian cancers and not cervical or uterine anyway (I don't know if I have the gene  - I did ask to be tested but they wouldn't)

Katia which gel do you think made your hair loss worse?  I have assumed it would be the Utrogestan doing it rather than the Estradiol.  As I've had a hair loss issue for sooooo many years it may not even be anything to do with HRT but it does seem to have accelerated a little of late.  Did yours sort itself out?  Apparently any changes to the hair cycle take three months to show up anyway 😬

Xx