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[shelley]

Hi Ladies,

i have been reading as many posts on this subject as possible it seems that although the dosage advised by gps the  woman on here  over the years have been trying different dosages and ways to make this more tolerable .  I must admit i have read this forum for about a year and still reading i would just like a little advice on what i am doing is right .

I am fifty years old still having regular periods give or take a week.  I am  only on month one of my HRT  which consists of Sandrena Gel 0.5mg  daily  fab no probs with that , and here is the bit i am worried about the dreaded progesterone. So the prescription is 200 mg for 12 days day 15 to 27 . Reading the posts and mainly following Hurdity links about it since 2012,  I  went the v route but only 100 mg  thinking this  would be enough due to the low estrogen dose and also must be making some progesterone myself  so:-

If i do not get a bleed monthly does that mean i am not taking enough to oppose the estrogen ? 
If i do have to up it to the recommended  200  should i up the estrogen as well ?
Does hrt protect heart and bones but only up to age 60 so why do people stay on after that ?

I am on day 7 of the utrogestan and the side effect i have is the bloating not all day just seems  to be effecting my tummy  in some way on an every day basis and sore nipples but can handle not too worried about that   

But to finish on a positive  i went on hrt because of the  lack of sleep and since taking the utrogestan i have slept like a baby first time in  a long time 

So if anyone can reassure me  as my gp is useless  i would very much appreciate it

[Hurdity]

shelley if you are not getting a bleed monthly despite taking progesterone, and your periods have been regular - it is possible that you did not ovulate that month. Once you are peri-menopausal then gaps start to appear and then you will be relying more on the oestrogen from the gel. Once you are post-menopausal - if you don't get a bleed on a particular regime ( and are taking progesterone) then the most likely explanation is that the womb lining has not built up enough to shed, rather than the progesterone is insufficient.

If you are feeling well generally - that's great! Some bloating on progesterone is par for the course for some women. If you can cope with this dose (V route) then personally I would carry on for a little while - so that when you do get a bleed it may well be more manageable ( were they heavy?). With your doc's approval, though, you might be able to reduce to 10 days per month if you continue to have no bleeds?

You don't need to increase oestrogen if you increase progesterone - but the other way round. The right dose of progesterone is crucial to protect the womb from over-thickening from stimulation by oestrogen. Some women find that they need to increase oestrogen when they increase a progestogen ( usually the synthetic types) to "drown out" the negative effects of the progestogen - but this is not absolutely necessary in the sense that there is no obvious safety issue.

HRT protects heart and bones for as long as you take it! The protective effect declines when you stop. Many women  (like myself) take it post 60 to continue with this protection and also there are many women for whom  some menopausal symptoms re-emerge after stopping, so quality of life is the predominant driving force behind continuation.

Glad you are sleeping better! That's brilliant! It totally zonks me out but then I sleep too heavily now anyway....

Hurdity x

[shelley]

Thanks for your reply Hurdity  i am hoping to stay on HRT long term because  all the benefits for me outweigh the negatives that is why i really want  this to work.

So just to clarify if i get a bleed every month  it means the dosage i have is correct ? You say it is crucial to get the dosage of progesterone right  so am i right thinking if i lower the progesterone say for me i am already only on 100 per 12 days v route if i go to 10 days and not bleed would that mean it is not enough and have to go back to 12 days   ?  I  know a lot of ladies on here really have an horrific time on utrogestan so i guess i am lucky  the only thing with me is the bloating  (so far in know early days) i should not moan but two weeks out of 4 feeling uncomfortable every month i do not look forward to  i am hoping it will settle and maybe if ok i can reduce to 10 days.

I am on a low dose of estrogen sandrena 0.5  mg  i came to this conclusion  due to the fact  i still have  normal periods ( never heavy) and think i must have  some hormones going on already   is this enough estrogen to progesterone ratio? I know you are not a Dr but i have seen three Drs  the first two wanted to give me prozac and the third looked about 12 and just gave me what i asked for .  so any advice i know is from your and others experience which i trust more that the Drs .

thanks for any advice given

[Aggie]

Hi Shelley,

I'm on a similar regime to you and was also concerned as to why I was not having a bleed.  My periods were pretty regular prior to starting HRT but my consultant assured me that I was definitely peri based on my symptoms.  I fully expected to bleed every month after the 12 days of Utrogestan, but certainly didn't last in the last gap.  Hurdity's reply to you has made me slightly less concerned, if nothing happens in my next gap I will contact my consultant to check and dig this thread up again if it's gone out of sight and let you know 👍😄

Aggie

[shelley]

Thanks for your reply Aggie

How long have you been on this regime , are you taking utrogestan v route or orally  .  Utrogestan gets quite a bad rap on here with the side effects etc so i have been a bit worried and reading as many posts as possible i thought my best bet was to start at 100mg v route so more gets through ( hopefully same as taking 200 mg orally )  my thinking  being the lower the progesterone the fewer the side effects   I  have only been having bloating problems everyday and quite severe   i start the day ok but gets worse by night and  i look 6 months pregnant and  have been living on windeze tablets (poor husband  thanks god he works nights ).

My gp useless so trying to sort this dosage myself i would be grateful if you could let me know what your consultant says about non bleed . I have just finished utrogestan  phase and waiting for a bleed in the next few days which i am hoping for because i think from what hurdity says  this means the dosage is ok .

thanks again good luck