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[Rosie63]

Hi everyone. Although I have read many posts on this forum over the last couple of months, I've only just registered to be able to post.  I'm hoping that you will be able to give me some advice before I see my consultant again tomorrow.

I'll try to keep my background brief !  I'm now 63 years old and up to about 6 months ago, I had been on Prempak C since I was about 50.  As you probably know, Prempak has been discontinued and I've been seeing a gynaecologist consultant over the last 4 months to try to find something else that suits me.  To date I've tried Femoston lowest dose, Everol Conti patches, Tibolone and Elleste Conti duet 2mg. The only one that seems to help with low mood and muscle and joint pains is the Elleste but the downside of these is the stomach pain and discomfort I'm now suffering. It's kind of a cross between period pain in lower stomach and back and wind ( hope that's not too much info!). The others I've tried just don't seem to touch the other meno symptoms so I feel I need to try to find something that helps with symptoms but is kinder on my stomach.  Just as an aside I have tried coming off everything and my stomach was a lot better but after about 6 days meno symptoms returned.

So one of my questions is, is it likely to be the estrogen or progesterone that's causing my stomach discomfort?

Also, after reading some posts, I'm thinking of trying Femoston but a higher dose as this seems to be kinder from a progest point of view.  Any views on this would also be appreciated.

Sorry for long post but wanted try to put as much info as poss which might help with your advice.

Thanks in advance.

Rose63

[Dotty]

Oestrogel and Utrogestan would be a good choice.  Dosage of the gel is 2 -4 pumps according to your needs.

[Rosie63]

Thanks for your quick response Dotty.  Is this both in one gel?

Rosie63

[Dancinggirl]

Hi and Welcome Rosie63

I had the same problem as you regarding cramps with HRT, especially as I got older. My uterus simply didn't' want to play ball anymore and I even had erratic bleeding which was a nuisance.  The only non bleed HRT regime that I would consider now(I gave up on HRT 18 months ago and doing OK) is going back to the Mirena with Oestrogel alongside.
The only thing I use now is local oestrogen (Vagifem) which keeps the urogenital atrophy under control.

I do think the bowel can be effected when on HRT because the uterus is reacting to the oestrogen and progesterone causing cramping etc.  However, oestrogen does often help with digestive and bowel issues as well.

Utrogestan, on a sequential basis of 10-12 days each month, might be worth trying ( it's a capsule that can be taken orally or used vaginally!!) but you would have a bleed each month.  Oestrogen can then used as pills, patch or Oestrogel alongside. 

I think some women really do find continuing with HRT into our 60s, 70s or beyond is simply too much hassle. There does need to be a way found to help us get some oestrogen without the progesterone problems.  DG x

[CLKD]

 

[Rosie63]

Thanks you CLKD 😊😊

[CLKD]

Broswe round.  Make notes.  Some ladies find that keeping a mood/food/symtpom diary useful 

[Rosie63]

Will do that. Thank you 😉

[Hurdity]

Hi Rosie63

 

If women suffer from digestive problems with oral HRT ie tablets, then the transdermal route is preferred anyway (this has been suggested to you). What dose of Prempak-C were you on? In your position I would go for Dancinggirl's suggestion of the Mirena coil along with patch or gel oestrogen (totally nil-by-mouth) or else separate oestrogen ( patch or gel) with utrogestan. If you have been having a bleed up until 6 months ago you may not mind having one again? The reason I say this is that if you want to be more "natural" and be nil-by-mouth then the utrogestan ( progesterone) would be taken vaginally - but not many women would want to do this daily for obvious reasons, but it becomes more palatable when used cyclically, the downside being a withdrawal bleed! If you can get by on a lower dose of oestrogen then you might be able to have a longer cycle as I do (with agreement of my doc) which limits to the duration to take the progesterone as well.

I realise now reading back I've repeated lots of Dancgingirl's post but giving my own perspective as you and I are almost the same age and I am on that type of HRT (patch oestrogen with utrogestan vaginally on 6-8 week cycle).

Hurdity x

[Rosie63]

Thanks very much for your advice Hurdity.  This is all really helpful and I now feel well armed for my appointment with consultant tomorrow.  I was on the 0.625 dose of Prempak. I've suffered with gut problems since I was a teenager (diagnosed as IBS) and always felt that those problems were worse at certain times of the month so I'm not that surprised I'm having problems again now ! Although I was ok on the Prempak most of the time.  My doctor said I should perhaps think about having my stomach checked out again but I'm  pretty sure it's all tied up with my hormones as it definitely improved when I stopped taking my hrt for a week.  I think we get to know our bodies as well, don't you?

Thank you again for your help.

Rose63 x

[Rosie63]

Hi, just wanted to let you know that I had my appointment with consultant today. He has prescribed me oestrogel and 100g Utrogestan.  He said to try taking the 100mg Utrogestan every day rather than 200mg so many days a month as this might not give me a bleed. He also mentioned the Mirena coil if this doesn't work out for me.  Fingers crossed it will though.

Thanks again for your advice and support .

Rosie63 x

[Hurdity]

Thanks for the update Rosie63 - great news and hope it works for you! Do let us know

Hurdity x

[Rosie63]

Hi all

I know it's still really early days but feeling a bit despondent again today.  I started my new regime of oestrogel and Utrogestan last Thursday and I suppose I was hoping to see some improvement.  However, I'm feeling pretty bad at the moment with really bad aches in my joints, tiredness and general feeling of awfulness ! The first couple of days I had 2 pumps but because I felt really unwell yesterday, I added another one this morning.  I was just hoping that because I'd already been taking another hrt and would have had some oestrogen in my system, I wouldn't have taken such a dip.  I'm guessing these symptoms are as a result of low oestrogen ?

A question for you please Hurdity if you don't mind.  I saw from one of your earlier posts that it could be fluctuations in oestrogen from perhaps just changing from one hrt to another so perhaps this could be the case at the moment with me?

Am I expecting too much after only a few days do you think? Your thoughts would be appreciated.

Thanks again for your support.

Rose63

[Dancinggirl]

Rosie63 - Changing from one type of HRT to another will bring some side effects - your body has to adjust and this will take time.  Nothing is going to be instant.  I wouldn't have started with the conti version of this regime - we tend to advice always starting with a sequi regime first to see whether the progesterone suits you and to give the oestrogen time to do it's magic without the progesterone having an influence. Many women stick with a sequi HRT well into post meno and put up with the withdrawal bleeds to avoid the negative effects of progesterone.

It is early days though and I would stick with 2 pumps per day at this stage.  You need use this regime for at least 6 weeks before deciding whether it works for you or not.  I found Utrogestan made me feel slightly sedated most of the time - it was a nice feeling actually as I felt quite high!!! Unfortunately I got a rash on my face and erratic bleeding with Utro on a conti regime so gave up on it. 

BE patient - it may well settle. DG x

[Rosie63]

Thanks DG.  Sorry to be dim but could you just explain the different between the conti regime and the Sequi please? Does the Sequi mean I would just take the gel for the first half of the month and then add in the prog?  I really wouldn't mind having a bleed if I felt reasonably ok on this regime.

Thank you.

Rosie63 x