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[Loulou1960]

Some advice would be great..aged 57,late menopause.have tried all products in H&B with no luck, HRT  patches slipped off as too clammy..gp tried Prozac and clonidine..no relief.
Saw gynae consultant privately who has given me oestrogel,2 pumps per day and urogestran 100mgs daily.
4 weeks in,super woman,sleeping like a baby,very few hot flushes.
My question is am taking progesterone vaginally as prefer idea of better absorption rate...but not sure how many days to use...used it for 7 days in 3rd week last month and had a good bleed for 4 days...will have an ultrasound each year to check endometrium,,but would like to know what other ladies do .
In a new relationship, so really don't want to use every day!!
Any advice,gratefully receieved
Thanks ladies !!

[Mary G]

Loulou1960, I am severely progesterone intolerant and take a very low dose of Utrogestan.  I do it under supervision with my gynaecologist and have regular scans which confirm that the super low dose Utrogestan is working well for me - I take a low dose every 5-6 weeks but I am an extreme case.

I would say stick with your current regime of 100mg Utrogestan vaginally for 7 days each month and have regular scans to make sure you are getting adequate womb lining clearance.  The 7 day regime works well for the majority of women but obviously there is always a chance that you will be unlucky and need to take more. 

It's a good idea to have regular uterine scans anyway because it's not just about womb lining, there are other conditions that need to be monitored.  My gynaecologist thinks that all post menopause women should have annual scans regardless of whether they are using HRT. 

[Loulou1960]

Ok,dokey,many thanks for info. What else could it effect with a low Dose? A little apprehensive about starting HRT,but for 18months have put up with horrendous hot flushes day and night..Such a relief to have a good night's SLEEP
Any idea of normal oestrogen level..mine was 44 prior to starting HRT .

[Mary G]

The only side effect of a low dose progesterone would be breakthrough bleeding and/or womb lining build up but if you have regular scans you will know about any potential problems pretty quickly anyway.

Your oestrogen level sounds very low.  On two pumps of gel, mine are somewhere in the 700s.

Don't be apprehensive about taking HRT, it will probably change your life for the better and rid you of debilitating symptoms.

Please let us know how you get on.

[Hurdity]

Hi Loulou1960

 

When was your last natural period - you said you are late menopause and 57 now? I quite understand why you would not want to use Utrogestan vaginally all the time especially in a new relationship. I take mine 200 mg vaginally x 12 days every 6-8 weeks - on a long cycle - with the OK from my GP. However I don't take a very high oestrogen dose as a compromise ( to keep bleeds to a minimum - as I am in mid 60's).

In terms of oestrogen level - you need to know the units of measurement which can be pg/ml or pmol/l. If the latter that is a very low - but not atypical - post-menopausal level. If it was pg/ml it is still low (161 pmol) but not quite so dire! There is no normal estradiol level. There is a huge range both during our reproductive years throughout or menstrual cycle, and also variation throughout the day and night. There is also a massive range of "normal" levels between different women. My oestrogen levels from a medium oestrogen dose are probably something over 200 pmol/l (220 I think when last measured). I have no flushes or sweats and function perfectly normally with no adverse symptoms. I may well feel superb on a higher dose but I have never tried because of the corresponding need for higher doses or duration of progesterone, which I don't want.

Mary G clearly attains a very high oestrogen level on only 2 pumps - which is a medium dose, whereas some women get far far lower than this. If possible and especially in the first instance while your body is adjusting to additional oestrogen, I would try to take it for a few days longer per month if you can. Ten days is pretty much the recommended minimum - and see what sort of bleed you get over the next few months. If it is minimal on 10 days x 100 mg vaginally then maybe you would be OK to reduce but perhaps I would not wait a year to have a scan. Ideally your dose and duration should be supervised by your consultant.

Hurdity x

[Loulou1960]

Hi hurdity, have had a mirena  coil for 15 years since aged 39 due to menorrhagia and anaemia.Had it removed as awful bloating pain in sides,backache etc. Scan showed ovarian cysts and not in menopause.spotting post removal of mirena,3years ago.

Had hysterosopy 18months ago and no bleeding since..ultrasound of endometrium pre hrt, 5mm thickness..gynaecologist happy with that.
My other question is, does progesterone cause ovarian cysts?? if too high a dose. So many issues !!! Lol
Loulou

[Mary G]

Loulou1960, sorry, I assumed your blood tests would be in pmol/L which is what is usually used in the UK I think.  My blood tests are always pg/mL and I just looked it up again and the oestrogen was 195 pg/mL which is about 715 pmol/L.  I should add that I take 25mg DHEA every day which means I now produce a small amount my own oestrogen again which would make a difference.  This is the level I need to eradicate all symptoms and feel good but everyone is different and you might be able to get away with less. 

Why not do another couple of months on the 7 days Utrogestan regime and then have a scan to see how your lining is clearing?  That way, you can have your ovaries checked too.  I have never heard of progesterone causing ovarian cysts.