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[HotFlush]

Hi ladies,

Before I start waffling about my woes, I just want to say that I do have a GP appointment booked in ten days time.

What I wanted to ask is this:

I've been on Elleste Duo for 8 months -6 months on 1mg, and 2 months on 2mg...

It's quite clear that I'm not getting on with the progesterone part of the tablets - I'm literally a raving looney when I'm on them - my moods are awful and I feel reclusive and very low.

I've currently got 6 days left of the 'evil tablets' before starting a new packet.  Would I be able to start a new packet right away?  I know this will induce my 'period' but it will get me back on the 'nice' tablets and hopefully improve my mood before I see my GP.

Also, I understand the reason for the withdrawal bleeds, but could I opt to have one every three months, rather than every month? I know this would mean more oestrogen, but it would also mean less progesterone which is my nemsis right now.

All advice gratefully received X x

[Dancinggirl]

Hi and welcome to MM
You need to try a different progesterone. Try Femoston next - it has a kinder progesterone. The Ellest HRT range is the toughest to tolerate.
Progesterone needs to be used for at least 10 days per month to protect your womb lining.
Some women who are extremely intolerant to any progesterone can use just 7 days of progesterone but  have to be seeing a gynae privately and have regular scans.
Don't experiment with changing your HRT regime without medical supervision or you could get erratic or problematic bleeding and increase your risk of uterine cancer.
You simply have to try different HRT options till you find something that gives you the least side effects. Nothing will be perfect. DG x

[Mary G]

HotFlush, join the club, I am a fellow progesterone hater.  The progesterone in the HRT you are taking is norethisterone which is renowned for causing horrible side effects.  There are better ones around although personally I don't do well with any of them.

If you are post menopause you can do a 3 month cycle but it's difficult to achieve if you need a high level of oestrogen to function.  The reason for this is that you could get breakthrough bleeding because the womb lining would build up and start to come away on its own.  If you were on a very low dose of oestrogen you might be able to do it but I think we would be talking something like a 25mcg patch or 1 pump of Oestrogel which might be too low. 

Another longer term possibility you might want to consider if you are severely progesterone intolerant is a endometrial ablation which basically blasts your womb lining away and that would mean you could do a 3 month cycle without getting any breakthrough bleeding and you probably wouldn't get a bleed after taking the progesterone phase either.  I am considering this option myself.

Before doing anything too drastic, it would be a good idea to change your HRT.  If you like oral HRT you could look at Femoston (2mg) which is well tolerated or perhaps the regime I use which is Oestrogel with vaginal Utrogestan for 7 days each month - this is often referred to as the Professor Studd regime for progesterone intolerant women.  It's not a perfect solution as far as the progesterone is concerned but I don't have the side effects I had with norethisterone and it's safe to reduce the progesterone the dose as long as you can arrange to have regular uterine scans. 

Have you tried Tibolone?  It doesn't contain progesterone so it could be an option for you.  It is a bleed free regime which is an added bonus.

Lastly, there is Duavive which is suitable for post menopausal women.  It doesn't contain any progesterone but it is a very low dose of conjugated oestrogen which may not be enough for you.

I wish there were some better options out there. 

[Hurdity]

Hi Hot Flush

 

Just to add that there is a tablet that involves a 3 month cycle although there don't seem to be many women who take it, and those that have may have experienced problems with it as it is only suitable for those in late peri-menopause. It is called Tridestra and listed here (scroll down): https://www.menopausematters.co.uk/perimeno.php

You haven't said how old you are nor where in menopause? This would enable us to help advise you better on the different types of HRT which might be suitable. For example Tibolone which Mary G suggests is for post-menopausal women only. I agree re the Femoston but also there are some CCP types if you are under 50 which help control the cycle and therefore mood swings - although they do contain high dose of progestogens, albeit more modern types. I would certainly not consider doing anything as drastic as surgery (such as an ablation) except as a last resort having tried everything and still not being able to function during the prog phase!

Hurdity x

[HotFlush]

Morning ladies,

Thanks so much for the replies -there's lots of helpful suggestions for me to look into.

I've just turned 46, and my periods started to go awry when I was 41.  I had my last natural period when I was 44.

Could I ask something else please?  My GP said that because I'm under 50 I have to have the 'bleed' HRT - is that strictly correct?  As I'm wading my way though various helpsites I'm sure that I'm seeing people under 50 on non-bleed HRT, although of course they could be abroad and under different rules etc..

[Hurdity]

Hi again - this is wrong. You can have the continuous combined HRT once you are 12 months past your last natural period when you are deemed to be post-menopausal even if under 50. However if you do go through menopause under 50 then you need to continue to use contraception for 2 years just in case there is spontaneous resumption of ovarian activity (ovulation!) which may be more likely in early menopausers. Some women prefer to continue with a bleed HRT despite being post-menopause ( eg me in my 60's) because we prefer not to take a progestogen for the whole time. If you don't get on with the progestogen part like you said in your original post then best to keep with the cycle though?

Hurdity x

[HotFlush]

Morning Hurdity,

Ahhh so to be bleed free you'd have to take progesterone the whole time?  Blooming heck, I am learning so much - it's a whole new thing to understand isn't it?

Understanding that I was actually in the menopause seemed to take forever - so many symptoms that I didn't realise were actually menopause symptoms, and now it's a whole new learning curve as to how to remedy it too!

My partner has had the snip so no chance of pregnancy but, having said that, that's another area that has dwindled away to almost nothing..  Thankfully he's been amazing and supportive.

I think I'm going to ask for Femoston 2mg when I see my Doctor - I agree with the view that I should try different tablets before going down more serious routes.  And I do like the ease of a tablet - I keep my tablets next to my toothbrush so no chance of forgetting.

A couple of colleagues at work are on non bleed patches which I had considered too, but I'm going to go with baby step tweaks rather than full on big changes.

Thanks so much for ALL of your comments -that you've taken the time to type a reply to me is much appreciated. I'll pop back a week on Monday when I'll have seen my Doctor again.

X x

[Dancinggirl]

Hotflush - it's wise to be patient and cautious - rushing to chop and change hormone treatment can just create more problems.  If you do want a non bleed option with minimal problems, then having a Mirena fitted can be good.  Initially after fitting there can be a hit of progesterone that can cause a bit of sedation and maybe low mood but this usually settles quite quickly and then you have 4 years of not worrying about any problematic bleeding, minimal side effects, non of the fluctuations involved with the sequential HRT regimes and you can use as little or as much oestrogen as pills, patch or gel, as you need to control flushes etc.

Low libido is a common problem when meno hits.  Feeling up for sex when a cuddle makes us break out into a sweat is really not good  -  feeling desirable, relaxed and in the mood does get harder and needs working at I find - I'm 62 and still enjoy  - I'm not on systemic HRT now but use local oestrogen regularly, vaginal moisturisers daily and lots of good lubrication for sex - everything has to be ‘managed' to keep things working well

You are young and need HRT - I would suggest until at least 55 - to protect your heart and bones.  Systemic HRT isn't always enough to prevent urogenital atrophy so some local oestrogen e.g. Vagifem,  used regularly, would as be a good idea. 

We often have to carefully lead our GPs when it comes to HRT treatment - they rarely have a clue!!! Do try Femoston to see whether that works better for you but keep us posed how you get on.
Do try Femoston to see whether that works better for you but keep us posed how you get on.  DG x

[HotFlush]

Thanks DG.  I'm loving your emoji ha!

I've only been with my partner for about 16 months and at first we were in the normal stages of the first flush of love, but it was last April/May I really noticed a difference in my whole 'being'...

I suddenly got anxiety out of the blue that went through the roof - so much so my Doctor put me on beta blockers and anti-depressants despite me not really feeling depressed. (and I have been depressed before, so I knew that I really didn't feel so this time).

It was only when a friend of mine posted something on Facebook that listed all the potential symptoms that I realised that I actually WAS in the menopause. 

I'd blamed needing a new mattress on my horrendous aches and pains every morning; flaky nails and skin - must need to drink more milk and water; loss of sex drive - well, the first flush of romance doesn't last forever...  It was startling how much I actually didn't know about the menopause - and this is despite having only had about ten periods in the previous four or so years - hello??

I've been reading around the board today and saw something about how women just don't talk about this enough, and it stems from generations before us... and so it goes on.

I have a son, not a daughter, but I will make sure he fully understands what his long term girlfriend/possible wife may well go through one day so that he can fully be supportive of her.

X x

Edit - I've remembered one other question I want to ask if I can...

Chinny whiskers, as I call them!

They were averagely bad before I was diagnosed - so much so I paid for a full eight week course of laser removal but obviously it would never have worked being this is a hormonal thing...

But since starting on Elleste it's got much worse.  Any tips or advice gratefully received X x

[Hurdity]

Oh dear - yet another doc dishing out the beta-blockers and ADs to menopausal women who should not be given them!!! Are you still taking these? If so do get settled onto the HRT and then hopefully wean yourself off them - no-one wants to be in unnecessary meds  long term - whereas HRT is just replacing one of your own hormones that has become deficient!

Some of the HRT types contain testosterone derived progestogens of which norethisterone is one - so that could possibly be the cause of your increased hairiness (and sometimes hair loss on the head). If so then Femoston is least likely to have this effect as it is derived from our own progesterone and is very similar to it.

Oral HRT can have more of a depressive effect on sex drive than transdermal types due to its effect on a compound known as SHBG which binds free testosterone so it is less available to use by the body. Ironically some women find their sex drive improves with the testosterone derived progestogens (judging by reports on this forum) - so it's all swings and roundabouts!

Hurdity x

[HotFlush]

Good morning Hurdity,

No I'm not taking the beta-blockers or AD's - I did take the beta-blockers for a while to help manage the anxiety but I always knew I wasn't depressed having been in that hellhole once before.

It's another tick for Femoston then if the chinny whiskers might decrease!  I'm not leaving my GPs without a prescription for it!

X x

[HotFlush]

Good evening ladies,

Gosh it's been a while.  Well I did get prescribed Femoston and so far so good - my mood has definitely improved, although I have found I'm having intermittent mild flushes, but on a balance, I'm pretty happy.

Since my last post, I've lost my Mum so overall I'm not doing too badly at all considering I was about to throttle someone last time yet I've managed to deal with mood swings and grief pretty OK on Femoston.

[Dancinggirl]

Pleased to hear things are better with Femoston. Sorry to hear about your mum.
Take care. DGx