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[Steffi]

Hi, wanted to ask if anybody takes a break of a few days or more each month with oestrogel and progesterone? My friend does this on the advice of a Dr and she said it works for her. My Dr said that I should use the oestrogel daily.

Also how does too much oestrogel make you feel, wired or tired? I am trying to work out whether to up from 2 pumps or just ride out the rough days each month. Was doing really well for the last year but have daily spotting despite using progesterone daily with 2 pumps oestrogel. Mid month levels are high in blood of oestrogen but early in cycle much lower (recent blood test results). Would really appreciate some clarity on how too little or too much oestrogel affects people?

Many thanksx

[Dotty]

Hi were you post menopause when you started the regime? X

[SueLW]

Too little oestrogen makes me very anxious and depressed feeling.  Gives me brain fog and removes all ability to think straight or do much of anything.  I also have low testosterone at the moment and that kind of doubles up on making me feel as above if I have a low hormone day.

Not sure what too much feels like. 

[Annie0710]

When I was on patches 75mcg it made me feel jittery but now I'm on 3 pumps oestrogel and feel fine most of the time

I do sometimes miss the odd day but it's because I've foegotten ie night away/ routine changed but it never affects me x

[Juliet]

I cut back on the oestrogen because I was convinced it was making me feel really anxious and terrible insomnia and have just got back up to 1.5 pumps a day from 1 pump every other day - so far the anxiety level has remained low and sleep remains good, although I have had a return or some mild flushes, so am going to go up to two pumps a day over a couple of weeks.  However, it has not been a month yet, and I have just added in the utrogestan, so need to monitor for longer before drawing any conclusions about impact of both. Of course, the raging anxiety may be related to my own cycle and having nothing to do with HRT. 

[Dancinggirl]

Hi Steffi - we need to know a bit more about you. Are you post meno i.e. when was your last natural period?

one. to two pumps per day are the average dose but some women feel much better on even higher doses.  You should use oestrogen daily or you will get fluctuations in mood and symptoms generally.  Using progesterone every day as a conti HRT regime can give more problems, so many women stick with a  sequential regime and put up with a monthly bleed.  DG x

[Steffi]

Sorry I am 49, still in peri, regular periods but in the last 4 months sometimes menstruating every 2-3 weeks. Drs think I may be low in progesterone vs oestrogen (I am spotting most days between menstruation for the last few months). Womb lining on scan is fine. Have an ovarian cyst. So it was suggested to reduce to 1 pump oestrogel or use utrogestan (100mg) vaginally for most of the month. I have never used more than 2 pumps oestrogel a day. Seem to tolerate progesterone well but am not sure if after 2 weeks it makes me feel low. Am worried about upping oestrogel dose to 3 pumps as I fear it making me feel wired/anxious.

My sleep has been up and down the last month, the month before I was using less oestrogel. When ovulating levels measured are up to 1500 and 2 weeks later down to 500. Meno specialist said stick to protocol and was not concerned about any of the above. Local Dr was more conservative and wanted me to reduce.

Been using HRT for just over a year now and really had no issues until periods came closer together and felt a little nausea.

[Dancinggirl]

Steffi - if you are peri meno then it's no wonder you are getting these fluctuations and erratic bleeding. I am very surprised they are suggesting Utrogestan every day!!!!- Normally you should not be using progesterone all the time as this is for post menopausal women. If you use a conti HRT regime in peri, this would explain the erratic bleeding.  When using HRT, the bleed is not a natural period, it is simply a withdrawal bleed that is shedding the womb lining and protecting it from building up. I suspect the cyst is having some influence on all this??  If you want a non bleed HRT option then I'm surprised you haven't been offered a Mirena?

What symptoms are you trying to control?  If flushes are under control with one pump per day then it is doing it's job.

Clearly your own hormones are fluctuating in the background so it is very difficult to get the Oestrogel dosage absolutely right - indeed this would be pretty impossible really.  However if you stick with one pump of Oestrogel per day and use Utrogestan for 12 days each month (preferably vaginally) you would probably get a predictable bleed after finishing the Utrogestan phase each month and in 3-6 months this would give you a better balance overall as the HRT regime would be taking more control of your hormones generally.

HRT cannot fix everything and it is seldom without side effects.  You cannot expect to feel good every day either.

I assume you are following good lifestyle strategies as well - so good diet and exercise and practising relaxation techniques?
Getting through peri meno can be challenging but chopping and changing HRT dosage and regimes can often make things worse - one has to stick with a particular regime for 3-6 months to see if it helps but in peri that doesn't always work as your own hormones will be having an influence as well. If you are in early peri meno and still ovulating regularly then it is particularly difficult. 
DG x