Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Turkish delight]

Hi gals!

I'm Dem, I'm so glad to join your community, though wish I didn't have to

So my quick back story(the boring bit I know)I'm 51 and have been struggling with the standard textbook meno symptoms over a few years but mainly in the whole of 2018, which was a write off due to worsening symptoms. I haven't had a period in 5 months so feel i fall inbetween peri and meno!?

So I presented to my gp and long story short, got a gynae apmnt which was last week to discuss whether I'm even a candidate for bhrt. I asked this bcz my mum died age 50 from breast cancer!! She got it at age 40.

So cut back to gynae who says...Yes you can absolutely have it! He said bcz of the ways I've been suffering badly with the symptoms ect, he wouldn't have any issues with it, and even prescribes it to women who have themselves had breast cancer, go figure! Want to add here that my eyes are wide open going into this, and obv it's me who has to live with the all the "what if's" and potential consequences of bhrt, but having the green light from a gynae was reassuring.(To any still worried for me I didn't take this decision lightly.)

So my question is, has anyone ever heard of taking 2 pumps estrogel twice a week??? with 100mg utrogestran 14 days per month!!!? This is what my take away script was, plus some Testogel(ask and you will/will not receive)a thimble size daily. Thimble size...excuse me a moment while I clear my hoarse husky throat...jokes! I have the pump dispenser type. There wasn't an explanation on why this dose and whether to tweak it. I don't have a follow up apmnt with gynae either.

When I went to the gynae, I didn't have any info on dosages of estrogel, partly bcz I thought I'd have the bhrt door slammed in my face. I just knew what treatment I felt would suit me. And bhrt being adjustable seemed a good fit considering my family history, as I am keen to take the"minimum effective dose"

I have started taking the estogel. I took one 1 pump instead of 2 pumps for the past 3 days bcz I'm a chicken, and want to ease into it like easing into a warm bath. Though secretly I fear it will be more like a baptism of fire in reality...yikes! Another question coming... So from every other shred of evidence I've read since my apmnt I should be taking it daily right, not twice a week...no? Help!! Why would he have suggested twice a week, won't I be on an up down oestrogen rollercoaster on this regime?

Another thing I'm not sure on is if 100mg utrogestran vaginally is enough with one pump estrogel daily, when I haven't had a period for 5 months straight? Should i go back to my gp and ask for more as I only have 14 100mg in my possession.

PS It might be worth mentioning I have Ankylosing spondylitis as well and take biologics Enbrel weekly injection.

I would be grateful for some advice from you lovely ladies and thank you in advance for that.

Peace out

D

[Hurdity]

Hi again Turkish Delight.

I see you've found the other boards!  I answered on your introductory thread. This is all the same forum though so most of your post is repeated from your intro one - although I see you have answered some of the questions I asked on there.The idea is if you start a new thread it's on a different topic as it gets confusing to have two threads going on the same subject but don't worry you'll get used to how it all works!

Re the Utrogestan - I suggested on the other thread you followed the advice that you have been prescribed ie one pump on altenrate days rather than two pumps twice a week. That being the case 100 mg (vaginally) may well be sufficient although did you say you have been presceibed 200 mg for 14 days? It's always best to start with the licesned dose though even if you do use it vaginally - to see how your body reacts - but be guided by your gynae in this. Yes ask for more Utrogestan - you should have been given at least one month's supply before reviewing with your doc.

Yes you should be on cyclical HRT (that gives a withdrawal bleed) as you are not yet post-menopause - so this is correct.

That's way too much testosterone as I said on your other thread.

Hope this helps and hope it works for you

Hurdity x

[Dotty]

Did the gynae or GP or pharmacist prescribe you the dosage of the oestrogel, utrogestan, and testosterone?

[Turkish delight]

Hi gals

Sorry, I messed up with duplicate posts, let's stick to this one. Dotty darling the gynae prescribed all the doses yes.

Hurdity, yes the gynae gave me one month of 100mg utrogestran which is 14 days. I reckon based on everything weighed up 100mg for 14 days maybe enough then.

I have a slipper v right now lol, based on what I've read in these parts that a good sign of absorption.

Cor thanks girls, I'd be lost without you.

Dem

[Turkish delight]

I'm just copy pasting this so it's all in one place, I have the hang of it now. Thank you for your patience.

Yep Hurdity he said 2 pumps twice a week but didn't expand on why and I was ignorant to the guideline dose at that point. So it doesn't seem like a weird regime or ineffective dose to you?

I can live with 1 pump every other day now you put it in context which he didn't. Read in another post about slippery discharge, I also have a slipper v situation already so maybe one pump is cutting it for me. I don't have another follow up apmnt so sort of cut adrift.

I haven't had any periods in 5 months so feel in the middle of peri and meno, so the guide lines cross over a bit in my mind. What else....don't know if I covered everything............um oh yea, what about bleeds with utro, will I expect one after stopping utro of 14 days, does that sound like i know what i'm talking about or not, bcz I don't lol!

Thanksy
D

[Hurdity]

Yes you should get a withdrawal bleed after stopping the utro. One pump every other day is better than 2 pumps twice a week but might not be quite enough - but I would go cautiously in view of the bc - until you maybe get checked re genetic risk?

You should have a follow up appointment - especially in view of that high dose of T and also because you would want to be prescribed at least 2 months of utro (so you don;t have to keep gong back) and you haven;t even been given one month's worth - as licensed dose is 200 mg for 12-14 days ie one packet ( contains 30 x 100 mg)

Hurdity x

[Dotty]

Not all gynaecologists are menopause specialists!

Are you on Facebook? There is a very good group to join where you can ask a question and there is a dr on there who will try and answer. It's called the menopause support group run by Diane Danzebrink.

[Turkish delight]

Thanks Dotty, don't know his exact qualifications. I think your right though, got a feeling he was more a specialist in the preggers end of gynae than the end I'm facing haha!

Hurdity, you're correct of course too! I see now that 100mg is half the recommended dose of Utrogestan. He only gave me 14 x 100mg and didn't say where to shove it either...as in how to take it orally or otherwise. But I'm going for the butt, front one obv My understanding is that it's got better absorption/strength if inserted down below...yes/no? In which case it could be ok.

I won't take any Tesogel for 3 months then I guess and will take a petit pea blob size.

I'm not sure about the gene test, I didn't think it was available on the nhs. It's a pretty loaded subject, and one thanks to you Hurdity I will re think on. X

Thank you-thank you-thank you ladies

D

[Turkish delight]

Just remembering now, that many years ago when I first heard about the brca gene I asked my gp about testing me and he said no not available on nhs. Guess it's changed since.

I have been having yearly mammograms from my early 40's, which ironically nhs stopped when I turned 50. I will pay to have it done in between the 3 years gap that the national screening carries out, if that makes sense.

D

[Dotty]

Don't be afraid of taking the Utrogestan orally . I take it orally and I've never had any side effects x

[Turkish delight]

Oh right, I must have missed you mentioning that you take it orally Dotty, interesting.

Being I have less than the 200mg recommended dose, shouldn't I try and maximise it's effects till I can get more of it.

Question..So which way has the optimum effects strength wise O or V?

D

[Turkish delight]

PS I haven't had any hormone tests. None for testosterone included. I just told gynae that I have had a lessening of libido and asked for some testosterone gel and he added it to the scrip.

Loss of libido, cognitive ability, and concentration is suffering too, whether to low estrogen or testosterone I don't know. Do we become testosterone dominant after menopause? My sister in law said we're starting to turn into men lol, that's why we start sprouting whiskers she said....yikes!

Right now I feel I'm slowly decomposing from the inside out, that's how I'd define menopause in the English dictionary

Peace
D

[Ladybt28]

Hey Turkish delight -  Reading your first post over, I wonder if there is confusion in the doses on the prescription.  If you have been prescribed testosterone gel, and oestrogel and utrogestan, the usual dosage for prescribing on a cycle is:

1-2 pumps oestrogel daily, 14 day Utrogestan starting day 15 ...and if adding in testosterone gel start with a pea size blob every other day or twice a week.

Maybe he wasn't clear between the oestrogen gel and testosterone gel?  Just a thought?

Ladybt x

[Dotty]

That's a good point Ladybt28.....testosterone should be twice a week and Oestrogel every day x

[Hurdity]

Testosterone can be every day depending on the preparation!  I do a small pea-sized blob daily (of 1 % gel). The Tostran pump is recommended twice a week to start though (because it is stronger) - but as T is unlicensed then gynaes seem to decide their own regime.....some gynaes say half a pump on alternate days for the Tostran.  I would still use low amounts of estradiol gel  as prescribed but alternate days - to start with due to your bc background - but yes do query the dosing of it all too in case they've actually got it wrong! (to reiterate it is defo wrong with the T gel)

By the way if your mum was diagnosed with breast cancer at age 40 that is on the borderline for referral as per NICE Guidelines and depending on other familial conditions. Please read this link here:https://patient.info/doctor/familial-breast-cancer. It may be that you can push for a referral although I'm not quite clear on the details?

"Referral to secondary care[3]

People without a personal history of breast cancer who meet the following criteria should be offered referral to secondary care:

    One first-degree female relative diagnosed with breast cancer at younger than age 40 years.
    One first-degree male relative diagnosed with breast cancer at any age.
    One first-degree relative with bilateral breast cancer where the first primary was diagnosed at younger than age 50 years.
    Two first-degree relatives, or one first-degree and one second-degree relative, diagnosed with breast cancer at any age.
    One first-degree or second-degree relative diagnosed with breast cancer at any age and one first-degree or second-degree relative diagnosed with ovarian cancer at any age (one of these should be a first-degree relative).
    Three first-degree or second-degree relatives diagnosed with breast cancer at any age."

In the same link it talks about genetic testing too - what criteria apply.


Hurdity x