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[Demelza]

Hi ladies,

I am new here but have been reading a lot over the last few weeks and months and have found this forum informative and helpful. I went to see my GP last October because I was suffering many symptoms of peri-menopause, and she put me on Femseven sequi. I felt fine for the first month but shortly after starting the second month's patches, I was getting migraines and parasthesia thoughout my whole body more or less, so  went back to her and she advised stopping the HRT to see if that helped and to go back to see her in the new year.

In the meantime I did a lot of reading about body-identicals, and also sent off a saliva sample to a lab for analysis which came back indicating that I was very low in progesterone (all other hormone levels seemed fine - oestrogen actually quite high).  This backed up the research I had done which pointed towards me suffering oestrogen dominance.  When I went back to my GP I asked if she could prescribe Utrogestan (which she hadn't heard of) and after looking it up she said I could only get it privately (funding issue I guess as we have free prescriptions here).  However she didn't know any private specialists in our area, just gave me the name of someone she thought might be (although looking at his profile on BUPA, it doesn't mention menopause).

Anyway, I had found online Dr Nicola Hembry, in Bristol, about an hour away from me, whose website said she was a member of the British Menopause Association and had had specialist training in bio identical hormones.  I went to see her and she was very thorough (I was there for 1.5 hours) - took a full medical history and discussed things at length.  She prescribed Utrogestan, Vagifem and compounded testosterone cream.  I have now been on the the Utrogestan and Vagifem for two weeks (about a week on testosterone as it had to be sent from Specialist Pharmacy) and feel fine apart from the fact that I am not sleeping well.  I am waking every night with a very dry mouth and throat, drinking water, getting up to the loo, repeat, repeat, minimum of three times a night, sometimes as many as five.  I'm thinking this may be the Utrogestan but when I tried to contact Dr Hembry today I had a message to say she was away until April 29th.  If this is a side effect that will settle and disappear eventually then I'm happy to give it a bit longer but at the moment I'm not feeling that I'm seeing a huge improvement in the way I feel and the restless nights are taking their toll.

Any advice please?  Sorry for the very long post!

[Dotty]

Hi these compounded hrt creams are not licensed for use in UK. You would be better to see your GP and ask for oestrogen in the form of patches or gel to go with the Utrogestan. X

[jillydoll]

Just to say  Demelza.

Ask away, someone's always on to give advice.

Xx

[Demelza]

Thank you Dotty, I am aware of that, but I do not need systemic oestrogen. I believe that testosterone is not licensed for female use full stop, and that is the only hormone that I am having as a compounded cream. If you read my post you will see that I am asking about side effects from Utrogestan which is a licensed drug.

[Demelza]

thanks jillydoll x

Just to say  Demelza.

Ask away, someone's always on to give advice.

Xx

[CLKD]

Saliva samples proof anything or what exactly  . If they were helpful they would be offered on the NHS 

Browse round.  Make notes!  Ask, ask .........

Also, you have had good advice.  It takes a while for hormones to have an impact.  Do look out for vaginal atrophy  - treated separately from generalised HRT. 

Maybe put the product name into the search box and see what pops up? 

[Dotty]

Hopefully Hurdity will be along to answer your questions. X

[CLKD]

Do a search 

[Demelza]

Thanks Stellajane, that's helpful to know. I did try using vaginally two nights ago to see if it would help and only had to get up once, but last night I did the same and was up five times!

CKLD - I have searched and browsed extensively before posting here and have discovered, from other sites that Utrogestan can cause dry mouth. My question was whether anyone here had this problem, and if so, whether it resolved after a while, or was ongoing. I consider myself pretty well informed generally but this was a specific question that I have been unable to find an answer to.

Also, just because certain things are not offered on the NHS does not mean that they are not necessarily helpful or indeed effective. Much of it is down to budgetary constraints. Case in point - I am unable to get Utrogestan on the NHS where I live. My late husband was a world-renowned drug discoverer so I know probably more than the average lay-person about the drugs industry and how the NHS operates in this regard 

[CLKD]

Oh smacked wrists 

[SueLW]

Thanks Stellajane, that's helpful to know. I did try using vaginally two nights ago to see if it would help and only had to get up once, but last night I did the same and was up five times!

CKLD - I have searched and browsed extensively before posting here and have discovered, from other sites that Utrogestan can cause dry mouth. My question was whether anyone here had this problem, and if so, whether it resolved after a while, or was ongoing. I consider myself pretty well informed generally but this was a specific question that I have been unable to find an answer to.

Also, just because certain things are not offered on the NHS does not mean that they are not necessarily helpful or indeed effective. Much of it is down to budgetary constraints. Case in point - I am unable to get Utrogestan on the NHS where I live. My late husband was a world-renowned drug discoverer so I know probably more than the average lay-person about the drugs industry and how the NHS operates in this regard 

I suspect you can get Utrogestan in your area, but the GP wasn't looking in the right place.  If they can't find it under HRT they can find it under fertility treatment.  It's a standard NHS medication.

The problem with saliva or blood tests in peri is that your hormones are all over the place all the time.  There is no stability and no pattern.  So you don't actually know you don't need oestrogen.  You just know that at the time of the test you didn't.  But that aside, I have had a lot of side effects from Utrogestan, it doesn't suit everyone by any means.  But vaginally is better than by mouth but will take a while to settle.  I'd try taking it that way for at least a week before you decide it's no better.

Personally dry mouth was not an issue for me, but then I use oestrogen as well, which is the lubricating hormone so perhaps it countered that effect for me.

[SueLW]

Oh smacked wrists 

It did feel a bit like that CLKD didn't it! 

[CLKD]

I am cynical - if one has to pay for things like 'saliva tests' then my hackles rise. 

I have a scientific background 

[Hurdity]

Hi Demelza

  from me too.

Sorry to hear about your side effects from utrogestan. You have given us a lot of information in your post - which is great!

What you haven't said and would be helpful to know is how old you are and whereabouts you are on the menopausal journey, specifically what your cycle was doing re period frequency in the months leading up to your starting the Femseven sequi?

Also I agree with SueLW and CLKD re your tests. Saliva tests do not tell you anything about the actual hormone levels and are really only useful (if at all) for women with fertility problems to look at relative changes in estradiol and progesterone throughout the cycle, as a rough indication as to whether a woman is ovulating. Oestrogen levels vary throughout the day and throughout the menstrual cycle and are also affected by taking HRT.

What a pity that your doc was ignorant about what hormones would be suitable for you ( if at all), and was not aware that utrogestan is the only licesned progesterone for HRT. It could have been listed in the book as "micronised progesterone" rather than the brand name. Unfortunately although the specialist you saw says she is a member of the BMS, she is not actually one of their accredited specialists which are listed here: https://thebms.org.uk/find-a-menopause-specialist/ .

If she prescribed progesterone only on the basis of the saliva test results I'm afraid this is not receommended practice, and the notion of oestrogen dominance is misleading - because, of course - oestrogen is dominant during the first half of every menstrual cycle and around ovulation. Private practitioners have coined the term to sell progesterone creams - and do so in US.

I am puzzled as to the rest of your prescription too - and especially the prescribing of compounded testosterone - as this is unregulated. Although there is no licensed product for women in UK, some private practitioners prescribe Androfeme imported from Oz which is developed especially for women and so is known to be safe (within certain parameters) and effective. Others (including some on NHS) prescribe the existing products licensed for men but in much smaller doses commensurate with our relatively lower amounts of endogenous testosterone.

What symptoms are you hoping to allevaite through the products you have obtained?

I can't comment on the dry mouth - as I have only ever taken utrogestan vaginally and cyclically and this has not been one of the side effects. However many of us would not want to take utrogestan or any form of progestogen all the time ( if that's what you are doing) because of the sedative effects and continuous low grade side effects, due to having to be ingested in larger doses than needed to ensure sufficient gets to the uterus. I suspect your side effects may well be due to this (Utrogestan) especially night waking and peeing!

Also just for info - although you only asked one question - you will find that on this forum members will happily comment on anything anyone decides to share - as it's an open forum! We're all trying to be helpful!

I am cynical - if one has to pay for things like 'saliva tests' then my hackles rise. 

I have a scientific background 

Yes I agree re the saliva tests!

Btw - CLKD - you've never said you had a scientific background before - I thought you worked in admin for NHS?

Hope this helps, Demelza...

Hurdity x

[Demelza]

Thanks annamuller and Hurdity for your replies.

Annamuller - I had read that about saliva vs bloods hence why I opted to get the saliva test done.  My GP arranged for me to have a blood test which actually showed a very similar result however.

Hurdity, many thanks for your comprehensive reply, it's appreciated. I am 52 and although still having periods, they are much more erratic than they used to be, and much lighter.  The doctor did not prescribe on the basis of the saliva tests - this was something I did off my own back (rightly or wrongly) because I was interested to see what they showed, and I understand that hormones can fluctuate at different points in the cycle - I just thought it might be interesting.The doctor in fact said herself that they are not necessarily particularly useful (although can be with regard to DHEA). She has prescribed based on my symptoms, which we discussed in detail. I am not worried about the testosterone being unregulated.  As far as I can see, Specialist Pharmacy appear to be professional.  Most herbal and vitamin supplements are unregulated and yet people still take them with often good effects.  (My late husband, a professor of medicinal chemistry and discoverer of new drugs, was amongst other things doing good work using glucosamine alongside his own technology, which is of course unregulated but felt to be safe and effective.) 

With regard to the Utrogestan, unfortunately it doesn't appear to have a sedative affect on me and I'm certain the dry mouth and peeing all night are as a result of taking it - I've tried both orally and vaginally and neither seems to be better than the other.  I'm thinking I may stop it until I can speak to the specialist again as I'm not sure I'm seeing any real benefits which outweigh the poor sleep - although I haven't had a migraine since starting it which may or may not be a coincidence.  Incidentally, my GP had no problem finding Utrogestan in her formulary, it's just that we don't pay for prescriptions in Wales and it appears the Welsh Government have decided that Utrogestan is not a drug that they are prepared to let us have here unless we pay for it privately. That is why she was unable to prescribe it.

The main symptoms I've been experiencing are VA (hence the Vagifem, which does seem to be starting to help), migraines, "fuzzy" brain, tiredness and lowered libido. Probably other symptoms that I can't think of right now (fuzzy brain...).

Apologies if I was a little touchy in response to some of the replies (another menopause symptom??  ) - it felt rather as though I was being patronised and criticised by a couple of members without offering anything helpful and I felt a bit under attack.  I had hoped that everyone here would be supportive and to be honest, a couple of the responses made me a little wary of coming back here as i wasn't quite sure what I would be under fire for next...