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[EmmaK]

 This could be a bit of a long one so bear with me. I've had a good look at the forum and there's loads of helpful stuff but not quite tailored to my situation (though I might have missed it!).  I'm also not used to this forum so this might be in the wrong place.  I'm giving the history for context and to get it straight in my own head.

At 49 after feeling generally run down and fully of rage and suicidal thoughts plus insomnia and itchy red skin I took myself to Nick Panay's clinic and was moved from Cerazette to Qlaira. I spent two years on Qlaira and it improved things for the first year or so. Then I started to get the odd debilitating headache that no pain killer could touch when I was on the ‘blank' pills. The headaches got worse and worse until I was losing five days a month and was in terrible pain and bleeding got a bit heavier. In February I went to my GP (couldn't afford NP's Clinic anymore!) and, in the knowledge I couldn't stay on Qlaira past 52 asked for something that would give me a more consistent dose of hormones.

The GP put me on to two pumps of Estrogel and one Utrogestan 100 orally at night for 25 days out of 28. She advised me to start straight away despite being half way through a packet of Qlaira. I started this regime on 1st March this year, at first I was dizzy and nauseous taking the Utrogestan but it settled. Two pumps of Estrogel was too much so I stuck to one and increased to two after about 6 weeks. I had light bleeding and the headaches were pretty much solved, my mood was better and the anxiety I was feeling was reduced, ticking along put periods getting a bit heavier and some break through too.
However, I've now been bleeding pretty much the whole of the school holidays. I had a breakthrough bleed which lasted a week or so and then came to the end of the 25 day regime a few days later, had a couple of days free of bleeding then started again, heavier and with much more breast soreness. I also noticed that the bleeding would be less in the morning and then I'd have a surge mid day as if my morning two pumps of Estrogel had kicked something off. The bleeding has got heavier and carried on and I'm about to enter week three of bleeding without any sign of it slowing down. In the last few days I've reduced my Estrogel to one pump (but any less and the headaches reappear).

I know I need to go to the GP but as I'm unlikely to get an appointment for a week or so I just wondered if anyone (who hasn't got tired of reading to the end of this epic tale) has any suggestions or thoughts. Am I too high in oestrogen or is the Utrogestan not man enough for the job? Fibroids?? I think I must still be peri as there seems to be some sort of hormone activity in the background. I've really had enough now - wonder if I'll ever feel positive and energised again.

[Dotty]

If you are still in peri menopause then you would need to take the Utrogestan on a cyclical regime. 200mg for days 15-26 of your cycle.

If you've only just started on the Oestrogel and Utrogestan then it can take 6 months to settle and bleeding can be expected for 6 months x

[EmmaK]

Thanks Dotty.  I think I'm still peri but it's hard to tell though I think there is background hormone fluctuation.  I'm a little scared of not taking Utrogestan for the majority of days because of the headaches I get on break days. I'd always assumed it was lack of progesterone that gave me headaches but perhaps it's not that.  It's all very confusing and I've yet to find a GP who really knows so perhaps I'm on the wrong regime.

[MicheleMaBelle]

Hi EmmaK. You are on the dosage for Peri and not post menopause. Your own hormones will be doing their own fandango in the background. In any event, you can take the Utrogestan every day, no need for the break even although it's mentioned in the leaflet.

[Dotty]

Hi 25 out of 28 days is the old dose for post menopause. The new guidance is every day.

The peri dose is 200mg from days 15 - 26.

[Hurdity]

Hi EmmaK

 

The headaches on the non-progesterone days could well be due to what is known as "progesterone withdrawal" - just like with pms and before a natural period. Many of us get these. If you are still peri-menopause then defo do as Dotty suggests and take utro cyclically 12 days per 28.Tricky thing is knowing where your natural cycle is - but you could just guess and if you are completely wrong then you can tweak the regime to try to sync the HRT with your own cycle. You may still get a monthly ( or 4 weekly) headache, hopefully not to debilitating but your bleeds would be predictable. I used to time my 4 weekly cycle (when I was in my 50's) so that the withdrawal came at weekends when I wasn't working so that at least I could function. My withdrawal migraines often lasted 3 days. I still felt better overall than off HRT though.

Now I'm older ( in my 60's) and well post-menopause, I have a longer cycle (with doc approval) so the prog withdrawal headaches are less frequent.

Hurdity x