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[Mogster71]

Hi ladies

Hope everyone is in a good place and on an even keel  I need some advice or a good talking-to please!!

2 weeks ago I stopped taking the HRT (short version of back story is that in June i took Novofem for a month, norethisterone did not agree with me very well. A month off, symptoms return and then they tried me on Femoston 2/10. Felt ropey most of the month with spotting and although progesterone not as bad as first lot, I still didn't feel right). I had a big annual work event last week and I couldn't face not feeling right. Well...within a few days of ditching the Femoston my headaches, the main symptom for me, returned with a vengeance. I ended up feeling awful while away for my event anyway and have done since.

My surgery let me down again yesterday - I desperately wanted an appointment, rang at 8, was told a nurse would triage me within 2 hours, only to get a call at 10 to say they had all gone to people with greater need (thank you very bl**dy much). The best I could hope for was a chat with the GP after morning surgery. I know they are busy people so I would have been fine with this.

I got a call at 3 and tried to explain the problems to the apparent menopause specialist in the surgery. I asked for advice about using a different method of HRT if the progesterone made me react - a gel, perhaps? She had not heard of utrogestran or it wasn't on her list of items she was allowed to prescribe. You can have progesterone tablets or the mirena. But we don't do the mirena here, it will have to be done at the hospital or the icash clinic. (WTF is that I thought - turns out its the old GUM clinic ) Her words were that they only give you the Mirena if you are wanting it for contraception?

Well what can I have then?
You said you were ok on Microgynon, what about doing that again? This was my pill I took for my 20's and 30's. Has a massive amount more progesterone, 150mcg. Surely this would be a bad thing?

I asked about low dose Premique, as this was the only other progesterone I hadn't tried in tablet form or that was available - I don't even know if they can get it....but it is only 0.3 oestrogen, as opposed to 1mg and 2mg I've had with the Novofem and Femoston.

I can't help feeling really short-changed by my surgery. I am close to tears and just want to feel well again. I've even had a chat with a homeopath to see if I can go it alone with some help from her. Why do we have to jump through so many hoops to be able to get through and function to live a normal life?

I do realise that only taking both of these tablets for only a month is a short time and I asked the doctor this yesterday, whether things would improve over time, and she said you would know fairly quickly if you weren't getting on with something.

Please someone can you give me some positive thoughts?? 

[Tracey E]

Hi Mogster, I'm in Leics and they fit the Mirena here for HRT. I would like to think that's pretty standard all over the UK and your doctor probably just doesn't know about it. Could you ask for a doctors appointment at your surgery with a HRT sympathetic/knowledgable GP?

I was in the contraceptive pill until I was 50 then I had a coil fitted for a couple of years. I didn't smoke so I presume they thought it was safe to carry on with it.

As far as I know patches and gels are safer than tablet form HRT and there's a number of different types you could try. All best discussed with your doctor. Hope you feel better soon. X

[sheila99]

If you want mirena you're probably better off going to your local clinic than being the Guinea pig for gp's first attempt. You can ask for a referral to a menopause clinic if you want gel. I got it gel/utro because a saw a completely clueless male gp who gave me what I asked for. The practice 'expert' will give you evorel or everel. I'm the only patient in the practice on testosterone (prescribed by meno clinic) , I'm sure I'm not the only one who needs it.

[Ladybt28]

Particularly with HRT its not really true that you would "know pretty quickly if you were not getting on with something".  Conventional wisdom amongst GP's and consultants who know their stuff on hrt say that you should try something for a minimum of 3 months before changing as it can take that long to settle.  Spotting can continue up to 6 months, so a few weeks is pretty normal.  HRT is all about balancing levels and putting back to the right level hormones we are depleted in, but we all have different levels that are right for us, so it is not a very exact science.  It might take you 2 months in peri at your age for the levels to come right or it might take 7 months (like me post meno at 57).
Personally as a medication I view all forms of hrt a bit of a "slow burn" if you get my meaning...?

The GP you spoke to sounds like a nightmare and doesn't seem to have a clue...they have no idea of the impact their useless waffle has on those of us who suffering but that's not unusual either unfortunately.  Why on earth would she put you back on the pill!!!!???

I posted a comment in the "hrt shortage" thread about premique the other day saying I was surprised it was still available and it appears there is no shortage on the very low dose so it could be an option for you if you can find a "useful doctor".   There is no problem getting a mirena for hrt purposes round most of the country but some surgery's wont insert it then send you to a clinic like the GP said.  My surgery will do it but I'm in Northern Ireland.  I couldn't take pills of any kind, Femeston gave me migraines and Everol patches of any kind didn't agree and I tried them all for 3 months.  The only ones which I knew were bad immediately were the Femeston and Provera (single progesterone tablets) - my reactions to those were pretty immediate but the others just were not working even by the end of 3 months I felt no better.

When I had problems with my GP I asked to go to a meno clinic to get advice but that also depends where in the country you are as to whether there is one local or whether GP will refer.  First suggestion would be to try and find out if there is a GP in your practice that specialises or knows more about "womens health" than the others and then you will have to wait a week or so to see them.  Unfortunately, it has been my experience that surgerys are not very quick at sorting appointments for this kind of thing as it is viewed as "natural" and not urgent despite nearly sending most of us over the edge.

Hang on in there try and find someone at the surgery who has a vague idea what they are talking about...maybe do some more research here and then go in asking for exactly what you think you should have and the reasons why xx good luck

[Mogster71]

Hi ladies

Thank you all so much for your kind replies, I am really sorry for my meltdown, I was feeling so angry and frustrated at having to justify the need for help. It wasn't a good start to the day and then I seemed to get more and more annoyed about it. Had a very good cry afterwards 

I had an unexpected call from the dispensary this evening to be told that my "new tablets" have arrived...I was really surprised, expecting a very low dose premique as it was the last thing we discussed, but they have ordered me in Tridestra. I did talk about long cycle with the GP as I have only had one period since April. Fingers crossed this will be the one or back to the drawing board.

Ladybt I know I have not been particularly good at trying things for very long, I feel useless about that. I just know that I did not feel well at all on the progesterone part of the tablets and I panicked worrying about having to do 2 more months feeling like that. Bit of a div, aren't i?

I'm not heartbroken about the Mirena, it was just surprising that they didn't do it in the surgery or for anything other than contraceptive purposes. I know you said about speaking to the menopause doctor of the surgery but that WAS her....I've now seen all 3 out of 4 GP's, 3 of them women.
Before I got the call today I did actually try and ring the local menopause clinic (local being about 50 miles away) but they prefer GP rather than self-referrals. I will go down that route if need be, hopefully this new regime will be better for me.

Thank you again x

[Ladybt28]

So Tridestra is a long cycle hrt and the pills are taken over a 3 month period with some blank weeks at the end of the 3 month There are 3 types of tablets white ones = estradiol, blue ones are estradiol and medroxyprogesterone and the yellow ones are blank.  Its a sequential hrt.  White tablets taken days 1-70.  Blue tablets day 71 to 84 and then the yellow blanks day 85 to 91.
The blanks are there really so you don't forget when you stop and startmand to bleed. I was given it and only managed one set of tablets. My problem was they were tablets and so went through the stomach and got processed by the liver. I got the same side effects with any pills but that's just me. The idea is you bleed once every 3 months. Its a good system if you can get on with it but the only way is to try. Xx

[Mogster71]

Hi LadyBT

My thoughts about taking HRT long cycle were that if I only had to take the progesterone once in every 3 months it might be tolerable!! It was the reason I bombed out before because I seemed to be adding in more side effects than improving anything; the progesterone made me feel cranky, jittery and caused extra trips to the loo!!

Can I ask if it is safe to take in peri? I do think I am fairly late on in the process based on my own cycle this year; my last natural period was in April and I started my quest for help on 31 May...the surgery then "lost" 2 lots of blood tests which involved almost a 6 week wait before I knew what my levels were. I know you shouldn't always go by blood tests because it's only a small window of time. I just knew that things had really stepped up a gear this year - migraines and headaches that had only been once in a blue moon in the few years previous were now a regular thing.

I have had a low grade period pain for the last few weeks - last period was when I stopped the Femoston mid September. Do you think it is advisable to get this checked out before a long cycle HRT? I think if anything is worrying me about this it is the chance of building up womb lining.

Thanks BT, you've been really helpful x

[Ladybt28]

Personally from my own experience and doing a lot of reading here I would say that you can only work out what suits by a process of elimination.  Do pills cause stomach problems or side effects like being more drowsy that are created by them going through the stomach or the liver, (extra trips to the loo??? would that be because of dodgy bowels? - then stomach issues) then maybe pills are not right for you....than patches - would you have problems with them stick, would you have problems in spikes or dips in delivery for example?...do certain drugs give you headaches etc and then because there are only a few types of progesterone which gives you the most side affects in your mood.

If you can eradicate everything and find you are fine on one kind then great the second next thing is to use what keeps them to a minimum and you can live with for a short time.  That would be where I am.

Tridestra can be used for both peri and post meno women but I would suggest that for the peri side it would be for women later in peri.  Being on hrt since 45 I have no idea when I went to post meno officially.  In terms of womb lining I personally don't think there is anything to worry about by starting a long cycle of 3 months and then seeing how you bleed.  You may get spotting during the 3 months that is common, or you may get a bleed which is due to changing again, you don't know how your body will react till you try.  My opinion and it is only my opinion is that I don't think you can do too much damage which cannot be resolved over a 6 month period of build up should it happen.  One round of heavy dose progesterone would shed the lining should it occur and it is something I have always had in my mind if I get in that situation.  Luckily for me my bleeds on a 28 + 12 days Utro are regular and heavy ish so I know that the linining is shedding on a regular basis.

I went through a period of regular and nearly continuous bleeding for about 3 months which was unpleasant when I was on Femeston and Evoril and switching between them but I didn't worry about that because I knew it was the hrt doing it.  Try not worry I don't think bad things happen that quickly 

[Mogster71]

LadyBT

Thank you again for your kind reply. Bit of a worrier by nature, which you might have gathered by now!!  I have picked up the tablets from the surgery this afternoon, and I'm going to start them tomorrow morning.

I'm not sure whether it was the tablets themselves that made me feel off, it was mainly overactive in the toilet department - I didn't notice any drowsiness. I used to feel like this just a day or so before a natural period and then the first day. So kind of like an enhanced version of that. Norethisterone was not nice with the heart racing and dreadful anger. Dydrogesterone was only a bit better.

Strange question but I've thought a lot about how long this has been going on for me and I think it initially started in my very early 40s. It's only in the last year that it seems to have speeded up lot, from being fair regular up till last year. My last period was in April, and when I spotted on the Femoston in September it was suggested that it could have been my own period coming through. That would be nearly 5 months apart. I do think I am in late peri.

You have rationalised it all really well - will just have to suck it and see 

I've come to accept that nothing is normal at the moment!! xx