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[anon2021]

Hi there,

I've been taking Estrogel and Utrogestan for over a year now. I'm Péri menopausal so was having regular periods prior to treatment. But they were very heavy (apologies if tmi!).

I've tried both options Utrogestan 100mg daily and the day 12 option 200mg. But I just break through bleed every two weeks. Some times even 10 days or may go 3 weeks but lost all regularity and sooo frequent! It's a wonder I have any blood left 

Should I ask for a scan? Just can't seem to get it sorted at all. If I don't take the Estrogel (I was only slightly low on oestrogen in the first place) I am sooooo grumpy!!! Other symptoms are palpitations if I take Utrogestan orally (now take the other way). But can't not take the Utrogestan as I still have periods. 🤔

Tried stopping it all and going back on Zoely pill (it's the closest to this regime ie bio identical hormones in it) but obvs not enough oestrogen in it for me as I just went back to that horrible rage from nowhere feeling. 

Any advice or similar stories would be much appreciated! My doctor seems rather disinterested so I never bother to go but feeling like a scan may be a good idea?

Thank you lovely ladies XX

[Hurdity]

Hi anon2021

Your post got missed - they soon drop off the page these days with so many members!

Firstly re the pill. There is QLAIRA which has higher doses of oestrogen (also bio-identical) than ZOELY and also one of the newer generation progestogens,. It is tri-phasic though ie a couple of days you take 3 mg oestrogen and a couple of days 1 mg but all the rest - 22 days - it's 2 mg - and there are only 2 tablet free days. Zoely is only 1.5 mg oestrogen for 24 days so less in total.

Re the bleeding - if you were having regular periods then a continuous combined regime is definitely not right but if you were also getting bleeding every 2 weeks on estrogel and 200 mg x 12 days prog then the prog is insufficient. Have you thought of having a Mirena coil - which will control the heavy bleeding and provide contraception? Then you could add the dose of oestrogen that suited you and not worry about the bleeding? This would be the best solution other than trying Qlaira I think. The only other option is to take a stronger progestogen than Utro - but there is only Provera - though you could take it at a higher dose to control the bleeding.

Also just to be on the safe side yes you should get checked with the doc too - it may well be that you have fibroids or a polyp that is causing the extra heavy bleeding (did you get checked out about these before starting the HRT?). Maybe you had endometriosis in the past? Go to another doc in the practice if yours is disinterested or go to him/her and press the point. It's their job to be interested and check out any potential health issues!!!

There are other alternatives to treat heavy bleeding - not sure if they can all be used alongside HRT - but eg endometrial ablation can help. There is more info about treatments here: https://www.menopausematters.co.uk/periodtreatments.php

Hope this helps

Hurdity x

[anon2021]

Thank you so much Hurdity for your kind and, as always, informative reply.

Yes I have tried Zoely before and I was literally just awake thinking about that just now!

Wondering if I could go back to that but top up with a bit more Oestrogel on top of the Zoely? Just because despite taking it previously I was still a little low on oestrogen hence I suppose the unbalanced/sudden rage feelings. But I know that Zoely has similar hormones in it to the bio identical ones I'm taking as HRT. Plus the Utrogestan gives me palpitations if I take it by mouth (better since I switched to the other way) but I do feel it's slightly overkill taking all this as I'm only perimenopausal. And I don't think a stronger progesterone would be good for me because of the palpitations. I have a mild heart condition from birth where my heart occasionally misses beats/suddenly beats faster. It isn't in any way a problem but is exacerbated annoyingly by progesterone it seems!

I've booked an appointment with a female doctor at the practice and will insist on a scan (or go privately). When I tried ivf (10 years ago) the doctor did mention he could see possible fibroid/polyp. I also bled throughout both my pregnancies, for which they could find no reason. So we suspected that may be the cause.

I can't use the coil as I have an incompetent cervix and had to have a cerclage in both pregnancies (I had CIN III cervical procedure in 2003 which removed some of my cervix making it incompetent).

So my next question is, is Qlaira better than Zoely? And can I top up with a little Oestrogel (I only use 1-1.5 pumps a day currently anyway) if Zoely doesn't (as previously it didn't) help with mood symptoms, brain fog. Prior to taking the HRT these were my main symptoms and night sweats/occasional hot flush.

Thank you Hurdity, I don't know what we'd do without your expert knowledge in all this! 😘 really appreciate your help.

Xx

[Hurdity]

Thanks for your comments anon but really no expert - just a bit older than many on here, have been reading about all of this for some years and am retired so have the time! All the info is available online.....

Anyway - just to demonstrate my lack of knowedge - I really have no idea about adding additional oestrogen to either of the combi pills.  I suppose it depends on the dose of progestogen - and as this is more in the realms of contraception I can't answer - sorry! I found an HRT product called Naemis - which may have been discontinued now - from some other countries, which contains the same progestogen but also the same dose of oestrogenas Zoely - so that doesn't help!

I can't comment on which of those two pills are better - just that Qlaira does contain more oestrogen overall ie 52 mg per month over 26 days in the month (+ 2 dummy pill days ie no hormones) whereas Zoely is 36 mg over 24 days (+ 4 dummy pill days). On that basis i would say Qlaira but depends also how you cope with the progestogen type too? Not sure how this would affect palpitations but all the contra-indications are given here: https://www.medicines.org.uk/emc/product/6536/smpc

Good luck with your appointment and do let us know the outcome and what you decide to go for.

Hurdity x

[anon2021]

Thank you so much Hurdity! I managed to get a private presc for some Qlaira which were in stock only at Superdrug pharmacy) so will keep you posted how that goes! Hoping with the higher level of oestrogen in it it will suit me better than Zoely.

Just really feeling that as I'm only perimenopausal I'd really like to not take full HRT until I really need it! But as with all things I think it's a bit of trial and error! So will see how it goes.

Thanks again for your always  helpful info!!!

X