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[Mintea]

I have been taking utrogestan and oestrogel for just over 2 months on a conti basis. I had a heavy bleed about 4 weeks in and my GP referred me for a TVS - the result was my endometrium is 6mm and I have multiple fibroids - the largest being 32 mm. I knew I had fibroids as was told this when I had a caesarean and they have caused me no problems. Anyway the GP says no further action required as all normal.
At my GP appointment I brought up the possibility of using the utrogestan vaginally and alternate days and also increasing the oestrogel (as I was only on 1 pump). I thought increasing it might help counteract the sedation I have been feeling from the utrogestan which I know is very common from reading posts on here. Anyway my GP was obviously totally ignorant about what I suggested and told me so. She gave me referral details of 2 private hospitals which apparently do NHS work for menopause which are in a city near where I live.  I was pleased with her response but am a bit unsure as to the expertise on offer as it is from a private hospital and not an NHS menopause clinic. I'm a bit wary of the type of advice I am likely to get. I emailed 1 hospital to ask if any of the doctors were members of the British Menopause Society but have not received a reply. I was wondering if anyone else has has experience of this type of referral?
Also on reading my online medical records my GP has put - ' she is still using ovestin as well' as if this is a bad thing. I'm a bit worried that they are going to stop me having both at some point.

[Dotty]

Hi Mintea
Sorry if you've put this in another post, but are you post menopause ? When was your last period? X

[CLKD]

Ask for a referral to a Menopause Clinic - not a Gynaecologist as they don't know much more than GPs!  Ring the Surgery and make the request.  You can use 'ovestin' for Life, otherwise symptoms will recur.

[Hurdity]

Hi Mintea, if your doctor admits to ignorance about the menopause and appropriate individualised treatment, then they should refer you to an NHS menopause clinic - whichever is nearest to you hopefully but if the private clinic does NHS work and they are BMS accredited then that's great! By the way you can check online about the clinics and also the names of the specialists will be listed if they are BMS members I think. Many of the specialists are also listed on their website.

The GP should not be able to stop your prescription (for ovestin) without your agreement. Really does sound ignorant. My nominated GP was too - she saw (a few years ago) that i was on estriol cream as well as systemic HRT and thought I might have too much oestrogen so sent me for a test (which of course is for estradiol and does not test estriol anyway!).

How will your fibroids be monitored because this may well continue to cause bleeding which will be annoying?

Hurdity x

[Jari]

Hi Mintea

I was just reading your posts with interest as I too had trouble with hrt.

I had various bad side effects and it also caused fibroid growth.

I saw two menopause specialists privately, but found in hindsight, my GP gave me the best advice.

May I ask the main reasons that you want to take hormones?

X

[Mintea]

Hi Mintea

I was just reading your posts with interest as I too had trouble with hrt.

I had various bad side effects and it also caused fibroid growth.

I saw two menopause specialists privately, but found in hindsight, my GP gave me the best advice.

May I ask the main reasons that you want to take hormones?

X

Hi Jari
I've just seen your post so sorry for late reply. I wanted to try systemic hrt for a variety of reasons:
I have VA and although used vagifem, ovestin and other products for a couple of years I was hoping it would improve things more. Unable to have sex for several years, complete disappearance of sex drive (no problems before menopause), pain, urinary frequency etc.  I also had jointpains,anxiety/depression that I thought might be hormone related. I also have a family history of osteoporosis so thought it would be wise to take it as my mother was badly affected by this and broke hips and thigh bones - it really badly affected the quality of the last years of her life. My sister has it as well.
As well as the above reasons the research shows that hrt has many beneficial effects for women if taken within 10 years of menopause although the nearer to the menopause the better. So it seemed silly not to try it. I just wish it had been a lot more straightforward. I am up to my 12th week now and just had a second episode of heavy bleeding.  I had felt some benefits from the hrt particularly less joint pains and less anxiety but the heavy bleeding is awful. It seems so difficult to get specialist advice. I have very reluctantly stopped taking the hrt now for a few days so I can decide what to do as I really dont want the heavy bleeding every few weeks- I wouldnt be bothered by a light period.
The tvs I had recently showed multiple fibroids so perhaps this is causing the bleeding. I really dont want to have a hysterectomy or any other procedure to deal with them so if they are the cause will probably stay off it.

Sorry for the long post

Mintea x

[CLKD]

Hormones can certainly trigger fibroids to react.

How much 'vagifem' do you use?  Some ladies require it nightly, every night for Life.

[Mintea]

Hormones can certainly trigger fibroids to react.

How much 'vagifem' do you use?  Some ladies require it nightly, every night for Life.

I tend to use every other night and ovestin as well for external area.

[Hurdity]

Hi Mintea

If the fibroids are causing the bleeding and in addition the utrogestan is not sufficient to keep the lining thin on continuous combined HRT, have you thought of getting a Mirena fitted? This might have already been covered but I can't remember with all that's going on! That way you would be able to continue with the oestrogen and gain the protection of your bones you are hoping for.

I'm not sure what is happening about NHS referrals to menopause clinics with the present crisis - I imagine services might have been suspended?

I hope you manage to resolve this...

Hurdity x

[Mintea]

Hi Mintea

If the fibroids are causing the bleeding and in addition the utrogestan is not sufficient to keep the lining thin on continuous combined HRT, have you thought of getting a Mirena fitted? This might have already been covered but I can't remember with all that's going on! That way you would be able to continue with the oestrogen and gain the protection of your bones you are hoping for.

I'm not sure what is happening about NHS referrals to menopause clinics with the present crisis - I imagine services might have been suspended?

I hope you manage to resolve this...

Hurdity x

Hi Hurdity

Thanks for your reply. I really dont fancy having a Mirena fitted or any other investigations really. I had a tvs recently and that was bad enough! 
I've decided to ask my gp to refer me to the nearest BMS accredited menopause clinic. The problem is there is a 2 month waiting list. It would be really helpful to just have a chat over the phone with a specialist but unless I'm prepared to go private that isnt going to happen unfortunately.

I hope things are going well with you.
Mintea x

[Bobidy]

Hi

Just to say I had awful bleeding, pain, anemia, frequent urination etc etc with fibroids and polyps that went on for years and ruined my life. I had a laproscopic hysterectomy last year which has been life changing for me and I've never looked back. It is a huge decision not to be taken lightly but may be something to seriously consider. I started estrogel a month after (so no increased risk of bc) and it's been fantastic, Vagifem and Ovestin started in December which have sorted the va. The trick is getting a type/dose which suits you. I wish you all the best x

[Bobidy]

I forgot to say that the Androfemme testosterone has also kicked in and thicky brain has been kicked out. I can now form a normal sentence again without forgetting the words or what I was trying to say! There is light at the end of the tunnel x

[Mintea]

I had fibroids before I started HRT and the lowest dose of oestrogel I have used is two pumps, and my fibroids have shrunk. I now use two pumps plus a curl of oestrogel. I also use Estriol cream every day.
I am post meno too.
Jari, please stop trying to encourage people to give up HRT!
Mintea's decision to use HRT is not yours to judge. And she wasn't asking if she should take it or not.
Mintea, Dr Louise Newton writes about fibroids and HRT. Try doing a search on these forums.

Thanks for your reply Birdy. Interesting that yours have shrunk. Did you experience similar heavy bleeding at any time. Are you taking progesterone as well?
I've had a look at Louise Newsons site but cant find anything detailed enough about fibroids just that it shouldn't be a barrier to taking hrt. I'll have another look on this forum but it would be nice to know if it could be resolved with a different type of hrt or different ratio of oestrogen to progesterone rather than going down a surgical route. It seems very difficult to get individualised information and advice.

Mintea x

[Mintea]

Hi

Just to say I had awful bleeding, pain, anemia, frequent urination etc etc with fibroids and polyps that went on for years and ruined my life. I had a laproscopic hysterectomy last year which has been life changing for me and I've never looked back. It is a huge decision not to be taken lightly but may be something to seriously consider. I started estrogel a month after (so no increased risk of bc) and it's been fantastic, Vagifem and Ovestin started in December which have sorted the va. The trick is getting a type/dose which suits you. I wish you all the best x

I'm glad your issues have resolved, sounds like you've had an awful time. The thing is I am 6 years post menopausal and have never had any problems with my fibroids up until starting hrt. I only found out I had them after a caesarean. My periods used to be quite regular sometimes heavy and painful but nothing too bad so it is surprising (and annoying) that I'm having these problems now and being unsure what to do.
I do appreciate having this forum to share things on.

Mintea x

[Mintea]

Do you use the utrogestan vaginally every night Birdy? I know you can use it alternate nights if on low or medium dose which is up to 2/3, I think.

I do like the idea of using it that way. I suppose as I've just started using hrt (well 3 months) I am still on a steep learning curve and trying to work out what's best.

Are you quite happy on your regime now? I would be interested in your reasons for starting it and your journey so will look at your posts so you dont need to repeat yourself.

I like your last comment that it is up to the individual ultimately to decide how to use it.

Mintea x