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[PeriPagan]

Hi all,

Well for just over 5 months I've been on 4 pumps of Oestrogel (applied in two doses daily) along with a Cerazette a day for birth control and Utrogestan for 12 days a month starting on the first.

However, for the last 2 weeks I've been struggling a bit, it feels like my baseline has dropped a fair bit all in one go again. I'm not sleeping particularly well, very tired and my mental health has been , well a bit s**t!

The worst is the vivid dreams I have if I get annoyed or anxious and then fall asleep. They're filled with nonsense but i find them scary. This is then followed by several hours of being very sleepy but as soon my eyes close i get weird nonsensical intrusive thoughts and images! It can be hard to cope with this as your anxiety screams that you're going mad!

Can you still be subjected to the effects of surges/dips even whilst the dose is overall good? I'm most definatley mid to late peri. The rule books of female reproduction no longer apply here! My last 'period' was 10 days ago and that 'cycle' was 24 days; the previous was 28 days. This followed a long period of anovulatory timings.

Do I have to grit my teeth and bear this or can it be mitigated? I'm lucky that I've got email access to my private menopause specialist should I need it, but I'd rather keep any long term increase in dosage in my back pocket and even a short term increase would need consultant backing as Mid Essex CCG are very penny pinching over prescriptions and demand they be controlled with a fist of iron!

Thoughts?

[Hurdity]

Hi Peripagan

It's tricky to know really as you are on HRT as well as the mini pill. Theoretically you won't be having a cycle due to that. You shouldn't actually be ovulating if you're on Cerazette. When you mention your periods - these are just withdrawal bleeds because you are on cyclical HRT as well as the mini pill so your womb lining will be stimulated from the oestrogen. The increase and fall in the utrogestan will definitely lead to some sort of side effects albeit mild pms and then when you stop taking it your body has to readjust. If you are on a cycle you should take the utrogestan regularly ie every 4 weeks ( or a month if that's what has been suggested), irresepctive of when the bleed comes.

Are you saying the withdrawal bleed has come early sometimes ie before you have finished the course of utrogestan?
Also where in the cycle are you getting these feelings ie during the Utrogestan, or after it etc?

We are all a bit on edge aren't we due to circumstances and even on HRT we may not remain excatly on an even keel all the time. The main thing is to feel better overall more of the time than not, while on HRT.

Many of us get vivid dreams when on the utrogestan phase!

Personally I would feel you have too much prgoesterone when on that part of the cycle but maybe you tolerate it well?

Hope you're feeling better today

Hurdity x

[PeriPagan]

Hi Hurdity,

Thanks for the reply. I'm currently not on a Utro phase (My consultant has me take it from the first of the month, though if I'm honest I use a 200mg capsule vaginally every other day as 200mg every day was way too much!).

My withdrawal bleeds (I did put commas round cycle as I know its essentially not the real deal). but the length between bleeds is variable. I seem to spend about 50% of the time in very short cycles.. & my body seems to do its own thing, they've been times I've stopped the utro as my body has decided its bleed time anyway!

Days between bleeds since 23rd November 2019 (start of 4 pumps a day); 40 days, 18days, 20 days, 17days, 27days, 24 days. These are longer than before I increased to this dose (When they were anything from 12-21 days). This suggests to me that my own hormone levels are fluctuating a lot behind the scenes! My body was an absolute stinker for anovulatory cycles when I was in puberty (I went on the combined pill at 16 because of it). These observations along with the knowledge that my mum was menopausal at 45 means myself and my consultant have concluded that i'm well along the path!

I'm tired and wired today. I'm just concerned that this is going to stop me from working. I landed a year long placement about 10 days before lockdown and I'm terrified that its going to put paid to it.

[Hurdity]

Hi peripagan

I still don't think you can work out what is happening at all if you are taking the mini pill as well as this suppresses ovulation and not sure that it would restart with taking hRT?

Have you though of trying one of the COC pills instead? There are a couple which contain estradiol so designed for menopause. They are QLAIRA and ZOELY. That way you would just take one pill and get the extra oestrogen too. Also it may well regulate your bleeding better. The progestogen in QLAIRA I think is one of the newer generation type. If you are under 50 this might be a better option and possibly have fewer side effects than the mix you are taking now?

Hope you are feeling less tired and wired today.

Hurdity x