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[Kate17]

hi everyone,
I'm new here. I'm 50 and started HRT about 6 weeks ago. I was peri menopausal. Still getting mostly regular periods. But getting symptoms like joint pains, anxiety, low mood, insomnia and fatigue.  So thought I'd try HRT. GP has put me on Evorel 25 patches. Plus Utrogestan 200mg days 15-26 of cycle.
I have questions relating to the progesterone:
I'm currently on day 22 of cycle and my period has started.  I've had dreadful pms the last couple of days. Really bloated, tired, depressed and snappy. I don't fully know why my period has started now and not after day 26 of stopping the utrogestan. Maybe my body's own hormones taking over? Should I stop the Utrogestan now or continue taking it until day 26? Should I reduce the dosage? I'm on the lowest possible dose of Evorel patch. So I'm wondering if 200mg of Utrogestan is a bit overkill?
Last month my period started on day 27 of my cycle.  And prior to starting HRT my cycle was a little bit irregular but usually about 26 days.
Thanks in advance for any advice/feedback x

[CLKD]

Hi I would, if the symptoms are bearable, continue as it can take 3-4 months B4 the body makes any kind of noticeable adjustment.  Many ladies can't tolerate the progesterone phase at all.

As oestrogen levels drop the body may become dry: inside and out ...... do read the vaginal atrophy and bladder threads.  Also the muscles may become lax = aches and pains. 

 

[Jane50]

Hi Kate17,

Welcome to the party! 

Are you taking the Utrogestan orally or vaginally? Lots of ladies have less side effects taking it vaginally.

My 'period' also has a mind of its own and doesn't play ball ie not arriving on withdrawal from Utrogestan. It can often arrive, like yours, days before I finish the course. My gynae advised I still complete the course to ensure enough progesterone to keep lining thin.

A good deal of patience is required on HRT - as CLKD says it can take 3-6 months to feel the benefits, especially as you're in peri and your own hormones are having a riot! It seems to be trial and error getting the right balance for your own body. Take it a day at a time and look after yourself. I was very stroppy when I started HRT (my partner would probably say I still am  ) and when my first gynae suggested yoga I felt like bopping her on the head! 'Give me pills that work!' I felt like screaming...

If it's any help, you're not alone on this journey.

Hope things settle down for you soon x

[sheila99]

My own cycle also always overrides the hrt one. I can tell when I ovulate so I start utro a couple of days later so I bleed at the right time. Before I figured this out I would stop utro if I bled early, no advice from clueless gp but I reckoned my body had produced enough prog to bleed so it should be OK. You probably are on too much utro but reducing from the standard dose should be with medical supervision because of the risk of your lining building up. I'm late peri now so miss some cycles. I find the side effects of utro are so much less on the missed cycles so I do think too much progesterone can give you symptoms.

[Mary G]

Kate17, I would say your HRT regime sounds very progesterone heavy.   You are on a very low dose of oestrogen yet you are taking the same amount of progesterone as women on more than double that dose ie a 75mcg or 100mcg patch.  It seems that the standard NHS Utrogestan dose is the same for everyone despite different doses of oestrogen.

To give you an idea, I'm using one pump of Oestrogel every day and 50mg progesterone every day on a continuous combined, bleed free regime which is 1,550mg of progesterone each (31 day) month.  You are on about the same dose of oestrogen as me but taking 2,400mg progesterone each monthly cycle.

Utrogestan is better used vaginally and when used in that way, you can safely halve the dose to 100mg which should help with the side effects.  It works better when used vaginally because it works directly on the womb.

I think that more dose flexibility is needed to help women overcome the side effects of progesterone.