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[Simmy]

Hi everyone

I’m desperate. Having just spoken to the private clinic I go to, I’ve been told I’m out of the time they can give advice until I have another follow up, and they are fully booked for 3 months.

I’m on 2 pumps Estrogel, a pea sized dab of Testogel and 100mg vaginally of Utrogestan (all daily).

I changed to continuous Utrogestan about 3 months ago and, apart from a month of spotting, all been well.

Until last Thursday, I had a migraine with aura and I’m still feeling the after-effects now, quite strongly. I feel drugged and headachy and so tired with body aches. Foggy thinking, blurred vision and the whole lot.

Do you think it could be the continuous Utrogestan and if I go back to 14 days on and 14 days off, do I go slowly and wean myself off, or do I just stop now and have a couple of weeks’ break?

I work as a counsellor and can barely string my thoughts and words together.

Thank you so much for any advice you can give.


Xxx

[CLKD]

'out of time' means what exactly 

Is the migraine continuing of it is menopause mugginess: crashing fatigue can be problematic at times.

Hopefully some1 will be along with advice .......

[Simmy]

Hi clkd

My last follow up was November last year. They seem to have changed the set-up there and they’re saying that it too long since then to be able to give me any advice.

This is definitely following the pattern of my old migraines. Not had one since I went on HRT almost 2 years ago.

But I did try HRT a few years before that and the Utrogestan seemed to trigger them and I had to stop everything.

That’s why I’m wondering if it’s the continuous regime causing all this bother!

Thank you for being here!

X

[Mary G]

Simmy, I'm sorry to hear about your migraine, I am a fellow sufferer.

I started having silent migraines (aura without headache) in the lead up to the my menopause and long story short, mine are caused by general hormone instability (which is caused by all types of synthetic progesterone and too much Utrogestan) and oestrogen spikes so it's a complex chain of events and it took me years to work it out.  I did not have migraines during my reproductive years because my hormones were stable.

Generally speaking, hormonal related migraine with aura is caused by oestrogen spikes and migraine without aura is caused by progesterone spikes or progesterone withdrawal.   

Your clinic sounds singularly unhelpful but I would take charge of the situation myself and try taking 100mg Utrogestan vaginally every other day and see if that helps.  If you can take 100mg for 14 days every month on a cyclical regime then it's OK to take 100mg every other day.

I think you are probably taking too much Utrogestan since changing to a continuous combined regime.   I take 50mg progesterone every day and found it was enough with two pumps of gel - I have since reduced the oestrogen dose.  The Newson clinic prescribes 100mg vaginal Utrogestan every other day although they suggest an annual uterine scan to check the womb lining.

Have you had migraines before?   How old are you and are you post menopause?

[Simmy]

Simmy, I'm sorry to hear about your migraine, I am a fellow sufferer.

I started having silent migraines (aura without headache) in the lead up to the my menopause and long story short, mine are caused by general hormone instability (which is caused by all types of synthetic progesterone and too much Utrogestan) and oestrogen spikes so it's a complex chain of events and it took me years to work it out.  I did not have migraines during my reproductive years because my hormones were stable.

Generally speaking, hormonal related migraine with aura is caused by oestrogen spikes and migraine without aura is caused by progesterone spikes or progesterone withdrawal.   

Your clinic sounds singularly unhelpful but I would take charge of the situation myself and try taking 100mg Utrogestan vaginally every other day and see if that helps.  If you can take 100mg for 14 days every month on a cyclical regime then it's OK to take 100mg every other day.

I think you are probably taking too much Utrogestan since changing to a continuous combined regime.   I take 50mg progesterone every day and found it was enough with two pumps of gel - I have since reduced the oestrogen dose.  The Newson clinic prescribes 100mg vaginal Utrogestan every other day although they suggest an annual uterine scan to check the womb lining.

Have you had migraines before?   How old are you and are you post menopause?

Thank you so much for your reply Mary.

It’s the Newson clinic I’m with. I wonder if I should go to 100mg every other day - that does sound like it would help.

My migraines with aura (and the rest!) started at age 40 and were my first noticeable sign of perimenopause. They went away when I got settled on my HRT regime almost 2 years ago (my utrogestan then was 2 weeks on, 2 weeks off).

Recently I noticed that I felt better on my Utrogestan fortnight and my Dr at Newson Health said I could try continuous Utrogestan. I’ve now been doing this for nearly 3 months. I had some spotting and then everything settled nicely. Then, last Thursday, a migraine, and I still feel I’m in postdrome. I’ve not come back yet. I feel drugged and spaced out, plus lots of other migraine-type awfulness.

About 4 or 5 years ago, utrogestan was a big problem for me when I went to a menopause clinic through the NHS. Hence me wondering if now, after 3 months, daily Utrogestan is just a step too far for me.

I’m 47 and not post menopausal as far as I know.

I definitely think I’ll try the every other day regime. Or, is that the right thing to do, as you mentioned that migraine with aura (which is what I have) is caused by oestrogen spikes?

Thank you again, so very much, for your advice. I can’t tell you how much I appreciate it.

X

[Mary G]

Simmy, that's exactly how my migraines started except I was 43.  I had a Mirena coil for contraception at the time.

For people like us with hormone induced migraines, HRT is very complicated and difficult to get right.   I thought I had suddenly become progesterone intolerant but I now know that it was my own produced progesterone that kept the migraines away pre menopause by acting like a kind of hormone stabiliser.

You probably felt better when you first introduced the Utrogestan on the cyclical regime because it initially balanced things out but it has a cumulative effective and because you were taking too much, it tipped the balance and created oestrogen spikes.   

My advice would be to start using Utrogestan every other day (I imagine you would prefer to avoid bleeding) but if you continue to have migraines, revert back to the cycle.   

Unfortunately the menopause is an evolving situation and when you finally reach the post menopause stage, you may find you need to reduce the oestrogen dose to keep the migraines away.   This is what happened to me once I was several years post menopause.   

The postdrome phase is a real horror isn't it?   Do you have a bad headache?   You might want to take a few days off from the Utrogestan to recover before resuming every other day.

[Krista65]

Can I just say - I've had awful migraines for 30 years and had all sorts of tests done. But since I started taking electrolytes, I've not had one. Might not work for you but I drink a litre and a half of coconut water a day (soo easy to drink) and an electrolyte tablet. There's a fair bit on the web about it, so maybe it might help.

[Simmy]

Can I just say - I've had awful migraines for 30 years and had all sorts of tests done. But since I started taking electrolytes, I've not had one. Might not work for you but I drink a litre and a half of coconut water a day (soo easy to drink) and an electrolyte tablet. There's a fair bit on the web about it, so maybe it might help.

Thank you so much for sharing Krista - I’ll definitely have a look at that. Happy you found the solution to these bloomin awful symptoms xx

[Simmy]

Simmy, that's exactly how my migraines started except I was 43.  I had a Mirena coil for contraception at the time.

For people like us with hormone induced migraines, HRT is very complicated and difficult to get right.   I thought I had suddenly become progesterone intolerant but I now know that it was my own produced progesterone that kept the migraines away pre menopause by acting like a kind of hormone stabiliser.

You probably felt better when you first introduced the Utrogestan on the cyclical regime because it initially balanced things out but it has a cumulative effective and because you were taking too much, it tipped the balance and created oestrogen spikes.   

My advice would be to start using Utrogestan every other day (I imagine you would prefer to avoid bleeding) but if you continue to have migraines, revert back to the cycle.   

Unfortunately the menopause is an evolving situation and when you finally reach the post menopause stage, you may find you need to reduce the oestrogen dose to keep the migraines away.   This is what happened to me once I was several years post menopause.   

The postdrome phase is a real horror isn't it?   Do you have a bad headache?   You might want to take a few days off from the Utrogestan to recover before resuming every other day.

Mary,

I can’t thank you enough. I’ve learned so much from you already!

I didn’t use any utrogestan last night and I already feel like I’m coming back. So much less foggy headed, headache has cleared and I have a bit more energy.

Deciding now whether to have those few days off you mentioned, or go straight into alternate days. I think I might give it a few days.

Honestly Mary, I appreciate you so much. Sorry that you suffered with migraine but we certainly have a lot of similarities and I’m so very grateful to you for helping me understand what’s going on.

Xxx

[CLKD]

We are a mine of info on here !   

Krista65 - 1 can drink too much so keeping an eye on the colour of urine is important.  Any lighter than straw coloured means that we are over hydrating. 

[Krista65]

We are a mine of info on here !   

Krista65 - 1 can drink too much so keeping an eye on the colour of urine is important.  Any lighter than straw coloured means that we are over hydrating.

Hi CLKD. Well, I can best you on that because I've actually been measuring how much I pee per 24 hours!! And it's something like 5 pints which is above average and I think that's why I've been low on potassium for 30 years. Pity no doctor mentioned this to me. 30 years of debilitating headaches and I now feel like I've won the lottery.

And yes, mine is a nice straw colour. Please do pass this on to anyone you know who has migraines. xx

[Mary G]

Simmy, you are more than welcome and I hope I have been able to help you.

You need some body identical progesterone for womb protection and balance but not too much of it!   

Key point to remember, unless you are severely progesterone intolerant, body identical progesterone at the right dose has a therapeutic effect but synthetic progesterone does not.

Please keep us updated on your progress.

[Simmy]

Hi Mary

So I’ve now had 3 nights with no Utrogestan. Still not right, but a noticeable improvement.

Noticed this morning that I’m starting to bleed so thinking it might be a plan to get this over with and use no Utrogestan for another 5 days or so, and then start the 100mg every other day regime.

Thank you again for all your advice.

Xxx

[Mary G]

The fact that you are bleeding is no bad thing and it means you can start your new regime with a clean slate.   

I would definitely leave the Utrogestan for another 5-7 days and then start every other day.  You are bleeding now because of the break but I doubt you will bleed using Utrogestan every other day.

I do hope this new regime gives you the hormonal stability you need and keeps the migraines away.

Please keep reporting back!

[Simmy]

Hi Mary G

So, it ended up taking me a couple of weeks to feel human again. Then I started every other day on Utrogestan (100mg vaginally).

I think I’m in my second week of this and I’ve had the most excruciating headache since yesterday afternoon. It’s not my usual migraine feelings - just a very bad headache. I can only think it’s the progesterone problem again.

Very tempted to do the Dr Studd regime of 7 days per month only.

Feeling like this, I’m not sure I could cope with going back to 14 continuous days.

I’m in a right pickle!

Xx

Update: Headache has all-but cleared. I haven’t done anything different as last night was a non-utrogestan night. I’m tempted to continue with the alternate days for now x