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[Postmeno3]

Hi,
I am already questioning my new regime and am concerned. Three months into lowest dose Evorel and Vagifem, my symptoms are worsening particularly the GSM side of things.
An increase in patch dosage is next after my first quarterly review last week, plus to "experiment" with the regularity of Vagifem to which I now wonder if I may be oversensitive. (Would it have taken this long to find out?)
I've been reading up a lot and there are theories that, even in ladies with no or one ovary remaining and no uterus, it may be that it's more a case of not enough progesterone rather than needing more and more oestrogen. Balancing this?
In some ways, it makes sense to me as the hormones are an interactive group are they not, therefore not best treated in isolation? As with any "complaint", there can be a whole range of interacting elements to the outcome?
So, all this has got me wondering about Tibolone or Intrarosa? Any experience or expertise?
I suppose, essentially, I didn't expect to deteriorate especially with the additional support for GSM.
At 69 and very postmenopausal, having had a subtotal hysterectomy decades ago (tiny bit of cervix and one ovary left) and just resuming the HRT journey after a lay-off since my 50s at the hands of a bullying gp, I'm focused on Quality of Life which many, many years of a potential M.E. misdiagnosis has already sorely denied.
Any thoughts, especially from those with experience of treatment of or expertise in the hormones' "dynamics"?
Thank you so much in advance.
😊

[Postmeno3]

Thanks, Avalon. I think Intrarosa is variably accessible in the UK. A range of licensed/unlicensed interpretations, probably readily available privately!
All the best.

[Hurdity]

You could always use an estriol-based vaginal treatment instead eg estriol cream or Imvaggis (!) - which is a bit like the old Orthogynest pessaries but slightly weaker.

I am not someone who subscribes to the view that additional progesterone is the missing link - the notion of balance usually applies to needing sufficient progesterone to protect the uterus when oestrogen is taken as part of HRT.

Tibolone is often prescribed when there are issues of reduced libido, because one of the metabolic products of Tibolone acts like testosterone and in the absence of any licensed testosterone product in UK this can be the next best thing. Probaby though it would not be prescribed for the first time in someone late 60's but depends on your general health - whether you have any risk factors for stroke. If you want to try it you could always ask! Possibly privately?

All the best.

Hurdity x

[Postmeno3]

Thanks, Hurdity. Very informative. It's a work in progress for us all, I guess. No quick fix. At 69, ticking clock syndrome is alive and (not so) well!
😊