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[Evangelista]

Hello

I've got a GP phone appointment on Wednesday morning, and I was originally going to ask to move to conti HRT, having been on sequi for 7 years, currently on Femoston 2/10 and was going to ask for Utrogestan and oestrogen gel.  My main reason for that was because I'm fed up with having periods, plus a couple of other things.

BUT.....I've finally done some proper research, mainly on this amazing forum but also on Louise Newson's site, and I'm now pretty positive that I'm low in testosterone and that I have some signs of (thankfully) relatively minor, but presumably therefore early stages of VA.

I've read up on low T and listened to Louise Newson's podcasts on both T and VA, and I bought Jane Lewis' book Me and My Menopausal Vagina, and feel in turn sad, outraged, frustrated, optimistic and a bit evangelical about it all. 

I'm sad and frustrated that I've had ongoing meno symptoms that I never knew could be helped - loss of sexual response, word struggles, which I only now see as brain fog, a sluggish body generally, and of course dry this that and the other.

So on Wednesday morning I still want to ask for Utrogestan and oestrogen gel, and will ask about T but think it will mean a referral to the meno clinic at the hospital.  I also think I should ask for some topical oestrogen cream for the VA, which at the moment only presents as a slightly sore vulva with the occasional split that bleeds a bit.  The VA threads seem to suggest that would work for me.

But I'm not sure whether it will complicate things if I also change the regime from sequi to conti, because I am a bit wary of changing too many things at once. I also don't know how differently I might respond to the change to body identical progesterone.

After finding out about T and VA and other things, my priorities for addressing symptoms has changed, and I don't mind about periods if I can get my head back and start feeling more sexually interested and interesting.

I gather it's possible that the libido might improve just for changing to transdermal oestrogen, but I don't think that will address the cognition problems or the low motivation in the way I have read that using T might, so I'd still like to pursue that, and in the meantime see how things go.

Any thoughts on things I should look out for in making these changes at all, or would anyone recommend doing it differently? I know from these forums that it can be a long road of trial and error.....

Thanks

[pepperminty]

Hi,

I would start with transdermal estrogen  first and utrogestan. See how you go and get the dose right for you. That may take time. Then introduce T if you need it. Also start using vaginal estrogen on the inside and outside.

You may need a meno clinic to prescribe the T as GP's are a bit hit and miss.

Good luck and keep us informed as to how you get on with the change.

PMXX

[Evangelista]

Thanks Pepperminty.

I've read in the last day or so about whether transdermal oestrogen is better in a patch because of the steady dose, but I'm really not sure which to try, either gel or patch. I do feel I've learned a lot but am possibly now a bit overloaded with info!

I also feel I should know which hormone gives you a low mood, but some people seem to report bad mood on the wrong level of oestrogen, and some seem to say it's definitely the progesterone, and of course, everyone is right because everyone is different.

Whatever, I do feel tomorrow will bring some positive change.....

Thanks

[pepperminty]

Hi, gel can be easier to adjust for some and patch can be be steady for some. It is trial and error, but give it at least 3 months and start slowly - you can always increase. hopefully you wont have any issues - most don't.  But do let us know as a good news story is always great to hear!

PMXX

[sheila99]

The dose of utrogeston is almost the same if you use it conti or sequi (100mg daily or 2x100mg x 12 days) so you could start on sequi and then change to conti. It's usually the prog that causes problems so it can be useful to start on a sequi regime to see if you feel different on oestrogen only.
Gel is great is great for tweaking the dose slightly so you can adjust it as necessary.

[Evangelista]

Soooo.....

I had the phone appointment with the GP and it went better than expected in some respects, and less well in others.

I explained that I wanted to change from Femoston because I wanted transdermal oestrogen, preferably start with Lenzetto, and that I wanted Utrogestan and not the Mirena. I also mentioned the early VA and associated symptoms and the desire to go for testosterone to address libido, sexual response, brain fog etc, gave her lots of detail from the research I've done and then held my breath....

She hadn't heard of Lenzetto but said it is prescribable so had no issues with that (I described it and how it is delivered differently to gel - get me, the informed patient!) and she also said she has several women on Utro so no problems there - amazing since this is Scotland....

She really wasn't sure that I'm describing VA because it 'normally affects only the inner vagina and has no external symptoms'......!!!! I almost offered her a loan of my copy of Jane Lewis' Meno Vagina book! She said she would want to rule out lichen sclerosus first.

She has no experience of prescribing testosterone to women, which I expected, so suggested a referral to the meno clinic, and for me to stay on Femoston for now so that I just make one change.  That makes reasonable sense depending on the waiting time to get to see someone at the clinic. She didn't know the wait time but said someone would check and come back to me and if it was going to be months then we could talk about changing to Lenzetto and utro in the interim.

I am generally ok with that if I don't have to wait too long to get to the clinic, because although I've got plenty of ongoing symptoms that I want to address, I have a glimmer of informed hope that I can get to a point of treating them in a more appropriate way. The Femoston manages some of the worst things well enough for now, especially with that light showing at the end of the brain foggy tunnel.

Re the VA, we didn't return to that subject and I'm ok with that at the moment too, because I wanted to check out the Lichen Sclerosus first.  Well having looked at some pretty graphic images online I am certain that's not what I've got! My symptoms are not too bad at the moment (and yes, I realise it might not stay that way) but I am managing them with appropriate moisturisers and a careful washing routine and will discuss that at the meno clinic, again subject to not having to wait months.  I'm also possibly better off because I had surgery some years ago to deal with recurring vulvar cysts, and they ended up taking away quite a bit of the outer labia tissue and pulling in more external skin to repair that.  It actually looks a lot neater as a result (result!!   ) but it also has skin that's more used to being dry and thus maybe not as thin as it might get.

That's probably sufficient detail for a Wednesday morning, so I'll wait hopefully for a referral appointment in the near future, and in the meantime will keep an eye on these forums as they are so useful. 

Thanks all

[pepperminty]

I am glad it went ok for you.

So no changes as yet. Let us know how you get on at the meno clinic

PMXX

[Evangelista]

Hi

I have a new question about changing from Femoston 2/10 to Utrogestan and Lenzetto and I really could do with some advice.  I've searched the forums and feel quite confused now...

Since my GP appointment I picked up a prescription for Utrogestan and Lenzetto because the GP found that the wait for the meno clinic is 19 weeks, which puts it at sometime in March before I get an appointment. She prescribed 100mg per day on a conti basis, even though I said I'm not sure about changing from sequi yet.

Per my cycle, day 15 (the day I should start the utrogestan) is this Friday, but I've now been bleeding for 13 days, so I'm really not sure about trying to go to conti immediately.

My last bleed started a week late, has lasted this long, and for the last 5 or 6 days I've also had sore and tender breasts.  All of this is totally out of the norm for me - my periods are always super regular, I bleed for 5 days, and I never get breast problems - so I got a phone appointment with the GP (a locum) yesterday.  Literally all she said was that it is probably my hormones.  She did eventually ask if I have been referred to the gynae clinic, and when I said I've been referred to the  meno clinic, she couldn't find the referral and said it had never been sent.

I'm now so confused about what's best. I think I'd like to stick with a sequi regime, but I'm not sure what length of cycle to try to go for, or even whether I should be changing at the moment.

I am two days into the combined progesterone & oestrogen tablets of my current pack of Femostan if that makes any difference. 

Grateful for any help, thanks.