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[juliemargaret]

Hello all - hope everyone is well. I’m at my wits end and wondering if anyone has any thoughts or suffered similar.    I was recently (just over 3 weeks ago) on 100 Estradot patch, 0.5 Androfeme and 100mg utrogestan on a cycle and taken vag.  Not quiet felt good since started hrt 8 months ago (previous gel which didn’t absorb) but the new patch regime was ok but just  something missing hence the Androfeme which been on 11 weeks now and no changes.
A few weeks ago I finally got an appt with a very good Meno renown specialist as felt so rubbish and needed firm guidance . We did all bloods and my estro was on the higher side 700. (But in august was more than double that so has come down) my testo was ok but my shbg was also on the higher side - which means the amount of free testo was rather low so I wouldn’t be getting the full testo/hrt benefits - she also suspected my body didn’t eliminate estrogen efficiently. My boobs were also very tender and swollen indicating her hunch that I had too much estro circulating in my body.  I was advised to lower my patch to 50 or 75 (I chose  75 to start)   And up my testo and also begin an alternate evening vag utro to try and avoid fluctuations I was having each month.  I took heed and reduced my patch and upped testo like she advised but decided to have one more cycle of utro so could have a good bleed before start alternate - I did this but began bleeding on day 7 (was ok so just carried on) but then my bladder started to get really iffy and constantly weeing (I did have a little more weeing on utro phases prior but nowhere like this)  and constant feeling of pressure down below as if needed a wee just after having already had one! My lower tum was also niggly.  I finished the utro cycle 4 days ago and since my bladder had been so upset! I even got my doctors to test my water for any uti but came back okay.  I had a realisation this morning that this is the first utrogestan cycle I’ve had that has ever been this bad bladder wise - and seems to coincide with less estrogen! I didn’t start the alternate utro yet as was too worried about bladder at the moment. Could the reduction to 75 maybe not have been enough to balance the progesterone (ie - was it too powerful and wasn’t enough estrogen now to ‘carry’ it) or could it just be that because I was bleeding for quite a few days alongside vaginal utro that my insides have just been ‘upset’ and this will pass? I also reduced my patch again 2 days ago as still didnt feel any better and boobs still a little tender so thought perhaps a estro still too much and shbg still too high hence still not feeling any benefits since testo increase!  Could this bladder issue just pass/settle after a few days? Or could it be I need the higher estro (100) to carry the utrogestan phase? How can I need more estrogen though if I already have too much and trying to get it down? I am now debating if I should have stayed at 75 a little longer so wonder to go back up (from 50 I came down to 2 days ago!) 
So sorry for the awfully long waffle rambling post- I’m Like a broken record but at my wits end. Bladder a little easier today but still feeling of  needing a wee and pressure down below! Never had this issue before.

Anyone any thoughts? I put hurdity in my title as she may have some but would love any others! X

[sheila99]

Did they send the water sample to the lab as they sometimes find something the surgery has missed? The other thing to rule out would be a prolapse, that often shows itself as a feeling of pressure. As for the hrt unless someone on here knows better I'd be inclined to follow the advice of your expert.

[Gynaikeíos]

If you  have  no infections, Could it be urgency from GSM? It was a shock to me to have to stay so close to a loo before I was diagnosed with this issue but with VA too. I had strange pressure feelings.  Your specialist will give you best advice once infection has been ruled out but maybe you could mention it?

[juliemargaret]

Hello Sheila and Gyn! Thank you for responding .  I’ve never had prolapse before so don’t know but hope not  (how would I know Dan you feel or see?) and Gyn what is GSM? Sorry.  Ohh I actually do feel it’s since reduced my estrogen as it’s the first cycle of utro on a reduced dose that I’ve had this issue. But as explained I had to reduce as was high along with shbg and I felt okish (was still waiting for any benefits to show with this reduction and the testo increase but boob tenderness did ease) until added the utro - which never had an issue with before vaginally - well apart from but more weeing but that passed once utro ended and as you’d expect.  I also reduced again to 50 a few days ago but today my whole body feels buzzing and I’ve an eye migraine . I used to get the buzzing pre patches and when gel didn’t work so I think the decrease hasn’t helped and if anything should’ve stayed on 75. I’m gonna whip a new patch on I think !  Thank you ladies - at a loss and worried as not had this bladder thing before and it’s thrown me as was looking forward to the new regime in the hope is finally cracked it given had all bloods and good specialist advise! I’ll email her weekend and let her know the bladder issues and hope it was just a one time thing and will ease each day. For now do you agree pop a 75 patch back on and as original regime given the symptoms I’ve got today?

[Gynaikeíos]

Hello Jmargaret, I do not take systemic HRT yet and and cannot advise you, apologies. GSM is -- deep breath Genitourinary Symptoms of Menopause (I learn so much from this website!) 
It affect the bladder. If I understand what I read correctly it is treated well with pessary or cream which carries a low dose of oestrogen right to where it is needed. If there is infection then that would need the correct treatment but GSM shows up with similar symptoms but no infection.

[juliemargaret]

Hi again Gyn! Thank you! I googled GSM- wow another thing to add to our Meno journey kit 😩. Feels never ending sometimes eh!  I’m going to go to doctors Monday and get water tested again. I do think it’s because I’ve dropped my estrogen though as my body (poss vag and bladder too!!!) were used to a bit more and seems coincidence that this bladder issue began only when reduced. I’ll email specialist too and see what she says. Do I go back up or stay down? Damned if we do damned if we don’t sometimes eh or so it feels! I hope you are well   X

[Gynaikeíos]

Again from my reading GSM gets treated separately so up or down with systemic is another balance-- or maybe juggle? 🤹‍♀️

Thank you for asking. It took some months for the treatment to make me feel well but I feel so much better now . I can go out for work to the remote sites without worry. Long walks are the pleasure they should be. Best of all I can sit down comfortably now the VA is under control! 

I hope you are soon well too X