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[Karras77]

Hi - I wonder if you can point me to some info or advise?

I am 11 months since my last period but only 45. I finally got my gyn app yesterday and was given evorel 50 patches for estrogen, utrogestan 100mg vaginally for progesterone and vagirux 10mg for va.

I asked at the app if I could have cylical progesterone as I really miss my monthly bleed (odd I know but finding the whole early meno thing a bit upsetting) but the gyn said there was a risk of uterine cancer with this as I'm in menopause so I have to have continuous. But I can't find any info on this online?

The main reason I ask is I briefly tried hrt a few years ago but really struggled with the progesterone bit as it made me feel really depressed. I also have a panic disorder to do with health anxiety and ectopic beats so struggle with new meds so for this regime I've started with a quarter of a patch last night, will go to half on Friday and so on to full patch, and will then start on the progesterone nxt week. Do you think its terrie if I do cyclical progesterone at least for the first month or two to try and get used to the progesterone and how it makes me feel? Is it really dangerous re uterine cancer?

My main meno symptoms are loss of periods, ectopic beats, weight gain, hot flushes, atrophy and loss of libido.

Thank-you for any info x

[sheila99]

I think there may be a small increased risk but I get fatigue on utro and for this reason use it on a long (6 week) cycle. It's the same dose overall and she isn't watching... I hope...  . If you want to use it cyclically it's 200mg x 12 days, days 15-26 where day 1 is the first day of your bleed. For some people libido recovers with oestrogen, others need testosterone. As you aren't quite meno yet you may be better on a sequi regime anyway.

[Karras77]

Thank-you. I think I am going to try the seqi regime for a month or so to get used to the utrogestan and what dosage of estrogen I need.

[Karras77]

Hi - sorry if I'm being a bit thick here. I'm on day 17 and used utrogestan the last 2 nights and will to day 26. Do I then wait for the withdrawal bleed before counting day 1 again? So the days between day 26 and the start of the bleed are just oestrogen? Sorry again if really stupid question!

[ATB]

Hi, I’m no expert, but my understanding is you need to be without a period for 12 months to be in menopause. I know you had 11 months, but I think maybe your doctor was jumping the gun a little as I know women who have been without a period for that long and then they get a couple again. How long were you on HRT before? It can take 3-6 months for your hormones to settle and for it to resolve symptoms. I have health anxiety too so understand the nerves, but am glad I persevered and started and am feeling overall much better after 8 months. I actually want my periods to stop! As I fluctuate so massively with my cycle and symptoms.
I was told to start Utrogestan on day 15 and thereafter take it at the same time regardless of bleeding, but I do 2 weeks on, 2 weeks off. The timing isn’t synced now though and I get my period 3 days before I finish so this month I’m doing 12 days. It is confusing isn’t it, if your cycle isn’t timed with Utrogestan and changes month to month. Yes days between day 26 and your bleed should be just estrogen.

[Dotty]

Hi Karras17….the easiest way to take cyclical Utrogestan is just to start it on the same date of every month. This is what the specialists advise. You take it for 12 days from that date every month. Use oestrogen every day. x

[ChocolateWombat]

I understand that many women use either continuous or cyclical when they are peri or post menopause…ie people often use what works for them.

Most peri women use cyclical, but some use continuous to maintain stable levels of hormones and reduce migraines.  I understand that as long as periods are pretty irregular and being cyclical doesn’t cause lots of break through bleeding that is annoying, it is fine.

Likewise some post meno women stay on ccyclical.  They find 200mg of Utrogestan makes them feel ill and that some kind of cycle makes them feel better.

Someone might correct me, but I understand GPs should be a bit flexible in response to individual circumstance.  What this means is prescribing off licence and this is where some GPs just aren’t confident to be flexible because their knowledge is limited.  That’s why some people go orivate because the doctors are more willing and able to respond to the individual patient.

The more I read and am on HRT though, I see that once a woman has been prescribed a product, most can be capable of making small adjustments if they have read up on it.  If they have irregular periods and want to try continuous after 10 mo ths with no period, they can just do it.  They will find out if it works for them or not.  If they use gel and want to increase from 2 to 3 pumps after having been on it for 6 months they can try it and see if the situation improves.  There is a requirement to personalise to a degree with HRT.

This isn’t the same as saying all women should be buying whatever they fancy trying over the counter without it ever having been orescribed.

[Karras77]

Thank-you everyone that's helpful. I think gyn was going on a fsh test a few months ago that was very high (I think 122) and just said yep you're done which rather startled me as i guessed I was near the end but thought maybe some wiggle room. I did want hrt. In the past I only lasted 6 weeks on it but there was so much else going on health wise gp said to young for peri it's anemia and periods came back so I presumed all good. It took me ages to get the new gyn referral as gp still convinced not peri. Anyway I'm feeling a lot better on it this time and no major probs yet. Hot flushes have stopped but libido still missing in action! Going to see how this cycle goes than add a bit more oestrogen as still only on half a 50 evorel.