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[Felix]

Hello,

I'd be very grateful for any advice or information please. I'm 59 post menopause.

After many attempts at HRT I finally thought I'd found the perfect regime for me, I've been on the following for 3 months and 2 weeks:

2 pumps Oestrogel
1 x 100mg Utrogestan vaginally alternate nights
1 x Imvaggis pessary alternative nights

This was a game changer for me, I felt like I'd returned to my old self, I was interested in life again and found a bit of VaVaVoom - it was wonderful.

I had a few silent migraines - no pain but lots of zig zags -  and a number of days of spotting.

However in the last 3 weeks I've had quite a bit of bleeding sometimes lasting for 4/5 days at time, like a period. Also 2 weeks ago I had some really intense auras, and also I've had some breast tenderness

I'm not sure what part of HRT causes what side effects as it's so individual and also both oestrogen and progesterone can seem to cause similar side effects from what I can make out!

So I'm not sure what to do? I know the recommended dose of Utro is 100 per night but, even vaginally, I don't think my body will take it. I've wondered about 2 nights on and 1 off?

Or should I try reducing my estrogel from 2 pumps (I did feel a bit wired when I started on 2 pumps) to 1.5 pumps and see if that stops the bleeding, auras and tenderness?

Or do I just hang on and hope that things settle down.

I don't have an appointment with my HRT Dr until mid July and she wanted me to take either 100mg utrogestan vaginally every night or 200 mg vaginally every second night.

I had a scan on in January and my lining was OK but I have a few grape sized fibroids.

Any advice would be gracefully received

Thank you so much

[Jan1234]

Hi felix im also goimg through exactly tje same i take 100mg vaginally everynight and 2 pumps i also feel my life as got back to normal but i been spotting and some heavy bleeds since being on this hrt since feb , i had a polyp / fibroid removed in February but my gynecology took me off hrt December until they was removed as she said they thrive off hrt and that makes the bleeding worse so i stopped hrt for 8 weeks didnt bleed once, went back on it after they was removed and now problems with the bleeding  im also 58

[Felix]

Hi Jan
Sorry to hear you are going through something similar.
It's so good to have my life back, I thought I'd found the ideal combination and amount.
It was interesting what you said about fibroids/polyps. When I had my scan they said I had a couple of small grape sized ones.
I didn't know they could cause bleeding.
I'm wondering if my bleeding is because I'm only taking utrogestan every second night. I'm a bit intolerant to it and I'd heard on the Dr Louise Newson site that some people take it every second night vaginally , so that's what I thought I'd try. I'm wondering whether I should up my utrogestan to 2 night on and one off and see if that makes a difference.  I wondering if now I've been taking utrogestan for almost 4 months my body might be a bit more used to it and tolerate it a bit better.
What are you going to do Jan?
Thanks,
Felix

[Felix]

I'm just wondering if anybody else is taking 100mg utrogestan vaginally every second night?

Also does anyone know what part of hrt might cause auras?

Thanks  and wishing everyone a good weekend

[Blue Kingfisher]

Hi Felix,

I don’t suffer from auras generally myself but there was someone on this forum I remember that posted quite a bit about auras & migraines in relation to HRT. If I remember correctly, for them it was the spikes in the oestrogen that was the main cause. Are you taking both pumps of oestrogel at the same time? If so, it might be worth considering split dosing to try & even the spikes out? Or consider patches for a more even flow? I hope you manage to get to the bottom of it & feel better soon.

[Felix]

Hi Blue Kingfisher

Thank you for your reply.
Yes it might be about spikes, I rub it into my inside thighs in the morning and when I had the auras it was usually mid morning.

The worst auras were when I was on holiday and my routine was messed up.

So it might be around spiking and consistency. 
Thanks for your suggestion about splitting the dose  ( I'm on 2 pumps) between night and morning.  If the auras come back I'll try that.

Thank you

[Felix]

Good morning everyone,
Thank you for all the help and advice.
Can I please ask if anyone else has experience of estrogel and auras?
Thank you 😊

[Hurdity]

Hi Felix

Sorry I can't help with your question about auras but just to confirm that it may well be that the bleeding is caused by insufficient progesterone as alternate day Utro is very much off licence and whether it works or not will depend on the oestrogen dose as well as your body. However if your lining was ok then yes also fibroids can be stimulated by oestrogen and can bleed....

Re the migraines - for those who are susceptible, sudden spikes in oestrogen or progesterone can cause these, and in addition most commonly, migraines are a symptom of progesterone withdrawal as in classic pms.

Have you kept a diary so that you can say if the incidence of auras is connected with the progesterone intake? This might help decide if it was the oestrogen or the progesterone.

Also you may find that patches give a more even delivery as it is attached to your body and delivers oestrogen continuously so not really any dramatic spikes. Have you thought of this?

Hurdity x

[Felix]

Hello Hurdity
Lovely to hear from you, you have helped me in the past on my long HRT journey.

After having problems with progesterone in the past and also with the utrogestan form of it I decided myself to try the alternative night 100 mg vaginal utrogestan.
It seemed to work very well at first and I thought yippee,  I finally cracked this HRT malarkey.  I had energy and an interest back in life. I did have a little spotting but not much and knew this can happen at the start of taking HRT so I wasn't worried.
However about a month ago the bleed started  more heavily,  like a period. It finally stopped yesterday which is a relief.

I've decided to try utrogestan 2 nights on and one off  to see if that keeps the bleeding at bay.
I'm on 2 pumps of estrogel.

Your idea off a log is good and I'm going to start one so I can try and make sense of all this.

I apparently have grape sized fibriods, I have no idea if that's large or small. It's bad news to hear they bleed though and are fed by estrogel.  It just all gets more complicated!!!!

I have tried the patches before. I was fine on evorel sequi for ( a long time ago now) but couldn't get on with conti. So that's when I researched and found out about estrogel and utrogestan.

Thank you  Hurdity and everyone else for you help and support,  one thing I've learnt is how unique we all are

[Jan1234]

Hi felix dont know what im going to do to be honest im trying to tolerate it 2 see if it settles as like you i feel great on this hrt, i was recommended by my gp to up my ultrogeston to 200mg for the bleeding side of it but unfortunately it made my bleeding worse and i was on my holiday at the time, i hvnt bled now for 2 weeks but ive had symptoms of a period going start for 8 days but no bleeding im not holding my breath though, if you find your solution let us know hope you can sort it.

[Felix]

Hi everyone,

It would be great if I could get some advice please?
As I mentioned way back at the beginning of this post I'm on:

2 pumps Oestrogel
1 x 100mg Utrogestan vaginally alternate nights
1 x Imvaggis pessary alternative nights

I'm bleeding or spotting about quite a lot and it seems to be increasing and I'm getting a lot of breast tenderness.

From the excellent advice I've had off you guys it seems like the bleeding/spotting is probably due to me only taking Utrogestan 100mg alternative nights. I'm doing alternative night because I've really struggled in the past with utrogestan. I was also hoping that as I started this regime on Feb 6th the bleeding might just be about me getting used to HRT again and that it would settle down the longer I took it. However I'm almost 5 months in now and the bleeding is still happening and getting worse.
In Feb I had 3 days bleeding or spotting,  in March 6 days, in April 4 days, in May 14 days and so far this month 11 days.

I did decide, back at the end of May to try upping my vaginal Utrogestan to 2 nights on and one night off but the first time I tried 2 continuous nights of Utrogestan I felt completely floored and exhausted. So I went back to utrogestan every 2nd night. I know I only gave it one day of upping the utrogestan so maybe I need to give it longer and hope that I get used to it - it's really hard to work when you feel exhausted.

If I up my utrogestan to 2 nights on and 1 night off, is it likely that the tired/floored feeling I get from utrogestan will die down as my body gets used to it?

So at the beginning of June I decided I'd try one last thing before upping the Utrogestan to 2 nights on and one off. I thought I'd try cutting back on the Imvaggis to see if that was feeding my small grape sized fibroids and if that was what was causing the bleed. I cut back on the Imvaggis and stopped it on 10th June however it doesn't seem to have had any impact on the bleeding.
However I have felt a bit PMT ish, bad tempered and irritable and I'm wondering if cutting back on  the estriol I was getting from them  (between 00.9 or 0.12 per week as I took them alternative nights) would cause this?

Could such a small change in estriol make a difference to mood?

I've also found that being next to a running tap makes me want to pee so I'm concluding that not being on the Imvaggis is having a negative impact . So I'm going to start Imvaggis again.

My auras/silent migraines have stopped  which is great and I'm presuming that's because my body has settled to me taking the 2 pumps of Oestrogel in the morning.

However, I have been having a lot of breast tenderness, in May I had 4 days of it  but I've had it most days in June, it's worse in the left breast and can sometime feel quite sharp, it's very annoying. I had a routine mammogram a couple of moths ago but I wasn't getting the pain then and the mammogram result came back clear.

Does anybody know please what part of the HRT is causing the breast pain?

Thank you and sorry this is so much information. HRT has brought me back out of the shadows again but with so many side effect - it's so difficult to get the tweaking of it right.

Have a lovely day,
Felix

[Felix]

Hello,

Thank you for reading my post and the help you've all offered me.

I'm going to copy my previous message and start a new post as things have changed a little.

thank you