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[Kat36]

Hi all,

I’m about 9 weeks into patches & utrogestan. I’ve been instructed to increase the dose of estrogen slowly as I suffer silent migraines. This has done the job for the most part(zero migraines beyond the first week).  I’ve also been told that I can continuously take utrogestan 100mg daily (no break).  I’ve been feeling the past two days absolutely wiped out (brain foggy, drowsy, sedated).  No amount of coffee helps lol. I’ve also noticed that my blood pressure readings show my blood pressure in general has gone down (was a little on the high side at times before hrt). 
I’ve started to take the utrogestan earlier at night to try and avoid the sleepiness.  I guess my question is, is there a chance that my estrogen is just been hammered by the utrogestan. I am currently on evorel 25 and a 1/3 of a evorel 25 patch.  I fear this is still quite a low dose. Am I correct?
As you can all probably appreciate, it’s hard to deal with when you have to work and do everything else necessary each day 

[McPeri]

Hi Kat36, do you mean you are on JUST one third of an Evorel 25 patch, that is, 8.3mcg? Or on one patch PLUS a third, so 33.3mcg?

If on the 8.3mcg that is very very low and, yes, that amount of utrogestan continuously would wash you out! If 33.3mcg, that is still quite low.

I completely understand why the oestrogen is being introduced slowly. I have found that slow introduction and continuous utrogestan have been best for me and my hormonal migraines.

I don't know how you take the utrogestan, but you could try it vaginally. It helps reduce the side effects. It also gives a more consistent dose because it doesn't go through your metabolism.

Your body will adjust to the utrogestan over time and will hopefully be better once you are on, say, 50mcg of oestrogen.

[Kat36]

Thank you McPeri for your response.
I’m on 33.3mcg as of the beginning of this week. I too find the continuous utrogestan stops the migraines, but the flip side at the minute is the drowsy/washed out feeling. I’m glad to hear that similar works for someone else too.
  I take the utrogestan orally (I have tried vaginally but having it in that manner every day was giving me thrush…sorry tmi). 
I hope as you say my body will adjust to it and as I slowly introduce more it will find a good balance. I guess it’s just about being patient if you introduce more estrogen very slowly.  I did not feel very patient today lol. 

[McPeri]

It's difficult...especially when dealing with migraines too. I have been advised by the specialist to try alternate nights on the utrogestan continuously. There is research to show that this is sufficient. However, I am not sure if there will be ups and downs which I would rather avoid!
I need to stop procrastinating and give it a shot, but always dread a change. Used to be such a spontaneous and care free person!!
Hope it works out for you as the oestrogen in gradually increased.

[joziel]

Kat, I also am having to be very slow with the estrogen because it's giving me heart palps and weird vasomotor episodes. And I've also been a bit heavy on the progesterone because I have a history of endo and it suppresses that...

Which is all to say, the estrogen tends to give you pep and zing and energy and the progesterone can have the opposite effect. Your estrogen dose is still low there and it's likely you are a bit progesterone heavy at the moment, which is probably how it needs to be for now. But hopefully as you gradually increase the estrogen, your symptoms will improve.

I noticed a big improvement at 50mcg but I still had a sluggish gut and constipation (which is what I get when I have too much progesterone and not enough estrogen - I always used to be constipated in the week before my period was due!!) and when I increased to my current 62.5 (!), that went....

[Kat36]

@McPeri- It would be lovely to take it every other day but my first journey at the beginning of the year with hrt on sequential was terrible. I feel for me consistency is the key, so like you would rather avoid the ups & downs. Trying to avoid the migraines makes this all a little bit more difficult and I can understand your trepidation at changing.  Same here..I’m feeling a shadow of my former self at the minute. I hope you find what works for you also.

[Kat36]

@joziel- Thank you for your response and sorry to hear you’re having a bit of a time of it too.   I do feel it’s still quite low, but like you said it’s just where it needs to be at the minute I guess. It just makes me feel frustrated I think that it’s long and drawn out and I can’t function well.  I’m hoping that as I move closer to 50 I’ll feel more of the benefits.
I like to hear the stories of women who have had to increase gradually-it just goes to show we’re all our own chemistry set and a small tweak can make a big difference 

[joziel]

Yes I envy those straightforward people who just start on a 50 patch and have no probs 

I went to A&E on Friday I was so worried about the heart palpitations!!

Not only that but I’ve just been told the pharmacy will only send me 3x 50mcg boxes of Estradot due to the shortages. When my dr ordered some 25s as well so I could gradually increase. But the pharmacy say I can only have 3 boxes. I thought I could have 3 months worth not 3 boxes…. anyway, am hoping doctor can fight the pharmacy and get me the 25s or I’ll have to keep cutting 50s into 4.  Which is definitely a skill 

[Kat36]

Joziel, this made me laugh. Oh I envy them sooo much!
The shortages are difficult to navigate.  Cutting patches is such a skill! My thigh just looks like a bad jigsaw puzzle.  This isn’t something they’re addressing on TV… bloody jigsaw legs!  I have little bits of quarter/thirds in separate envelopes next to my bed. Oh how life has changed! 
I’m sorry to hear that and feel your pain. 
Oh you poor thing! My partner is the only reason I haven’t been to A&E more. I swear I’d be there weekly if he wasn’t the voice of logic

[joziel]

My husband is working away at the moment which doesn't help!

Oh and we are supposed to be buying a house and moving countries 

You couldn't make this up.

[Nicola Winter]

Finding a balance is a nightmare and giving a new combo time to settle makes it so difficult to know when/if something is working.

[Kat36]

I agree Nicola. It can be very frustrating.

Oh joziel, that sounds like a lot to deal with! Hopefully everything gets sorted out for you soon.