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[Peanut31]

Hi

I’ve been on HRT since May on Oestrogel via the NHS and Utrogestan. I could no longer cope with riding my peri menopause symptoms, as it was effecting my day to day life.

To cut a long story short, as I thought I may not get anywhere with the NHS. The original nurse was very dismissive, but luckily for me the original nurse was on holiday, and after a second consultation with a different nurse, she started me on HRT.

However, I had a back up plan of having a consultation with a Doctor, at the Newson clinic prior to speaking with the second nurse.

I kept my consultation with the Newton clinic and they listened to my concerns and we went over things, where as I felt slightly rushed with my NHS consultation. The Newson clinic advised to up my gel to 6 pumps a day as the two pumps  the NHS told me to take were having absolutely no effect.

I was told to start taking my Utrogestan in August, and not start it when the nurse told me too. still to take this) and given instructions on how and when to take it.

However, I’ve started to be getting water infections consistently now, I use to sometime suffer, just before a period, but thought they were finally under control with some probiotics.

They are now all the time, it goes from Thrush to cystitis, I’m gaining weight, which is getting me down and want to eat everything in sight, my tummy feels more rounded, and I’m basically fed up and feel low.

When I increased my pumps to 6 I originally felt fine, my memory was better, I had energy and felt really good, but, now I’m just so exhausted with the constant infections, weight gain, no zest for life.

 I’m due another consultation with the Newson clinic, and may contact them earlier.

My question is, will it be the amount of Oestrogel I’m taking causing the infections as in too much?

Any advice would be greatly appreciated. I’m dreading taking the Utrogestan. I’ve felt I have had some mental clarity on HRT, but nothing else major. Weight gain is a big fear of mine too, as I was badly bully as a teenager for being overweight, and this has left me with self confidence body issues, so to have a change in my body isn’t helping either.

Any advice greatly appreciated.

[joziel]

Hi and welcome.

Are you taking any local estrogen? That means - Vagifem pessaries, Ovestin etc, inserted in your vagina? That is the best solution for UTIs and infections. Systemic HRT often isn't enough - 20% of women need both local estrogen and systemic HRT. Newson can provide you with this, or your GP can.

As for the estrogen.. there is a big difference between 2 pumps and 6 pumps. Were you just advised to leap suddenly from 2 pumps up to 6? Rather than to see if, say, 3 pumps or 4 pumps worked for you??

Really the advise is to increase as needed up to 4 pumps or 100mcg patch (same dose), trying each dose increase for 12wks to check if it is working and see the full effect. If you get to 4 pumps and still want more, then BMS advice is you need a blood test to check you are actually absorbing it - if you are smothering yourself in gel but it's not getting into your blood, then that's not going to be doing much for you and you might need a different way of taking estrogen. Have you had a blood test?

With the utrogestan, I don't understand what you mean about being told to start taking it in August. Any time you are taking estrogen, you should be taking progesterone to protect your uterus. Especially if you are taking 6 pumps of estrogel you will need a good amount of progesterone - the BMS actually recommend additional progesterone if you go over 4 pumps, whilst Newson are a bit gung ho about that. I don't understand why you are dreading taking the utrogestan either? Many women love utrogestan. It helps with sleep, with mood (calmer, less anxious), and progesterone is a diuretic so it should help get rid of any retained water which could be behind your weight gain.

I don't think the estrogen is causing your infections (probably you need local estrogen to protect against those) but it could for sure be behind the weight gain, especially if it isn't opposed by enough progesterone...

[Peanut31]

Thank you for your prompt reply

This is all new to me.
I had a telephone call with my local GP as over the counter things for thrush wasn’t helping and I couldn’t take it anymore.

Anyway, they advised to use the vaginal thrush, rather than the oral vaginal and cream. Do you mean the HRT you insert vagina, as I’m not on that. 

 I managed to get a telephone call, so I’m going to the chemist tomorrow to collect a prescription for it.

With regards the Oestrogel it was the NHS that said two pumps and when I had my consultation with the Newson clinic they said go on 6 pumps as I felt no effect.

I did question this but they said it was ok.

With regards the Utrogestan I too questioned this as I was under impression I should be taking it when on Oestrogel, but the Newson Dr said to start the August. I’m going to contact them as i don’t feel happy with that. I have it in a letter to start August.

With regards the Utrogestan I don’t want to have that groggy feeling, but as you said it may help, it the unknown that’s frightening.

I had a long battle with my Hashimotos and thyroid and took over 2 years to finally sort this out, so it frightens me with my menopause journey.

With my peri menopause symptoms it was my mental health that was struggling and forgetting how to do things. I would feel overwhelmed and not remember peoples names or how to do things at work, a job I had been doing for years.

I haven’t had any bloods with the Newson clinic, but I do my own bloods for thyroid levels with medichecks, so I could do this?

Advice on what bloods would be greatly appreciated.

 My hubby suggested going down to 4 pumps a day to see how I am feeling, but, as said I’m going to contact Newson clinic Monday about the Utrogestan.

I’m grateful for your advice, thank you.
 

[joziel]

Are you peri menopausal or post? I’m guessing peri after your first post?

Yes, if you are getting recurrent UTIs you should be on vaginal (local) estrogen. It is very low dose and perfectly fine to take with the other HRT and will help stop the UTIs - those are due to low estrogen in that spot.

You do need to also treat the thrush if you have it. However using estrogen -
Especially 6 pumps of it - can be giving you some (normal but more than you are used to) discharge. Are you sure it’s thrush? Is it itchy and uncomfortable or just a change in discharge?

If you have used thrush treatment and it hasn’t worked then really your GP should give you a swab so you can check for thrush. You can do this yourself - a self swab they can give you to do. But you don’t want to repeatedly use thrush meds if you don’t have thrush as you’ll upset the micro biome up there and that can cause other issues in terms of discharge and discomfort.

Personally I’ve not had any problems with any groggy feelings on utrogestan and most women are fine with it. Of course those which aren’t come online and share their experiences so it might seem like no one can take it but actually it’s only the minority.

You need to be taking utrogestan 200mg a night for half your cycle and then stop the other half.

And I think for sure you should have tried 4 pumps of gel before going to 6. This is the insane use of estrogen which Newson GPs often seem to want to use - clearly not all but a lot. I’m a newson patient and have ended up in a mess myself by being told to use higher levels of estrogen than my body needed or could tolerate.

I think - ask your GP for some vaginal estrogen (vagifem pessaries). Ask them for a Self swab to test for thrush. Ask them to clarify if you should be on utrogestan. Good luck!

[Peanut31]

Hi,

Thanks again for your reply, I am peri menopause, periods changed to every 2 weeks, very heavy bleeding and painful.

yes it’s definitely thrush, very itchy, burning when I go for a wee and discharge. It’s a very regular occurrence now, and this time it’s come with vengeance.

I asked the GP if I could have a swab and they said no necessary as gave a description of symptoms.

I’ve just emailed the Newson clinic explaining I’m concerned I’ve been told not to start my Utrogestan until August, hopefully Monday I will hear back.

It’s 2 x 100mg Utrogestan I’ve been told to take, and the instructions from the Newson clinic are to wait until my period in august then 14 days after my 1st day of bleeding take tablets, 2 weeks on 2 weeks off.

When you say you are a patient of Newson, was it your own research and trail and error that you found your sweet spot, so to speak?

They also prescribed me testosterone, but I felt I should wait until I see how I get on with the gel and tablets. 

I had to do my own research with my thyroid medication, as often the advice given to me wasn’t always right, so with the help of forums like this my health really improved.

I’ve been getting terrible leg cramps during the day too, where all my leg muscle tense up, never had that before.

Thanks again.

[joziel]

I’m still trialling and erroring and haven’t found the sweet spot 😂 Newson GP assumed I would need at least 100mcg without even knowing me, just from the start. I was only told to use 25 for 2 weeks on the way up and then to increase every 6wks (not 12).  Even after I ended up in A&E with heart palps and high blood pressure she just said to increase “very gradually” (I was at 62.5 by then). 😳 Seemed obsessed with blood estrogen levels rather than how I felt (on 50 patch I was only 233nmol)…

It was only when I emailed dr Currie via this forum that I learnt the BMS advise starting low, remaining at each dose for 12wks, increasing only if symptoms reMain and not doing any bloods unless you get to 100 (4 pumps) and still want more estrogen. - they don’t believe there is any target for blood estrogen levels.

I think it’s wise not to start testosterone yet. That’s another thing newson do - give that to you from the start. I also held off and waited a few weeks.

I’ve not heard about leg cramps but are you taking magnesium? That is really helpful for sleep, for cramps and so much else. Magnesium bisglycinate 300-400mg a day, of elemental magnesium. 

If I were you, I’d reduce the estrogen to 4 pumps and see how that feels. If you are just waiting for one period to start the utrogestan I can’t see a prob with that - but it sounded like you’ve been taking HRT since May and haven’t yet taken any utrogestan?

[ATB]

Hi there. I’m also hypothyroid and I’m with Newson. I’m also a little surprised anyone there advised you to go from 2 pumps straight to 6. This isn’t how they normally advise as it’s way too much of an increase at once. You are meant to slightly adjust, and wait 12 weeks.

With having a thyroid problem, unfortunately this is much much more complicated. There’s a lot of info on this site if you want to search. One of the things I didn’t know was that taking thyroid medication lowers your available or free testosterone by sometimes quite a lot. I am on testosterone and I started it 2 months after starting estrogen- using gel at first and then switching to patches. You would be wise to read up on this or trust your Newson doctor has advised you correctly and follow their instructions on testosterone.
I’m assuming Newson told you to wait till the next day 15 of your period for Utrogestan, which is the right advice, but I’m not sure if they’ve told you to skip some months? Did you just see them and then they’ve advised you based on where you are in your cycle? What day of your cycle are you on now?
How long in total have you been on the estrogen gel?
Did you go from 2 pumps straight to 6? Did Newson specifically say to do that or did they say to gradually increase? What did your letter say?
When did they tell you to start testosterone? I was told 8 weeks after starting estrogen and Utrogestan and that’s worked well for me.

For thyroid patients it takes sometimes a lot of tweaking to get it right and I also had to lower my thyroid meds, so you might want to do a thyroid test to see where they’re at. I was well over range even though that dose had been my dose for 5 years, the estrogen increases your T4. So please do check that. Some anxiety related issues sleep issues etc can be too much thyroid medication.

[Peanut31]

Hi,

Thanks for your advice reference thyroid meds, I’m pretty good with monitoring this myself as I take NDT and T4 as couldn’t tolerate T4 (Levo) alone.

I’ve looked back at my letter from the clinic and it does say start taking Utrogestan capsules in August, day 14 of my period to start taking two capsules for 2 weeks and two weeks off. I’ve not started my period yet, but, due soon.

I wasn’t told to wait 12 weeks between increasing either, the Dr immediately told me to increase to 4 pumps and then increase to 6 pumps daily according to my symptoms, no mention of giving it 12 weeks.

The Testosterone (Androfeme) I was told to use as soon as it arrived, 0.5ml cream to buttock or outer thigh each day. As said I haven’t used this yet.

Thanks

[ATB]

That is very odd you weren’t told to increase gradually, it’s so harsh what they’ve advised you to do as it is such a shock to the body and confuses the symptoms. It does sound like you have symptoms of too much estrogen, I had to lower my estrogen in March after being on HRT 6 months.
Depending on how long in total you’ve been on estrogen you’re probably doing the right thing waiting to start your Androfemme. I noticed so much more energy and mental clarity after starting it myself.

[Peanut31]

Hi,

Thanks for your reply, I even got my husband to read the letter to check I was correct.

The first thing I noticed on HRT, was I remembering things, it got so bad that I burst into tears at work and told them I was leaving as I couldn’t remember how to do things. I was so embarrassed and felt so useless. Luckily for me my manager was very sympathetic and when she spoke to her mum (I didn’t mind) she told her that everything I was going through was the same for her. However, I kept it quiet for a while.

I’m not liking the weight gain, it’s very deep rooted for me as I mentioned I was overweight as a teenager and very badly bullied for it. I lost the weight, but it’s creeping back on. I know everyone is different but how did you find the HRT and weight side of things?

I look at Davina McCall and think what’s her secret formula.

Best wishes

[ATB]

Now I’ve got my estrogen at the right dosage, I think! I’m fine with my weight. I’m very active though, since I started HRT I’ve been able to go back to my former exercise routine. Testosterone in particular helped with that, I started estrogen & Utrogestan in September, testosterone in mid Nov and by early January I was back to a very consistent daily exercise routine. I hadn’t been able to do that for years. When I had too little oestrogen it was hard to maintain my weight and really hard when I had too much, I had much bigger boobs then too.

Davina has her HRT right for her, that’s an important thing, plus she exercises a lot and really controls what she eats. She has a job that now relies a lot on her image though, so she prioritises that. We don’t all need to be that size though. Try and be kind to yourself  

[Peanut31]

Thanks for your reply.

Best wishes
Peanut31

[joziel]

I totally agree with ATB, too little or too much estrogen (for you) can make you put weight on. Especially if the estrogen is unopposed by progesterone.

Once you find the right (for you) amount of estrogen, it becomes relatively easy to eat normally and not gain weight. It can take some experimenting to find the right amount but don't go chopping and changing things fast or too readily because it takes time to know what each dosage is doing and you can upset your body a lot by changing things too much.

I read online women going 'HRT is making me put on weight - I'm stopping it'. Which is just a total misunderstanding of things. They need to find the right amount of estrogen for them and ensure they have enough progesterone too. Not just throw it all out...

[Peanut31]

Hi

I didn’t know how to reply to you as someone sent a message after you, so couldn’t find the reply button for you.

How do I reply to a post if it wasn’t the last one?.

In answer to your question about magnesium, yes I take it at night Magnesium Glycinate, I also take individual vitamins to support thyroid and my Hashimotos.

I totally agree with not giving in. I had a long journey with my thyroid medication, and had to increase slowly and keep notes, luckily after a year or so, I’ve finally got my sweet spot.

I’ve emailed the Newson clinic regarding my concerns and waiting a reply, I’ve also waiting to hear back from Dr Currie with a question request, as I’ve received my Menopause matters magazine, which I read with interest. I think you  mentioned her and thought I would ask about advice.

Thank you for all your help and advice, it’s greatly appreciated.

[joziel]

I'm a big fan of asking as many people as possible and then making a decision. I've found that the answers I get from different doctors are vastly different - even when they are both menopause experts and specialists. That's why I like to get several different opinions and then think about my own body (which I know) and history (which I know better than any doctor!) and make a decision...

And sometimes you have to be a bit creative and think outside the box. For eg, I think I am going to attempt reducing to 25mcg at night and going back up to 37.5 during the day. This is because I feel great during the day with 37.5 and like the idea (for preventative health) that I am getting a bit more estrogen - but I am getting weird estrogen side effects at night. So it's an experiment...

As for how to reply, it's difficult. I tend to just write the relevant person's name and then respond...

Good luck!