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[Mary G]

Just to add, I received my latest blood test results back today and the Darstin is delivering a progesterone blood level of 4.57 ng/mL (14.53 nmol?).   No idea how that compares with other products.  Oestrogen was 77 pg/mL which is about 282 pmol. 

[Marchlove]

That’s interesting MaryG, progesterone is so difficult to reliably measure, especially in serum, so it’s difficult to know.
Have you ever had it tested in saliva, urine or bloodspot by any chance?

M x

[Mary G]

Marchlove, my progesterone levels fluctuated between 5 and 10 ng/mL with the lozenges and the drops so I suppose this level is OK.  My base level when not using HRT is about 0.79.

I have only ever had conventional blood tests, never saliva or any other type of test.

[Marchlove]

It’s how you feel MaryG which I think you strive to be in tune with.

A base line measurement comparison must be something worth going by, for want of any additional but unfortunately non existent research.
It’s interesting that it’s slightly lower than other forms of delivery, but it’s difficult to read what significance that may have.

Oh a quick aside, at what stage did you get the baseline done, was it before you went on hrt or after you’d stopped it for a certain amount of time?  Also, how many years post meno were you?

[Mary G]

Marchlove, it was last year and I literally stopped everything to get a baseline hormone reading.   I'm 61 and about 15 years post menopause.  Back in 2007 when I was first post menopause, my progesterone level was 0.50.

I feel fine on my current dose of progesterone and the womb lining is just below the 5mm danger line so I suppose that means it's working!

[Marchlove]

Sounds good to me MaryG!

My womb lining is about the same, so scans are our companion’s with our particular hrt regime’s.

x

[Mary G]

This is an update almost one year later.

I had a transvaginal scan a couple of days ago and my womb lining measurement was 3.8mm.

I was almost surprised when the gynaecologist inserted the dreaded probe and said that's very good, no problems at all.  I was expecting to be nudging 5mm.  Darstin is not supposed to work on the endometrium!

I have now been using 1 pump of Oestrogel, testosterone and 50mg Darstin progesterone gel every day since July 2022 and although it's not as strong as the excellent compounded progesterone I was using before, it is still very good with zero side effects and obviously good womb lining protection with a measurement like that.

Several months ago I got a bit slap happy with the Oestrogel and had a slight bleed but other than that, nothing to report.

Last week I decided to start interspersing Cyclogest @ 50mg twice weekly but that is far too recent to make any difference to the womb lining.  I have to say I don't like Cyclogest as much as Darstin but I have found it far more tolerable than Utrogestan.

[Scampidoodle]

Hi and congrats Mary G and glad you have found something that works and I think it’s really important to let us know all different options with menopause and peri. What has led the majority of us to this forum is that because we are having issues and the standard regime doesn’t work for us.

I am seeing a consultant and am in peri and she has mentioned both cyclogest cut into half or crinone gel as our next options so yes private meno consultants can prescribe and seem happy to so worth a discussion.

As hurdity says I’m unsure with the crinone whether smaller doses can be taken or not.

I’ll report back if I find any success!

And yes Crispy compounded products tend to be made at maybe One of 3 different compounding pharmacies in the uk so there isn’t much variation.

[Mary G]

Thanks Scampi.  For women who struggle with the progesterone component of HRT, I think the key takeaway is flexibility and openness to different types/doses of progesterone.

In theory, my regime should not have worked and my womb lining should be dangerously thick but it very obviously has worked.  It also proves that not all women need the same high dose of progesterone to get good womb lining clearance.  I wonder what the result would have been if I had dosed myself up to the eyeballs with 100mg progesterone every day for the past year?

Dogmatically sticking to the NHS guidelines means many women give up using HRT altogether and then struggle on with debilitating symptoms for years on end. A more flexible approach would avoid this.

It should also be more widely publicised that the Chelsea and Westminster menopause clinic sanction the low dose Jaydess and Kyleena coils for women who are progesterone intolerant or sensitive to high doses of progesterone - with regular scans of course.  I think they also ship in the much sought after Duphaston although I might be thinking of one of the private clinics.

In your case, I think you will find Cyclogest more tolerable as long as you use a low dose.  I have never tried Crinone but if it's a vaginal gel, you should be able to use a low dose. 

Good luck with the appointment and please report back.

[Scampidoodle]

I will do thanks Mary G,

Just a note on Duphaston, another consultant offered me this. It’s only available via one pharmacy in London apparently but was also hideously expensive. So I declined. And I think it would only be available privately as you say.

[Lesley M]

Hi Mary,
Thank you for your posts. I’ve struggled with utrogestan and have gone to my GP asking if I might try Cyclogest as an alternative. He checked with the practise pharmacist who said they would contact the menopause clinic, after trying to persuade me to use patches which I had explained I don’t want and anyway fall off.

It has all gone very quiet and I can see I am going to need to be persistent if there is any chance of it happening. In the meantime I’m without HRT and being over 60 don’t want to leave it too long but NHS does not appear to be well equipped for such requests.

I’m curious whether Darstin available without prescription in Spain?  Also if you are still using Cyclogest at times and, if so, how you doing with it.

Thanks,
Lesley

[Lesley M]

Hi Mary,
I’m curious how things are going with the Cyclogest? I  think a regime similar to yours might work well for me.

I’ve never needed to use much oestrogel max 1 pump, and utrogestan knocks me off my feet and seems to do weird things with my emotions.

I stop everything early last year and since have developed tinnitus and feel rubbish much of the time.

I’ve asked my GP if I can try Cyclogest but this seems to have sent them into a bit of a flurry! I think I might end up with a menopause clinic referral.

Last time I was there my uterine lining was ‘thin’ but still came away with the dreaded utrogestan and a stern talking to about it. After having told them I found it difficult to tolerate.

It’s frustrating seeing possibilities that might work and then encountering what seems like endless obstacles to trying them out. Especially as I already feel exhausted and brain fogged much of the time since stopping oestrogen.

I’m also interested how Scampiedoodle got on with crinone. I asked my local pharmacist about it a while ago but was told it’s not available here (uk).

I’m not sure about posting etiquette, so many apologies if I’m stepping all over the rules and doing things i shouldn’t be doing! I don’t really participate in forums and am unsure of what’s ok and what’s not.

Thanks,
Lesley

[Mary G]

Lesley M, I'm sorry to hear about your problems with Utrogestan but it's very common (the most debated subject on here) and a lot of women don't get on well with it.  You certainly don't have to be progesterone intolerant to have problems with Utrogestan but fortunately, it's nothing like compounded progesterone, Cyclogest or progesterone gel in my experience.

I'm afraid my Darstin progesterone gel is not available in the UK and Cyclogest also seems to be difficult to get hold of but I don't know why because it's not expensive - it's under €20 per box of 600mg pessaries in Spain.  When you consider the pessaries are cut into 50mg doses, it makes them quite economical.  It's years since I had a UK prescription so I'm a bit hazy on that but is it £10ish per item?

I find I have excellent womb lining protection with the gel but I added in a 50mg vaginal Cyclogest dose a couple of times a week just for good measure but since my scan, I haven't bothered to do it very often because I don't really need it.  I found I could tolerate 50mg Cyclogest well and without any side effects which is encouraging but overall, I prefer Darstin and it's more user friendly.

I buy Cyclogest, Darstin and Oestraclin (the Spanish equivalent of Oestrogel) at the pharmacy without a prescription but some pharmacies can be a bit sniffy about selling it without a prescription although it's not a controlled medication like antibiotics.  On the rare occasions I have used a prescription here for non HRT medication, they always hand the prescription back to me anyway so I can reuse it.

One further thought... bespoke progesterone from the compounding pharmacies in the UK are excellent with zero side effects and again, I always had good womb lining clearance/womb lining protection with these products despite all the dire warnings.  That said, it's expensive which is a major drawback for many people.

So there are quite a few options available.