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[LuLuLu72]

Hello all

I am in the process of reducing my Oestrogel from 3 pumps to 2. I take 100mg of Utrogestan nightly. I decided to reduce my oestrogel after getting some insanely high estradiol readings coupled with rock bottom ones. I have never really known by my symptoms if too much or too little causes me so much anxiety and low mood. It just made sense to me to try reducing things as upping my oestrogen makes it worse.

I also am wondering if possibly the ongoing issues are caused by the Utrogestan which I take orally. However I always feel fine after taking it in the evening, my anxiety is worst during the morning. Does anyone know how long Utrogestan stays in the system?

My symptoms are mostly anxiety and low mood and hot flushes.

 I am in late perimenopause, no period for 3 months and counting.

Any advice on lowering dose, trying a different progesterone would be really appreciated

Thank you!

[bombsh3ll]

Have you ever used the utrogestan cyclically? If you have, you may be able to recall whether you felt better on it or off it.

That would give you a clue if it is impacting your symptoms.

Utrogestan can also be taken vaginally, and anecdotally this seems to reduce side effects in some.

2 pumps of gel is reasonable if this feels better for you, however as your bloods show, taking gel results in peaks and troughs that some women can be sensitive to.

If you think that's you, splitting the estradiol into one pump twice a day, or alternatively considering a patch which releases a steady amount might suit you better.

[LuLuLu72]

Thank you so much for your reply.

Yes I have and to be honest felt better on a higher dose, it has felt difficult taking it daily but I suspect it is the oestrogen causing the main issues.

I like your idea about splitting the dose, when I was on 3 I did that. it is a good idea. Thank you

Unfortunately the patch does not work for me as I seem to absorb the estradiol all on the first day which is awful. Gel while not ideal is at least more reliable.

Thanks again 

[Penguin]

Thank you so much for your reply.

Yes I have and to be honest felt better on a higher dose, it has felt difficult taking it daily but I suspect it is the oestrogen causing the main issues.

I like your idea about splitting the dose, when I was on 3 I did that. it is a good idea. Thank you

Unfortunately the patch does not work for me as I seem to absorb the estradiol all on the first day which is awful. Gel while not ideal is at least more reliable.

Thanks again 

Perimenopause typically involves spikes and dips of estrogen, even without hrt. However, I found that taking estrogel (even just one pump) made the highs too high for me resulting in jitteriness so you may well be better on a lower dose. It seems a lot of women find it hard to get the dose right when in peri due to their own fluctuations, so hopefully you'll move into meno soon and things may be more stable. I ended up giving up on hrt a couple of months ago as my E went too high and I also couldn't tolerate the utrogestan despuye using it vaginally. Trying a split dose is a good idea and it may help with the morning anxiety. You may also find having a snack before bed so your blood sugar doesn't dip too low helpful, and also eating first thing, even something small like a banana and a handful of nuts.

Utrogestan has a half life of around 16 hours, which means half of it should be gone from your system by then. I used to take it cyclically and found it would take about 5 days before I felt back to normal after stopping it. The withdrawal dip was horrendous.

[LuLuLu72]

Thank you so much, I really appreciate the time you have both taken to respond to me. it is so kind.

I fully agree, getting the dose right in perimenopause is hard. I think my biggest mistake was going from 2 to 3 pumps on the advice of my doctor. Looking back on it things went wrong from there but even then I was being told to go up to 4.

TBH I think a lot of women must struggle with perpetually not being on the right dose, seems it is hard for many and it is a difficult, very fragile time for sure.

I am going to take your advice, split the dose, have an early breakfast and see from there.

I guess if I was sensitive to the Utrogestan I would not feel so good when I take it or sleep well right?

thanks again, you have both made me feel less alone xx

[Penguin]

Utrogestan gave me a very low mood and heightened anxiety for the days I was talking it, then intense anxiety for the first few days of stopping it. Sleeping well on it is good though, I never managed that as it made me too hot.

Anxiety has been my worst peri symptom, I am now on the right anti depressant and no hrt and doing a lot better. That said, a lot of women find hrt alone sorts their anxiety, particularly if it is a new thing and (unlike me) not something they were already prone to. Mornings are still the worst, lots of people say that. My psychiatrist says it is to do with the diurnal rhythm of the body and that there's a lag when we wake up that it takes our body's systems time to catch up from. If I eat and get moving first thing (even though I rarely feel like it) then the anxiety is usually gone by mid morning.

[Penguin]

Just to add though, you need to eat the right combination of snack. So a banana on its own was too high a sugar hit then crash, so I was advised to add the nuts or other form of protein / fat in to make it more slow release energy.

[LuLuLu72]

Thank you so much and I am very glad to hear that you are now feeling better off HRT. That is great!

Yes mornings are always awful. That doesn't change really. I find getting up and doing yoga very helpful.

Thank you again! really appreciate it