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[Felix]

Hello,
I've been on 2 pumps estrogel (mornings) and 100 mg utrogestan (vaginally, evenings) since Feb this year. However, I've been having problems with lots  bleeding and regular silent migraines.

My menopause doctor recommended some blood test which I had in Sept  and I'm not sure how to interpret them.  If there is anyone here who understands such things I'd be grateful for their advice:

1. Serum progesterone 11.6nmol/L  Normal range

2. Serum C reactive protein level - 3 mg/L Normal

3. Serum ferritin - 64ug/L  Normal

4.Serum oestradiol level  494 normal

5.Serum Vitamin B12  318ng/ L normal

6.Serum testosterone 0.42 Normal

7. Serum sex hormone binding blob  88.5 nmol/L Normal

8. Serum folate 15.8 ug/L normal

I'm comforted by the  word 'NORMAL' but I haven't got a clue what any of this actually means or, more importantly if any of this give a clue why I'm bleeding so much of having auras (silent migraines) The aura seem to be link to Estradoil and often precede a bleed. My speech can sometimes go a bit strange at these time too.

Thank you all in advance this is a fabulous site

[Anne G]

I'm not sure I can help with interpreting results, but just wondering if nightly utrogestan is too much?  I use two pumps estrogel and 100mg utrogestan vaginally every second night.  As I understand it when you take utrogestan vaginally you usually take it every second night, as it is getting to where it is needed more directly and therefore the dose can be reduced.  Might we worth checking that out?
x 

[Felix]

I'm not sure I can help with interpreting results, but just wondering if nightly utrogestan is too much?  I use two pumps estrogel and 100mg utrogestan vaginally every second night.  As I understand it when you take utrogestan vaginally you usually take it every second night, as it is getting to where it is needed more directly and therefore the dose can be reduced.  Might we worth checking that out?
x

Hi
Thank you, yes I started off just taking 100mg utrogestan vaginally every second day (and 2 pumps estrogel daily) and after many difficulties with HRT this seemed to work well. I was so happy, I thought I'd finally cracked it and found something that worked for me. However I soon started to have bleeds and auras/silent migraines.  I stuck with it for months thinking it might settle but it didn't and it got to the point where I was bleeding most of the time, even though I felt great.
My HRT Dr recommended cutting to 1 pump gel and upping to 200mg utrogestan vaginally every night. 
I cautiously cut down to one and a half pumps but after a week or so I started with night sweats and anxiety surges, this didn't settle so went back up to 2 pumps. I never increased the utrogestan as I'm scared. I thinks I'm a bit utrogestan intolerant and I'm worried what 200mg might do to me. I've gotan appointment in a few weeks and I don't know what my Dr will suggest.  I'm fed up with the bleeding and auras and just wish I could get the balance of hormone right.
Thank you

[Molly57]

Any update ? I think utrogestan orally is triggering migraine aura

[bombsh3ll]

Your estrogen level is really good for two pumps of gel, assuming it was a steady state level rather than the peak, and not taken from the application site.

You could split the estrogen dose so you have one morning one night - more stable levels can help with migraines rather than a large spike then a drop.

That's assuming patches aren't an option - they give the most stable levels, however they don't tend to stay on if you have an active lifestyle.

200mg utrogestan is reasonable with that blood level, if you want the bleeding to stop. This could be tried cyclically to at least make the bleeding more regular however I can understand someone with migraines preferring a monophasic regime.

Your other option would be to change the progestogen eg IUS or off label 150mcg desogestrel. Micronised progesterone sometimes just isn't potent enough to control bleeding.