Sandie77 Hi and welcome to MM
I had a premature meno and started HRt at 37, which is now over 20 years ago. I had to try a variety of HRTs before eventually going to a private meno clinic and being given Oestrogel with a separate progesterone which worked really well for me through my 40s. When all the scares came out in 2002 I got really worried and stupidly took myself off HRT at the age of 49. I then suffered for 3 years with horrid flushes, night sweats and waded through my days with headaches, exhaustion and depression. Then one day a lady friend, who was 80 at the time, noticed I refused a glass of wine. I explained it made my flushes so bad and she firmly told to me go back on HRT a.s.a.p. - she was still on HRT and her gynae had told her the risks were really quite small. I then took myself off to an NHS meno clinic that put me back on HRT - I had to try a few before ending up with the Mirena and Oestrogel. This combo wasn't too bad but in hindsight during the first year I did feel very sedated so I don't think the synthetic progesterone was quite right for me.
Aged 57 my GP wanted me to take another break from HRT to see how a I coped. It wasn't tooooo bad but I got horrid headaches, the vaginal atrophy and bladder problems became worse so I went to see a private gynae who specialises in the meno who has now got me back on HRT.
I am on One pump Oestrogel per day with 100mg Oestrogel everyday - this is quite a low dose but it keeps me ticking over really well. I did try doing a longer cycle (like Hurdity) with Utrogesan for 14 days every 6 weeks but I got bad breakthrough and heavy bleeding. I was reluctant to try the conti Utrogestan but I'm finding it really good and I hope I can stay on this for the foreseeable future.
I wouldn't worry about PMT at this stage - Utro in natural and you may find you feel really good on it as I do. The licensed way to take Utro is as your pharmacist has said and as you are probably still in the peri stage(so not deep into post meno as you haven't gone 2 years without a period) then the 3 day break should prevent problematic bleeding - you may have a slight bleed after this 3 day break. I haven't used Sandrena - I like Oesrogel as it gives you greater control over dosage - I think the Sandrena comes in sachets which give slightly higher doses but is still the same principle as Oestrogel.? I wouldn't go off license with the 7 days of Utrogestan as this needs to supervised with a private gynae with regular scans and it won't necessarily make the PMS any better unless you prove to be severely progesterone intolerant and this is very rare.
I take Utrogestan orally at night on an empty stomach and it really helps me to get a good 5-6 hours sleep which is fabulous for me. I would try this first and if you find you feel really sleepy in the morning then try using it vaginally. As Hurdity has explained, in the UK it isn't actually licensed to be used vaginally which is silly but vaginal use can aggravate the bladder and perhaps is not ideal when used continuously - sex could be a problem!!!!
I am very sensitive to drugs generally but these bio identical hormones suit me really well. Do keep in mind that what you are using will simply replace the hormones your body needs - this is not a drug. In the first few weeks, you may find you get some stomach cramps, odd spotting or bleeding, tender breasts and even some headaches - this is all normal and my gynae describes this as your body welcoming the hormones and waking up the areas that need it - things usually settle within 3-6 months. You may well be very surprised at how good you feel. ENJOY feeling good and getting your life back on track. DG x