Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[anna123]

Hello
I've recently been diagnosed with POF (I'm 39) and understand the importance of HRT for bone issues. I have been feeling terrible recently too with insomnia, headaches,neck and back pain, moodiness and other symptoms which I'm hoping HRT will help with.

I've been prescribed Evorel Sequi patches (50) My GP contacted a consultant due to my age and my sister had breast cancer at 35 and the consultant has advised she wants to see me. I'm hoping the consultant will advise if the HRT I've been put on is suitable or if it needs changing and wondered the following:

- My concerns are the progesteron in this one appears tohave testosterone. Ive read mixed reviews-some that it is better for younger women to take this and others say it can cause increased moodiness and PMS. I just wondered if others had experience of this please.

- I like the patches though would be happy to take a separate pill for progestogen. I've heard good reviews of utrogestan and read it is 'breast friendly' Do you think I should ask for this and just have oestrogen only patches? 

- Or do you think  I should just run with the one I'm on for now and not go in asking for a change.

- Whilst I slept better last night for the first time in months I've had horrendous headaches twice this week though not sure if it's related .
 
- Is there anything else I need to be aware of / ask

Of course, I'll go with what she suggests but just want to have some more awareness and not appear too naive
Thank you     

[Taz2]

Hi anna - it's good that you have finally got a diagnosis as to what may be making you feel so horrible.

I just wanted to ask where you had read that Norethisterone contains testosterone? I haven't heard this before. I was on these patches for a few years but did suffer pmt symptoms so changed to Femseven although they fell off a lot. Not all women are affected by the norethisterone so don't think that you will automatically get a bad reaction mood-wise.

As for the most suitable type of HRT I'm sure the consultant will take everything into account re your age and your sister's breast cancer. Do you know whether the cancer was oestrogen receptive? Someone else will be along soon with more knowledge I am sure.  Do you belong to The Daisy Network as they might have some useful info?

Taz x

[anna123]

Hi Taz,

I read about progestogen being testostorone derived on this website.
 If you look at HRT Preparations -Perimenopause on the LH side it explains:

"Progestogens which can be used cyclically are of 3 main types:

1.Testosterone derived - Norgestrel, Norethisterone acetate and Levonorgestrel.
2.Less testosterone related - Medroxyprogesterone acetate(MPA).
3.Least testosterone related - Dydrogesterone and Micronised progesterone (Utrogestan). "

This was why I thought the Utrogestan might be better as least testosterone plus some good reviews from other ladies on this site on an earlier thread I had

Thanks for your info-I'll look at the Daisy Network.
Anna.x

[Taz2]

Ah yes I see! I thought you meant that it was an added component which would be great for those of us suffering from lack of sex drive!  I think that Femseven has dydrogesterone in it - although eventually this also gave me horrible pmt and black moods. However, now I am without HRT (due to reaching that unmagical age of 60 in a few months)  I am getting black moods and irritability all the time.

I was prescribed Utrogestan but couldn't use it due to a soya sensitivity but it does give good results for some women.

Good luck. Let us know how it goes.

Taz x

[oldsheep]

I got headaches for the first few months on Premique low dose, which is (I think) norethisterone.
Too high a dose of Utrogestan (200 mg per night) made me feel ill too; 100 seems fine, touch wood.
From my experience with GPs, they know nothing about Utrogestan, but the meno clinic consultant suggested it as the most tolerated progesterone.

[anna123]

ThanksTaz. That's why I'm concerned as also suffer from black moods and irritability  so don't want to take something that makes it worse Do you have to stop HRT when you reach 60? that must be frustrating especially if it was beneficial for you

Thanks oldsheep.My GP didn't know much about utrogestan either so hoping seeing the consultant will help

[andius]

Testosterone derived just means the molecule is more similar to the testosterone molecule than other progestins.

All hormones are steroids and many are very similar in composition with minute changes in molecular structure.  That said, some progestins have side effects in some women that are not well tolerated, so another type of progestin can be tolerated better. It depends on the person. This is found through trial and error, usually 3 months or so, then a report to doctor of how you feel.

At your age, you may be better suited to other kinds of hormones than the patches.  They really provide low doses for menopausal women. You might even require 2 patches due to needing more hormones at your age.  In US, doctors tend to prescribe the birth control type pills for younger women needing hormones and many of these contain norethisterone/norethindrone, then switch the woman to patches at menopausal age.

Thus, if the headaches and other symptoms don't go away in a week or so, you should talk to consultant about it so they can consider changing the HRT you are on by either switching the type to a different progestin, changing to pills, or upping the patch dose. They will know what to do by your report of how you feel. That is probably better than going in and asking for a specific type of HRT.  The consultant is a specialist in this medicine and should know what you require by what you report.

Andius

[anna123]

Thanks Andius
I like the idea of patches as less fuss and goes in directly without having to go through the digestive system though understand I' ll probably need a higher dose,as you suggest. I'm not keen on tablets.  I really don't  want to take the contraceptive pill either and would prefer 'normal' HRT.

You're right, it's better to tell her my symptoms etc rather than asking for  a specific sort. I think I'll keep a diary of changes and side effects. I prob won't see her till the New Year now so will have at least a month on these to see how things go
Thanks for your help 

[Dancinggirl]

Hi anna123
I would just like to add something: If you don't get on with patches and you need to adjust the amount of oestrogen you need then Oestrogel is a good way to go.  You can use as little as one pump per day and increase the amount (up to 4 pumps per day) you use over a few weeks till you reach the level to keep your symptoms at bay. You then take progesterone (whichever one that suits you best) for a few days each month to induce a withdrawal bleed.
I was peri-meno from my mid 30s and have used Oestrogel for most of my peri & post meno stages. I've never needed more than 2 pumps per day.
Hope that is helpful  DG x

[Hurdity]

Hi anna123

I agree with the others - at your age, if you are now in menopause, you may well benefit from a higher dose of oestrogen and as has already been recommended I would go for separate oestrogen and progesterone.

You talk about the "normal" HRT - and I think from what you are saying you mean something more natural to your body. Many use the term "body-identical" or "bio-identical", in that the hormones are the same molecules as made in our own bodies.

The oestrogen in Evorel (estradiol) is bio-identical but the progestogen is synthetic as has been mentioned. Utrogestan is the brand name for "micronised progesterone" which is bio-identical, and if you are going to be on HRT long term and want something "normal" (as opposed to synthetic I presume?) then this is what I would recommend - and I do think you can ask for a specific sort, if that's what you feel is better.

The biologically identical replacement progestogerone (ie Utrogestan) is least likely to cause adverse side effects and is bound to be better for you in the long run, as it will perform all the same functions in the body as the natural one. I have read that the synthetic progestogens do not necessarily have the same effect as progesterone in other parts of the body - except in the protection of the womb lining and maybe some other functions.

Re the progestogens in the other HRT types mentioned  - Femseven patches contain levonorgestrel - the same as in the Mirena coil, Femosoton (the tablet) contains dydrogesterone, and Premique contains MPA (medroxyprogesterone).

If anyone wants to know what their HRT contains, all the information is listed in the menu on the left (green writing) under HRT preparations (the different sub-headings give all the different types!).

The norethisterone in Evorel can cause headaches in some women (it did me so I switched to current combo - estrogen patch and separate progesterone).

Hope this helps and you start to feel a lot better soon! Good luck with the consultant in the new year.

Hurdity x