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[jedigirl]

Hi lovely ladies,
would like to ask your advice again please! After a visit to my GP  today I will be starting on Utrogestan and Estragel next week(apologies if spellings incorrect waiting for my prescription to come in).
I have been really struggling with the huge dip I have coming off the progesterone part of the Femoston I was on.
After a chat my GP was happy to let me try 1-25 days on Utrogestan with the Estragel and three days for a bleed. I'm terrified to feel worse than I do now but know i need to sort this out for the longer term.
My question is should I wait to see if I have a bleed on the Femoston 1/10 (about to switch to the estrogen only pills so should be having a bleed) or can I start on new regime straight away and hopefully avoid the dip in progesterone?
Also is anyone who switched to Utrogestan this way from a different HRT able to tell me if there was a huge settling down time or did being on HRT previously help?
On a positive note my GP was very helpful and was impressed with the research I had done! When I mentioned it was from this site she said " Oh yes, us doctors do take note of that one!"
 
 

[Dancinggirl]

Hi jedigirl
So pleased to hear you have a good GP. If you have finished the progesterone section of the Femoston I would just go straight onto the new regime.  You may still get a bleed anyway but don't worry about this. You may find you get a bit of spotting or breakthrough bleeding for the first few weeks with this new combination. How much Oestrogel are you going to use?   I'd start with just one pump per day for the first couple of weeks to see how you feel and then increase it to 2 pumps if you feel you need it. I've always found it easier to apply it to my inner thighs. Don't forget to take the Utrogestan on an empty stomach before bedtime - at least 2 hours after food.  Utrogestan is similar to the progesterone in Femoston so you should feel fine but expect some settling time.
Good luck  DG x

[jedigirl]

Thank you dancinggirl, that's what I was hoping I'd be able to do! I will start on 1 pump per day and see what happens. 

[jedigirl]

Dancing girl,
Do you apply the gel on a night when you take the utrogestan or on a morning?xx

[Briony]

Will be really interested to see how you get on as I too hate the progesterone dip and would like to try a conti regime. Was your doctor easily persuaded? I am convinced mine will say no as I am only 42 and have regular periods. Out of interest, did you consider Femoston conti, or is there no such thing? I take Utrogestan for two weeks (vaginally) but wouldn't fancy it for 26 days this route(!). Good luck - hope it works well for you xxx

[Dancinggirl]

Hi Jedigirl - when to apply Oestrogel is up to you. I always have my shower before bed and apply the gel first thing in the morning so I can allow it to dry for at least 10 mins before I get dressed.  If it's been a hot night and I need a quick shower the morning I make sure my skin is really dry and apply it afterwards and give it the 10 mins to dry. You can certainly apply it at night after the bath or shower if you wish.  It's important to apply it to clean dry skin that hasn't got any moisturising cream (some shower gels have moisturiser in them so I use unscented vegetable soap).
Good luck  DG x

[jedigirl]

Thanks DG.
Briony, my doctor was open to suggestions especially as i went in armed with research! I don't think this is quite classed as a conti regime (might be wrong though!)as you have a break for three days to allow a bleed if needed.
There is a Femoston conti (find it in HRT Preparations on left ) but it is a non bleed type. I wanted the option of a bleed as was having bleeds before i went on hrt a few months ago and think i probably still them. I'll certainly consider it as time goes on. Also i like the idea of the Oestrogel and being able to adapt it to my needs and the Utrogestan being a good progesterone to take. I'll probably take it orally though. x

[Briony]

Really helpful info Jedigirl - do let us all know how you get on xx

[Hurdity]

Hi jedigirl

So glad your doctor was supportive and pleased that you had done your own research - unlike some we hear about who do not like their "superior knowledge and wisdom" being questioned!! How refreshing!

You asked about changing HRT and whether you will notice the difference - it goes without saying that we are all different. However the main difference in the progestogen in Femoston (Dydrogesterone) and progesterone is that the former, a synthetic progestogen - is a much more stable compound than progesterone so that much smaller doses are needed to obtain the physiological level required to keep the uterus thin ( maybe this is why many women feel OK on it?).

With progesterone much large quantities than really needed have to be taken because so much is lost through digestion and metabolism, and it also breaks down very quickly/easily. Notice that with Femoston you take 10 mg dydrogesterone daily but with utrogestan you take between 100 mg and 200 mg. It is this difference that probably accounts for the side effects of progesterone that some women feel, especially taken orally - the only downside of using a bio-identical product.

Having said that though - many women use it quite happily with only minimal side effects - the main thing is you might expect to feel sleepier, and of course the usual pms changes such as in the breast etc - depending on how you were with your own periods.

Good luck with it and interested to see how you feel!

Hurdity x

[jedigirl]

Thanks Hurdity,
wouldn't mind being sleepier tbh, fed up of waking early in a fog of anxiety! I will let you all know it goes, start on Monday evening x

[jedigirl]

Do any of you ladies know the equivalent dose of oestragel to the estragen in femoston 1/10? Haven't got my prescription yet and want to be prepared for Monday when I pick it up and start using it?

[Dancinggirl]

I think 2 pumps of OEstrogel would be about 1.5 mg in pill form so 1/10 Femoston is a bit lower. I'm really not sure about this but that's my understanding.  DG x

[jedigirl]

Thanks DG you're a star, as always will check when i get them but wanted rough idea x

[Hurdity]

It's really difficult to compare because individuals vary so much in how much of the tablet HRT is absorbed and how much gel.  You can't compare the quantities either because one is transdermal and the other is digested/metabolised through the liver.

However, if you look at the Summary of Product Characteristics for each, and the pharmacokinetics (how much gets into the system, and how quickly it breaks down) - the data give the average systemic estradiol concentration over 24 hours for 2 measures of estrogel (2.5 g gel= 1.5 mg estradiol) as 76.8 pg/ml, and for Femoston 1/10 as 30 pg/ml ie less than half the amount! I'm not sure though if these readings can be compared ie for Estrogel it's given as average over 24 hours after 12 days, but for Femoston, at "steady state" - which may be similar?

How much have you been prescribed? Normally the standard starting dose of gel is 2 pumps, and in view of the variability why not start with that? Alternatively start on one pump for a week or two and then increase to two?

There may be more accurate information in the medical/scientific literature....

Hurdity x

[jedigirl]

Thanks for the info Hurdity! I think the doc recommended 2 pumps per day, will check when I pick up prescription. I want to try and keep the level of estrogen similar as don't  want to rock the boat too much especially as starting utrogestan too. I realise this might not be possible as swapping from oral to transdermal route. Oh I wish this was all easier, can feel the anxiety mounting for Monday when I start on them, just can't face feeling worse than I do now. Hey ho, off sofa shopping now to distract myself, the hubby overjoyed!!