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[honorsmum]

How do you sync utrogestan with your natural cycle in perimenopause?
My cycles are a bit haywire - 25 days last month, 20 days this month...who knows how long next month?

[honeybun]

Someone will be along with a more scientific reason for you but

You don't really sync it terribly well at all. If you think of it the same as birth control...you override your own cycle. It's the withdrawal of Utrogestan that will give you a bleed.
Some woman find this very helpful because you then know when you will have a period every month.

Not a terribly good explanation but I hope it helps a bit.

You can start HRT at the end of your natural cycle to try and get some rhythm but it doesn't always work if you just don't know when your next period will be.


Honeyb
x

[Hurdity]

Hi honorsmum

I always think the idea of trying to sync cycles as odd - well I mean it doesn't always work because many women start HRT when their cycles are irregular, and the dose of HRT is not high enough usually to override the cycle at least initially when you still have lots of oestrogen of your own.

It's always advised to start in sync though - you just start the Oestrogen on Day 1 of you bleed and take it from there. What I find weird about that is then you finish the Utrogestan on Day 27 but the progesterone withdrawal bleed usually happens a day or two ( or more ) later - so immediately you've gone into a longer cycle. It doesn;t really matter that much though ( a few days either way) but sometimes it means women feel various pms symptoms at the "wrong" time and difficult to decide what's causing what when you are peri...

Hurdity x

[honorsmum]

Thanks,HB and Hurdity.
Does every woman take utrogestan for the same number of days each month?
If I decide to try it, do I now have to wait for my next cycle to start the Sandrina? Annie said I could start it straight away, in advance of having the Mirena, but of course we didn't talk about utrogestan.

[honeybun]

I would follow her instructions to be honest. As long as you don't leave it too long without progesterone you will be fine and hopefully start to feel much better.

The days that you take utrogestan depend on whether you are planning a bleed or not. Some women take continuously so no bleed.
Just to confuse things further...some women work to a longer cycle if they don't do to well on progesterone. You really need to be guided by a doctor for that one though.
As you are young you will need to use a sequi regime, so oestrogen all the time and then add in your progesterone for the second half of the month.

Confusing or what 


Honeyb
x

[honorsmum]

Thanks, HB.

I guess I'll have to ring her secretary and see if she can get a prescription and instructions.

I'm at the point of abandoning the idea of trying HRT, in all honesty. Waking up every morning with my head full of questions and worries isn't doing me any good. 

[dogdoc]

Honours mum.  I think we are at the exact same 'stage' in this lovely drama.  I was so keyed up and stressed about the hrt that I had convinced myself I would stroke out with the first patch I placed. At the same time I could not live how I have been living for over a year.
 
Struggling with the idea of Lupron, mirena, all of it. I finally just bit the bullet and placed my first patch ( 25ug) two months ago. I cried and cried while doing it too and had about 50 panic attacks. I have not died so that's a plus. So far I see small but noticeable improvements in just about everything. Was pretty convinced I was going to die again when I started the progesterone component this month. Still here. Did not lose my mind ( which I though was a real possibility)

I've since increased my estrogen to 37.5 patch and am working my way up slowly. Dr currie says that with symptoms like mine ( and yours i suspect) some women need to go up to 200ug to fully control their symptoms.  Especially as we're young.

I'm still not 'normal' and when I'm not in my right mind I think 'this is never going to end and this will be my new life FOREVER!!!! But I seem to be having quite a few more days a month where I'm normal or nearly so. This might just be random chance and next month I'll feel just as bad again but the timing was awfully coincidental. 

It's a helluva hard decision to make, particularly when not in your right mind and you're pretty convinced you're dying. I'm still not 100% convinced I'm not
Good luck though. I know almost exactly how you feel!!!
Tara

[Hurdity]

Hi honorsmum

Try not to worry too much! I know the feeling of wanting to find out as much as possible about what's going on in your body and what all the different options will do, but your body will respond in its own way and depending on how your own ovaries are doing too!

It is definitely best, since you have started this journey (re HRT) with a specialist, to make sure that you get her advice as to what to do, especially as you are wanting initially to do something different from her prescription. She used to do paid e-mail consultations if she doesn't give follow-up advice free. Not sure if she still does? Failing that you could always ask Dr Currie (cost £25) and send her the info re Dr Evans and any relevant medical info - but of course that's not quite the same as sending a prescription although you could print it out for your doc to go with the Dr Evans prescription?

I think I've already said I am on a long cycle and use utrogestan vaginally - but you will need to discuss this with a professional especially as you are still very much peri-menopausal!

I imagine it's fine to start the gel anytime, but think of Day 1 as the first day of your last bleed, so if you are using sequential utrogestan rather than having a Mirena, you would still add it in on the appropriate days of the cycle.

Also I've just remembered re my post about the cycle that utrogestan is only taken for 12 days I think so the bleed should occur on Day 1 ( sorry about that - was in a hurry this morning). So it's: Day 1 = first day of bleed. Oestrogen only Days 1-14, Oestrogen + Progesterone (Utrogestan) Days 15 - 26, Back to oestrogen only Days 27-28, Bleed starts Day1 ( this is variable with different women) - but once you've started the Day 1 you are supposed to keep to the 28 day cycle although sometimes because of your own cycle you can shift it back or forward a few days!

Please try not to worry - whatever decision you make, you can always change it later and it;s not going to do you any harm, and may make you feel a whole lot better for a lot of the time.

Good luck with your decision!

Hurdity x

[honorsmum]

Thank you so, so much, Tara.
I am so relieved to know that you understand how I am feeling.
My head has been a mess the last few days. I don't know which way to turn, and I'm not even sure whether how I'm feeling is hormonal or just sheer stress worrying about it all.

My biggest issues are from some bad reactions to drugs previously - antidepressants nearly killed me, and the progesterone-only pill made me depressed within a couple of weeks. Because of this, I'm terrified to try anything that may cause similar side effects.
That said, the idea of struggling through the next 5 or 10 years, only being able to think about my hormones is not much fun either.

I am lurching from Mirena to uterogestan to doing nothing every few minutes - the indecision is killing me.

[honorsmum]

Thank you so much for explaining, Hurdity.
I think I will ring Annie's secretary and see if it's possible to get a prescription. She doesn't appear to offer email consultations any more.

[dogdoc]

I'm still on fence about mirena also. I like the idea of possibly no periods and no oral hrt, and sleeping. Oh how I love sleep. 
What I've decided to try is the micronized progestetone for a few month and see how I am with Protestins to begin with. If I do well during my progesterone component and it doesn't make me crazy ( er) then I might consider the  Mirena. If you lose your marbles on the mirena it can be removed immediately!!

From everything I've read the micronized progesterone seems to have the fewest pms like side effects. I will stick with it if it works. If you find the progestetone component of your cyclical hrt to hit you too hard and you can talk to your doc about long cycle ( only need to take the progesterone every three months this way). But they need to be paying close attention to your uterine lining with this method. 

I am cautiously optimistic that I'm doing better since starting the estrogen. Trying to be patient and move very slowly.  I just competed the week leading up to my period and did not have a single episode of uncontrolled crying. This is progress ( I hope)