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[lisa789]

Thanks Hurdity I didn't know that.

So if I bleed isn't that shedding the womb lining so why do I need progesterone? Sorry for sounding so thick but I'm new to all this and don't know how it all works!

[CLKD]

Like you I took my periods for granted without really thinking what was causing the various symptoms  .  I kind of knew that hormones were involved ………. but they happened 'out there' so I wasn't aware of oestrogen or progesterone inputs. 

[lisa789]

UPDATE

The hospital never called me back despite ringing several times. I was prescribed the HRT by the gynae unit so my GP said I must speak to them. Totally fed up by it all so I rang a private clinic and saw a consultant last night.

I'm to stay on the Evorel 50 as I'm doing ok on that and have to change it twice a week, the doctor I saw at outpatients prescribed it to be changed everyday which makes no sense. He's given me 200mg of Utrogestan to try but as I have severe PMS he says that indicates progesterone intolerance so even this might not be the solution. Aside from the mirena coil which I don't want he says my only other option is hysterectomy with my ovaries removing.

He says it's the last resort for people with severe PMS. I'll give the Utrogestan a go and pray that it works without making me too ill as the thought of such major surgery and the implications of it scare me.

[CLKD]

Did he suggest what treatment you will require after hysterectomy?  That's a big question to ask!

[lisa789]

Did he suggest what treatment you will require after hysterectomy?  That's a big question to ask!

No, he said we'd see how the Utrogestan goes first before going into all the finer details of surgery and what happens after.

I did have a small taste of it when I was given zoladex. The same incompetent department at the hospital didn't give me HRT when I'd had the zoladex implant put in so I had my pituitary glands shut down and went into menopause cold turkey. It was horrendous.

[CLKD]

I bet it was!  Doesn't 1 Dept. speak to others 

When do you see him again?

[lisa789]

the guy who I saw last night is the head of gynaecology at the nhs hospital I'm under so he's arranging for me to have a scan to look at my ovaries and says he'll do that under the nhs. My next follow up nhs is due at the end of May for the HRT they prescribed and he says I've to ring outpatients the day before and make sure they put me in to see him. If I have any problems with the Utrogestan before then i'll probably have to go see him private again. It would seem he's not after the money or he'd have done the scan private and set another appointment date.

It did concern me that I had to tell him about Utrogestan, he said its not one he's familiar with prescribing. I mentioned using it vaginally to minimise side effects and he got a book out and looked it up and said orally only. Loads of people on here take it vaginally.

If I do have problems I'll see if there's any specialist PMS/PMDD clinics in my area for another option. He also said he thinks I'm peri as PMS gets worse nearer menopause especially to the extreme like it get.

Once again thanks for your input kind lady xx

[CLKD]

Nice that he seems interested enough to see you in Clinic.  However, maybe check with Dr Currie about the Utrogeston so that you can be firm about using it vaginally/not?  It may be that the product is not Licensed to be used vaginally?

[lisa789]

Nice that he seems interested enough to see you in Clinic.  However, maybe check with Dr Currie about the Utrogeston so that you can be firm about using it vaginally/not?  It may be that the product is not Licensed to be used vaginally?

I had an email from Doctor Currie the other day after the nightmare of the norethisterone and she said the dose he'd given me was too high. She suggested Utrogestan first orally but can be used vaginally. I think it's prescribed off label in this country for vaginal use. The consultant I saw looked in his drug book and it only said orally.

I'm going to give it a go orally and hope it's tolerable. Maybe I was so bad on the norethisterone as he'd given me 10mg which is apparently high, and also because it's synthetic. Fingers crossed CLKD as the thought of a full hysterectomy is terrifying. I keep thinking what if I have it done and the HRT doesn't work and a whole host of other thoughts. 

[CLKD]

So the Consultant is correct.  Maybe explain at your visit how successful it can be 'off Licence?'

Let us know how you get on!

[Mary G]

Lisa789, I think the standard of treatment you are receiving is pretty poor to say the least.  This comes up on here time and time again whereby doctors do not understand the menopause or HRT and it is women like you who always pay the price for their lack of knowledge.

There is no reason why the NHS cannot licence Utrogestan to be taken vaginally - I have yet to hear a reasonable and logical explanation for it.  If you take it orally, you will probably have more side effects and it is less effective when taken in this way because much of it gets lost in your digestive system and you will need to take about twice as much of it to get the same effect.  It makes no sense whatsoever.  If you are intolerant to synthetic progesterone, the Mirena coil is unlikely to be suitable for you either. 

I am severely intolerant to all types of synthetic progesterone and to high doses of Utrogestan but I have never suffered from PMS.  Therefore, I take the barest minimum which is 100mg Utrogestan vaginally every month for 7 days and that is enough for me - like you, my only other alternative is a full hysterectomy.  What you really need to do is to seek the advice of a hormone specialist who will probably prescribe the same for you along with 2 or 3 pumps of Oestrogel every day. 

I would suggest you make an appointment with either Professor Studd, Dr. Nick Panay or Dr. Annie Evans. 

[lisa789]

Hi Mary, thank you so much for your reply.

It's great to hear from someone who understands my situation and the frustration that it's causing me.

I'd gone to see the gynae consultant private yesterday as the nhs were useless and I had to tell him about Utrogestan and he got a book out to look it up! I could've cried I was so peed off. I'd gone with so much hope.

The PMS has gotten so bad over the last few years I've got panic disorder with agoraphobia. To get to last nights appointment I had to take privately prescribed Xanax to sedate me as I can't go more than a few yards of my home without getting crippling panic attacks. Since I started the Evorel I've felt a lot calmer and haven't had a full blown panic attack apart from a couple caused by the prgrsterone. Due to this condition there's no way I could to any of the clinics you suggested as they're all miles away. I'm in Yorkshire and can't seem to find anyone nearer to home.

 Honestly don't know what my next move is and all the worry is making me feel ill. I've started bleeding today so that's day one of my cycle so I have a couple of weeks until I have to try the Utrogestan. I'm thinking of using it vaginally anyway regardless of what the clueless doctor and his book said. He also told me if I'm ok on the Utrogestan to ring and he'll issue another a private prescription. I'm hoping my GP will prescribe it