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[Aoife]

I am 56 and post menopausal. For last year have had really bad bladder problems urge and frequency problems. No help from docs and had to go private to see gynaecologist. He put me on estrogel. Have been on this for 6 weeks now and feel great. Bladder had settled and much better. Have been doing a lot of research on synthetic hrt and very worried about taking utrogesan tablet s as i dont want to have hair loss or get awful side effects. Been reading dr christiane nirthrups book on meno and she says should keep it natural. Thinking of getting coil in as it only releases progesterone locally. Can u please advise. I have never had children and my doc says i will need to b put under a local anaesthetic to have coil in. What if it needs to come out. Will have to b on hrt forever for this problem. Please help i feel mt life is over.

[Hurdity]

Hi Aoife

 

Utrogestan is more "natural" than any other progestogen used as part of HRT! It is progesterone itself and is "bio-identical" to the one made in our bodies! The Mirena coil does the same job but is synthetic - and it is wrong to be told that progestogen in that type only releases locally - most of it does go to the uterus where it is needed but there is some systemic absorption - minute compared to the POP containing the same progestogen, but very roughly on a par with a Femseven combi patch.

Re hair loss- - some women find this is more likely on some of the synthetic progestogens ( like in Mirena) but not with progesterone itself ( like Utrogestan) but some women also seem to report hair loss on this too? I think low oestrogen (and maybe testosterone?) contribute to post-menopausal hair thinning.

Utrogestan can be used vaginally but this can sometimes exacerbate bladder problems. Are you supposed to be taking it all the time or cyclically to give a withdrawal bleed and have you just been having oestrogen until now?

Are you also using local oestrogen for your bladder problems as this is advised as it targets oestrogen to where it is needed?

You should not need to pay to see a private doc about this - all these preparations are available on NHS.

Do not despair - and let us know what you decide and how you get on?

Hurdity x

[Aoife]

Thank u so mych hurdy. I have been using estrogel for few months now and feel much better. Have been advised by consultant tobusevutrogestan fir 12 days every 3 m9nths for bleed. Will i always bleed ir onltvif lining has built up in endometrium. Am a
Akso using vagifem 2 3 times per week to address the issue locally as i have read that this type of symptom has to be addressed locally. What other progestan wud u advise if this 9ne does not work. Also reallt dobt want a bleed as i have been poat meno fir 9 years. Any other bio hrt that i cud use.

[Ljp]

I too had bladder issues, and began my HRT journey on topical oestrogen in the form of estriole, six months later I had a light post meno bleed, which led to me seeing a gynae at my local hospital for a hysteroscopy, she recommended Mirena coil, to protect uterus from any effects of the topical and any subsequent form of oestrogen I might need to use.
I had it fitted while I was there, no anaesthetic was offered, it was uncomfortable, but soon over.

I now use oestrogel and have an estring for vaginal/bladder issues, I also take one 5mg tablet of vesicare to help my bladder, recently I have been able to reduce that to every other day as bladder is much better than it was.

The coil did cause a bit of spotting for the first 5 months, but all fine now, and unaware it's there, if there is any progestogen in my system, it's constant and i can't say I notice, plus I have no bleeds, and apart from applying oestrogel every day, nothing else to think about.

Everyone has their own thoughts and opinions, at the end of the day, it's what works for you, and helps your symptoms best xx

[Hurdity]

Hi Aoife

Your post is a bit difficult to read with all the typos....

To answer what I think you're saying - yes you will be most likely to bleed if you are only taking a progestogen every 3 months - that is long cycle HRT. Also depending on how much estrogel you are using your womb lining may thicken earlier than this so something to keep an eye on. Has the consultant recommended a scan every now and then to check on your endometrium thickness (womb lining)?

The only way not to get a bleed (after some possible spotting during the settling in process) is to take progesterone every day - and this can be associated with side effects especially utrogestan. Most women who take this type tend to take it cyclically as it is quite sedating in large doses. You could also have a Mirena coil - which delivers progestogens continuously to the endometrium with only a little systemic absorption.

Edit - sorry I realise that's what you asked in the first place and I've already answered!  Head's a bit foggy today... Yes the coil will not give a bleed!

Hurdity x