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[shelley]

Hi Ladies,

Hoping for some reassurance i am a 50 year old peri menopausal  still having periods and after a year of research mainly this site i have finally taken the plunge and started hrt .   I went to my GP and asked for what i thought would be the best combination   sandrena gel daily and 12 days of utrogestan  days 15 to 26  she did not seem to know much about  it but was happy to prescribe. I thought i should start with the lowest dose of sandrena 0.5 mg daily but the part i am worried about is the dosage for utrogestan basically i have read every thread on here concerning it and went with 100mg days 15 to 26 taken at night v route not oral.

I am wanting to know if this dosage would be enough to oppose the estrogen i know i will have to up the dosage of both when the symptoms get worse but for just starting out i want to give myself the best chance of hrt working is this dosage ok?

Sorry also  when you apply the sandrena gel should you use just two main sites ie inner thights or buttocks or should you have more that two. I have read conflicting advice also on where you should apply some saying not on any fatty areas but lower inside arms  Hurdity said in some thread there was a paper on this  could not seem to find it. please could you advise . Thank you for anyone that can help i just wish i had a decent  gp .

[Salad]

Hi shelley

I'm not familiar with your HRT but wanted to say well done on getting it sorted with your GP - it's great they listened even if they aren't too knowledgeable.

When I used Oestrogel I applied it to my inner thighs. What does the Sandrena gel leaflet tell you to do?

If no one here offers help it might be an idea to email Dr Currie on this site or perhaps talk to your local pharmacist who might be able to do some research for you then advise you.

It's not easy sorting yourself out is it 
 

[Annie0710]

I use oestrogel and rub it on middle/outer thighs.  I don't think you should let it touch breasts

[Hurdity]

Hi shelley

  from me too.

What are you periods doing - when you say you're having them - are they few and far between or maybe your cycle is just a bit longer than normal?

Depending where you are in menopause will determine what dose of oestrogen will benefit you. In early peri-menopause - some women are fine with just a low dose top-up but as your oestrogen levels drop it might need to be increased? The dose of progesterone you are taking is lower than licensed but as you are on a very low dose of oestrogen and also taking it vaginally it should be fine although this should be done under medical supervision - eg if you have bleeding problems/heavy bleeding - the licensed dose might be preferable even if vaginally. If your periods are still pretty regular ( give or take a week here and there) then you will be producing your own progesterone after ovulation which will help to clear the lining and protect the womb.

re application of Sandrena - these are the instructions:

Apply on dry and clean skin.
The Sandrena dose is applied once daily on the skin of the lower trunk of the right or left thigh, on alternate days. The application surface should be 1-2 times the size of a hand. Sandrena should not be applied on the breasts, on the face or irritated skin. After application the gel should be allowed to dry for a few minutes and the application site should not be washed within 1 hour. Contact of the gel with eyes should be avoided. Hands should be washed after application.

Provided you are consistent then you will minimise the chances of variability in dose. It shouldn't need to be rubbed in as such - because gel isn't designed for this unlike creams, although I gather some women do this.  Also maybe some gynaes suggest this? I haven't used oestrogel although I use testosterone and I just spread it on the part of my body that I apply it to and let it absorb.

Hope this helps?

Hurdity x

[shelley]

Hi Ladies,

First of all thank you for taking time to reply I really do feel alone in this matter and i think i might have spent so much time researching that i have frightened myself about starting HRT . I am definitely early stages peri as i have been having regular periods  give or take a week,  i do not have the flushes but i have been extremely tired , joint ache and moody last couple of years but the defining symptom was the disrupted sleep last 6 months. I have always slept well so it was hard to deal with when this started happening especially as i am  as most women  working running a house and dealing with teenagers .

The sandrena gel i found easy to use etc but i am finding my boobs are very sore  ,   the utrogestan i decided to take v route to avoid the side effects and also think it  more safe  ie thrombosis ?  I am not far enough into it i suppose to make a judgement  but was wondering if the sore boobs could be too much estrogen ie  , i have enough and  not ready yet for HRT ?  See what i mean about frightening  myself .

Should  i just  give the routine 3 months and see if  it all settles down  and does it  settle down once your body gets used to it? Is it always a case of living with side effects or living with menopause symptoms .

Sorry ladies i sound a miserable sod  but no one ever tells you just how awful this menopause business really is  .

I appreciate all your support thank god for this site

[Hurdity]

Hi there - sore boobs are often a side effect of progestogens, and also temporarily from increased oestrogen. Personally I think that the 25/28 day regime is not suitable for peri-women in your position unless you have heavy bleeding. You could give it 3 months and see how you feel and if it's not right for you then follow the usual regime for peri-menopause ie utro x 200 mg for 12 days per 28. If you use it V route then you could probably get away with 100 mg especially with only that small amount of added oestrogen, and given that you are still ovulating most months and producing your own progesterone. You do need to tell the doc about this though if you decide to change.

Thrombosis risk is not associated with the progesterone - it is the oestrogen which may be linked - but you are under 60 and if you have no risk factors for thrombosis or heart disease then you shouldn't need to worry. Transdermal HRT is associated with v low risk anyway, and in fact starting oestrogen within 10 years of menopause can be protective (re cardio-vascular disease), so it is thought.

Hurdity x