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[Meeka]

Hi Everyone,

I use Utrogestan vaginally and have noticed that I get facial flushing during its use.   I have been using it or 2 nights and woke this morning with bright red cheeks and visible capillaries.    I have had facial flushing issues with certain triggers, heat, alcohol, stress, spicy food , so I am prone to facial flushing.   I have used laser in the past to treat the facial thread veins which are caused by facial flushing so i am concerned that using Utrogestan  may cause more broken capillaries.

I wonder if anyone else has had this issue and found anything that helps?    I am a patient of Prof S and on a recent consult he said to use utrogestan for 10 instead of 7 days because it offers increased protection from thickening  of the lining of the uterus.    I wonder if he has informed others to do this as i have had no issues that indicate i need the extra days use. 

[Katia]

Would it be possible that it is because the progesterone raises the basal body temperature?  Estrogen lowers body temperature.

[Mary G]

Meeka, he certainly hasn't told me to increase my Utrogestan dose but he knows I am being very closely monitored and have very regular scans via my gynaecologist because I am severely progesterone intolerant.  He also knows I can take a small amount to get adequate thinning and clearance.  That said, he thinks that long term I should be considering a hysterectomy and I agree with him. 

Katia, I think you are right, progesterone does raise the body temperature and this could be part of Meeka's problem.  I had facial flushing when my oestrogen was too low, particularly after drinking wine, so it could also be that the progesterone is overly surpressing the oestrogen. 

[Sarai]

Mary G, I'm very interested in the logic of hav8ngba hysterectomy to avoid the need for prog.
I was told 8 was nearly given one during my last C Section, now I really wish I had been given one it would make like a lot simpler for me now.

[Meeka]

Would it be possible that it is because the progesterone raises the basal body temperature?  Estrogen lowers body temperature.

I was feeling very cold in bed last night and tried to keep warm with extra covers.  Does this mean that my basal body temperature may have risen but I was feeling cold?  Not sure if that makes sense but if the basal body temperature rises do people feel cold like when they have a temperature or fever? 

[Meeka]

Meeka, he certainly hasn't told me to increase my Utrogestan dose but he knows I am being very closely monitored and have very regular scans via my gynaecologist because I am severely progesterone intolerant.  He also knows I can take a small amount to get adequate thinning and clearance.  That said, he thinks that long term I should be considering a hysterectomy and I agree with him. 

Katia, I think you are right, progesterone does raise the body temperature and this could be part of Meeka's problem.  I had facial flushing when my oestrogen was too low, particularly after drinking wine, so it could also be that the progesterone is overly surpressing the oestrogen.

Mary G,  I have varying reactions to the Utrogestan, sometimes I feel exhausted and teary , moody and snappy, get migraines and generally can't wait to stop taking it.   Other times I don't feel too bad at all but then when I stop taking it I have a few nights when I sleep badly and can get migraines.    I wish there was some other way to keep the lining thin other than hysterectomy but sometimes that route does seem the best answer.     I need HRT for my bones as I have osteopenia and osteoporotic in one hip....otherwise I think I may have given up.

[Mary G]

Meeka and Sarai, I think it's dreadful that there are no real viable alternatives to progesterone other than a hysterectomy.  It seems that people who don't have severe problems with progesterone struggle to understand just how bad it is - it's not like you can just flick a switch and make yourself about to take it.  God knows what's in that stuff but I do wonder why it causes migraines in so many women and numerous other unpleasant side effects.  Utrogestan is supposedly like our own progesterone but the experience I have with it is absolutely nothing like the experience I had with my own progesterone.  It think it is very sad that so many women end up ditching HRT because they just can't tolerate the progesterone.

One thing I am looking into is having a uterine ablation.  That way, you can do a very long 3 month cycle which makes the progesterone much easier to bear.  It also means you don't have to put up with the ensuing bleed and you will not get any breakthrough bleeding.  It's not a perfect solution but it could be the difference between sticking with HRT or giving up on it completely.

I keep saying this but it really is time something better came along.

[Hurdity]

Some women do find that they get flushes during the progestogen phase and not sure why this is - and is interesting.

Interesting too that you have been asked to increase your progesterone use Meeka. A patient of Studd recently reported on here that she had been using his regime (starting HRT in late 50's having been post-menopausal for several years, if i recall correctly) and developed endometrial cancer. The 7 days regime is associated with increased risk of endometrial hyperplasia and therefore of cancer and the Prof's own research demonstrated this years ago, which is why the dose/duration regimes were developed.

As for what progesterone contains Mary G ("God knows what's in that stuff "), as you know it is simply progesterone itself and is biologically identical to our own. As I've said on here many times, it is needed to be taken in higher doses ( orally and vaginally) because it is unstable in the body so has to be taken in high enough doses to enable sufficient to reach the womb where it is needed.  Some of us are sensitive to these higher amounts. When we are menstruating the ovaries (corpus luteum) produce (s) it continuously at the right amount but when we take it obviously we don't want to be popping it every hour! The only other time we have it at very high concentrations is when pregnant and many women remember feeling very tired at this time - but we also have very high concentrations of oestrogen whic makes us feel good so that we don't notice the negative effects of the progesterone so much.

The synthetic progestogens are more stable and are taken in far far lower doses but can be associated with their own side effects.

I do agree that a better system would benefit so many women who don't get on well with progestogens including progesterone. Surgery is far too drastic except in extreme cases.

Hurdity x

[Meeka]

Meeka and Sarai, I think it's dreadful that there are no real viable alternatives to progesterone other than a hysterectomy.  It seems that people who don't have severe problems with progesterone struggle to understand just how bad it is - it's not like you can just flick a switch and make yourself about to take it.  God knows what's in that stuff but I do wonder why it causes migraines in so many women and numerous other unpleasant side effects.  Utrogestan is supposedly like our own progesterone but the experience I have with it is absolutely nothing like the experience I had with my own progesterone.  It think it is very sad that so many women end up ditching HRT because they just can't tolerate the progesterone.

One thing I am looking into is having a uterine ablation.  That way, you can do a very long 3 month cycle which makes the progesterone much easier to bear.  It also means you don't have to put up with the ensuing bleed and you will not get any breakthrough bleeding.  It's not a perfect solution but it could be the difference between sticking with HRT or giving up on it completely.

I keep saying this but it really is time something better came along.

The ablation is interesting......I have heard of it for certain conditions but didn't know it could possibly be used for this reason.   

[Mary G]

Meeka, you are right, ablation is not normally used for progesterone intolerance in HRT but there's no reason why not.   It's not as good as a hysterectomy of course but it is a good compromise with virtually no recovery time.   I can't do a long cycle because I have to be on a high dose of oestrogen which means I get breakthrough bleeding after about 5-6 weeks so that's another reason for looking into it.   

Progesterone without ensuing bleed every 3 months sounds like bliss.  Now it's about plucking up the courage to do it! 

[Katia]

Meeka, I find too much estrogen makes me cold.  I have had facial flushing from the progestegen drosperinone in Yasmin and it was years before the menopause.  I switched to a pill with a different progestegen and had no problems.  Perhaps ask to try a different one and see if the problem persists with that or not, or maybe slightly increase your estrogen during your progesterone phase to see if it helps. 

Mary G, no matter how bio-identical something is to our own bodies, we don't know if our bodies reconise it the same as ours.  There are still subtle differences.  I am not too sure bio-identical is any better than synthetic and that our bodies process something that is almost the same any better that something that is obviously not the same,  but that is my own personal opinion. 

[Meeka]

Meeka, you are right, ablation is not normally used for progesterone intolerance in HRT but there's no reason why not.   It's not as good as a hysterectomy of course but it is a good compromise with virtually no recovery time.   I can't do a long cycle because I have to be on a high dose of oestrogen which means I get breakthrough bleeding after about 5-6 weeks so that's another reason for looking into it.   

Progesterone without ensuing bleed every 3 months sounds like bliss.  Now it's about plucking up the courage to do it!

Mary, may I ask what dose of oestrogen you are on?   I use 4/5 pumps of oestrogel but my oestrogen level in blood tests is only 138.   I have never experienced break through bleeding except when I was per-menopausal and I am now almost 55.

[Meeka]

Meeka, I find too much estrogen makes me cold.  I have had facial flushing from the progestegen drosperinone in Yasmin and it was years before the menopause.  I switched to a pill with a different progestegen and had no problems.  Perhaps ask to try a different one and see if the problem persists with that or not, or maybe slightly increase your estrogen during your progesterone phase to see if it helps. 

Mary G, no matter how bio-identical something is to our own bodies, we don't know if our bodies reconise it the same as ours.  There are still subtle differences.  I am not too sure bio-identical is any better than synthetic and that our bodies process something that is almost the same any better that something that is obviously not the same,  but that is my own personal opinion.

Katia, I think increasing oestrogen during progesterone phase could definitely help.   I also struggle to see how any progesterone replacement can actually be 'bio'identical ' to our own.

[Mary G]

Meeka, I use between 2 and 3 pumps of Oestrogel every day, I'm 56 and about 10 years post menopause.   That sounds like a low level of oestrogen, is that pg/ml or pmol?

Katia, agreed, the reality is very different from the theory.  It is evident that oestrogen replacement is far more successful than progesterone replacement.

[Meeka]

Meeka, I use between 2 and 3 pumps of Oestrogel every day, I'm 56 and about 10 years post menopause.   That sounds like a low level of oestrogen, is that pg/ml or pmol?

Katia, agreed, the reality is very different from the theory.  It is evident that oestrogen replacement is far more successful than progesterone replacement.

Mary, yes its 138 pmol/L   .  I use 4/5 pumps every evening after bathing  and rub in well on my inner thighs, always wait till it dries before wearing clothes.