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[Rosti]

Good Morning.... well okay, morning at least....

So here I am again wondering what happened...  There I was on Estradot 50mcg and Testogel with the dreaded Progesterone still causing problems but hey, then I started to get night sweats and flushes again .. I had visited the Gynae who said that they would like to increase the dose of Estradot and so I duly moved to 75mcg.  Well that's when it all went wonky!  I started with a sore throat and then a nasty cough but only at night time and allergy symptoms with lots of goo (I assume that this is a histamine reaction) really sore nipples swollen boobs and bloating.  Gynae said its only a 25mcg change and shouldn't cause any issues.

Then the Progesterone time came.  My plan, 200mg for 12 days which is always the plan but it doesn't succeed and I have posted elsewhere on the joys of either being wired or zonked depending on whether its 100mg or 200mg.

So I had to give up after 8 days (although I must confess I was fairly chuffed at having managed 200mg for that long) using the last Utrogestan on 27th March.  I guessed that as the progesterone was dropping I would bleed within two or three days but didn't.  Indeed it wasn't until a week later on 2nd April that I had a light bleed (ongoing).  So I don't quite understand what is going on.  The previous month I had finished the Utrogestan on 2nd of the month and bled on the 5th... why the long wait this month?

Could it be that my own cycle is still in evidence and enough to influence the situation both in oestrogen and progesterone (I have been Peri for at least 3+ years now) ...  In that case, if I am still producing my own progesterone could that be what is tipping the balance during the latter half of the month (I have the symptoms which so many describe including the total "flat" can't work the enthusiasm for anything at all and its a push to get out of bed)...

My thinking was then that perhaps I should be overriding or suppressing my cycle and I wondered if anyone is doing this with patches because me and Oestrogel have an on/off relationship...

Currently:
Estradot 75mcg
Testogel pea sized blob daily
Utrogestan vaginally optimistically for 12 days realistically around 7


Sorry I may have waffled a bit...but its all too much again !

Any and all advice as always is very welcome and thanks

xxx

[Hurdity]

As far as I understand it, high dose oestrogens are usually only used to suppress the cycle when periods are regular and in early peri-menopause when extreme mood swings caused by the fluctuating hormones are so severe that a woman becomes alternately depressed and elated. If your cycle is sporadic and you are fairly near menopause then you just need to take the dose of oestrogen that eliminates the negative symptoms and makes you feel well most of the time, accepting that there will be some negatives eg if your cycle kicks in occasionally. Do you have any idea where you are in menopause - ie how long have you been taking HRT and what was your cycle doing before you started in terms of periods and how often?

Hurdity x

[Rosti]

HI Hurdity, I gather you  have been on holiday, I hope you had a wonderful and very relaxing time.

Thanks so much for your response, I have been trying to piece together this whole sorry tale for a few years now.

I started having problems with my muscles in 2014 but no one realised that it was hormonal and so I spent the best part of 3 years playing that well known game "meet the specialist" and was sent to allsorts including Rheumatologists, Neurologists, Pain clinics, physiotherapists pretty much any "ist" you can think of.  Everything came back normal on all fronts.

In the meantime, my periods were normal, the odd one a little heavier but nothing unusual, sometimes a little lighter, then in Dec 2016 they stopped, returning in May 2016 as though they had never been away.

By now I was having hideous issues but no one thought it could be hormonal until one "likely lad" young GP suggested off the cuff a blood test to include FSH and LH.  These showed I was in perimenopause.  I started HRT in July 2017 and it has been a horribly rocky road.  I have a pre-existing genetic condition which means the collagen I produce is extra stretchy and this causes allsorts of entertainment so the hormonal fluctuations were impacting this as well as everything else.

At first I was given Evorel Sequi 50mcg but my body threw a huge wobbly at those and I was told to cut them in half but then the flushes and the sweats weren't good and the muscle pain especially was intolerable.  Next they tried Oestrogel beginning with one pump upping to two pumps daily, spread on the upper outer arms and shoulders.  This was okay except that the dose didn't seem stable enough and there were fluctuations, then I began having terrible muscle problems as though I had dislocated my left shoulder.  I was told that the gel might be having an impact on me and so I stopped that and had several injections to the shoulder.... now all seems fine....  Swapping from Oestrogel I started Estradot and after a little to ing and fro ing settled at 50mcg.  Although the sweats were mostly under control the total lethargy and inability to be positive about anything remained.  Then I had Testosterone added in Feb of this year which made a big difference but the cyclic "nothingness" around my period time stubbornly remained... then the sweats returned and I was told to increase the estradot dose to 75mcg.  I haven't really settled at all and every month something goes completely wrong to the point where we dare not plan anything in case I am in bed... 

For the first time I managed the 200mg utrogestan this month whilst on the 75mcg and I wondered whether the increase in oestrogen was making the progesterone more tolerable in which case if I upped the oestrogen dose it would kill off my own cycle which seems to be throwing a spanner in the works.

Just to add insult to injury I went to the Nick Panay clinic in Feb and despite chasing them, I am still waiting for them to come back to me with a strategy and way forward... The person I saw said they had to escalate it to Mr Panay himself.

Sorry, I think I have waffled again... and again....

Thanks

xxx

[Hurdity]

Hi there Rosti - not been on hols yet but thanks - going during next week for 10 days or so!

Sounds like you've had a difficult time trying to sort out the right dose - however if you are with Nick Panay's clinic then he's your man and you're in good hands. Hopefully you will get the right advice in order for you to feel better most of the time. Why not suggest the increased dose (to suppress your cycle) to the clinic and see what they say? Peri-menopause can be tricky as you say when your own hormones come into play and play havoc with the HRT and hormonal stability you are trying to achieve.  You will most certainly be ironing out the worst of the fluctuations but the main thing is as I said before that you feel better for most of the time - there are bound to be blips and days in the month when you still feel rough, like most of us felt during our regular menstruating years.

I hope you get an answer soon

Hurdity x

[Mary G]

Rosti, I would increase the oestrogen dose and decrease the progesterone dose and take 100mg vaginally instead of 200mg.  Nick Panay specialises in progesterone intolerance and should agree to let you reduce the dose and offer you regular scans - this is what I do but not via the Panay Clinic. 

Take a look at racjen's progesterone withdrawal thread in this section. 

When you do finally manage to communicate with Dr Panay, you might want to ask him about a new(ish) type of oestrogen spray called Lenzetto (Evamist in the US) which is brilliant for women who have problems absorbing transdermal oestrogen and/or need a constant steady/high  dose.  I don't think it's available in the UK yet but he might be able to give some indication as to when it will be.   I'm currently trialling it myself (thanks to paisley on here) and so far, I think it is an excellent, user friendly product and from what you have said, I think you could benefit from it.

[Rosti]

HI Ladies,

Thanks for your responses and the advice.  Of course, nothing is ever simple with this game !