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[bramblyhedge]

I would really appreciate hearing others advice and experiences on my HRT experience.

I was put on 3 pumps oestrogel plus 100mg Ultogestan (7 days) for six months and didn't have any bleeding.  Hence was changed to 4 pumps oestrogen plus Provera 2.5mg for (10 days)  I have been on this new regime for 3 months and have had ridiculously heavy bleeding and clots for 7 days each month since. 

I have spoken to gynae and been recommended Mirena coil or to try Provera 5mg for 14 days or hysterectomy!  I'm not feeling very reassured after this discussion and it all seems very vague and unscientific.  I don't understand why I would suddenly need a hysterectomy after being absolutely fine (bleeding wise) before starting HRT 9 months ago. 

The reason I decided to go for private HRT was because I thought it would be a more natural way to manage my menopause symptoms, but now I'm just wondering if I should have just seen GP for regular HRT.

I also take use testosterone gel and that and the oestrogen seem to have worked very well on my menopause symptoms. (although I am more anxious and don't know if they could cause this.

Sorry, lots of questions really, I would be so grateful for some experienced input.  Many thanks

[Dancinggirl]

Hi and welcome to MM - who are you seeing? Is it Studd?

Have you had a scan since starting HRT?  It sounds to me as though your womb lining has built up as Utrogestan for 7 days each month is not always enough to shed the womb lining properly - also increasing from 3-4 pumps of gel per day would also build the lining significantly and this may well have resulted in the heavy bleeds once you switched to the more effective progesterone?!

What menopause symptoms are you trying to control? How old are you?  Where are you in your menopause journey?
Has the anxiety started with HRT generally or more specifically with the Utrogestan or Provera? You could try stopping the testosterone to see if the anxiety lifts.

So many women believe that anxiety can be controlled with really high doses of oestrogen but, after a few years of reading posts on this forum, I personally do not believe this is always the best strategy.  I think it is a range of strategies that will control anxiety and low mood during and after menopause. HRT alone will not really tackle all the menopause issues - it can help but is simply one strategy. Have you had CBT and tried Mindfulness and other relaxation techniques?  Have you looked at your diet and exercise choices to see what you can improve?   

Why did this specialist advice you to increase the oestrogen? The average dose in 2 pumps per day and ideally one should be on the lowest dose that control your symptoms.
Having a hysterectomy is very extreme so I wouldn't go for that.  The Mirena would be a good option as this is likely to result in no bleeding at all after the first few weeks, which you may like. The Mirena is very popular as it often solve many problems and allows you to use as little or as much oestrogen as you need.
Why not drop your Oestrogel dose to see if your bleeds reduce? You may feel better on less oestrogen??!!
DG x

[Lanzalover]

Hi bramblyhedge


 
I use Oestrogel (2/3 pumps)and 10 mcg of Provera for ten days on along cycle usually six weeks unless I am going away or have an event.The withdrawal bleed is quite manageable,
Are you progesterone intolerant ? As the 2.5 mcg is supposed to taken every day.
A dose of 2.5 for ten days seems very low and could be why you are having such a heavy bleed.
Hopefully the 5mcg dose will help as a hysterectomy seems a bit extreme


Love Lanzalover x

[Mary G]

bramblyhedge, I am a patient of Professor Studd (I don't know if you are) and I have always had a good bleed on that regime.  Sometimes it is good to change your progesterone because people vary as to how well they tolerate the different varieties.

Are you progesterone intolerant?  I am severely progesterone intolerant and don't get on with any form of progesterone used in HRT preparations and Professor Studd recommended that I have a hysterectomy.  I am currently struggling on with a very low dose of progesterone with regular uterine scans but it is not sustainable long term, I will have to make a decision at some point and when it is possible for me to have the downtime needed to recover.  It is a major operation and not one that should be entered into lightly but sometimes there is no alternative but obviously that depends on how progesterone intolerant you are and how long you intend to use HRT. 

I find that I suffer with the ill-effects of progesterone a long time after it has left my system and it takes me a long time to readjust after I take the last Utrogestan capsule.  How do you feel on the progesterone phase?

If you like Provera, why not stick with it for a while?

[bramblyhedge]

Thank you for your replies Dancing Girl, Mary G and Lanzalover.  I am a patient of Prof Studd and I am 3 years post menopausal.

The symptoms I needed help with were hot flushes, joint pain and excessive tiredness/weakness.  I am pleased to say that these are now alleviated.  I was increased from 3 to 4 pumps as oestrogen levels had not increased enough and symptoms were improved but not fully controlled.

I seemed to be getting on fine with the Ultogestan 100 (x 7 days) with no significant side effects but no bleeds.  I did have a scan at one of my appointments and was told the lining was fine.  I was changed to Provera 2.5mg (x 10 days)as I was not having bleeds.  I have been having a few side effects with this, mainly headache for a couple of days and some PMS type grumpy moments.

I'm wondering if it would have been an option to take a higher/longer dose of Ultrogestan, as I have seen some ladies take 200.

I'm feeling pretty overwhelmed and just not sure which way to turn.  I am wondering if it worth calling back and discussing more options with one the Professor's colleagues, as I didn't find the discussion very helpful today.

Do you think that reducing Testogel could lessen my anxiety?

[racjen]

Testosterone shouldn't cause anxiety, if anything the opposite - low testosterone is a common cause of anxiety at menopause. Having said that it makes me very depressed which it shouldn't do either so who knows? Utrogestan switched on anxiety for me and the anxiety has remained despite my not taking it for months. So it's very very hard to predict how an individual will react to any of these things - in the end trial and error is the only foolproof method.

[Dancinggirl]

brambly - I have heard from others on this forum that Studd himself can be quite inconsistent with his advice, so I would contact one of his colleagues for further advice.  You most certainly should have been able to simply use Utrogestan for more days and possibly at a higher dose.  I would try dropping to 2 pumps per day in the mean time.  I personally felt awful on high doses of oestrogen. DG x

[bramblyhedge]

Thank you for your replies Dancinggirl and racjen.  It really helps to know what others have experienced.  I think it will have to be trial and error.  I have reduced today from 4 pumps to 3 pumps of oestrogel and will see how I go with that for a while.  It also seems to make sense to try Ultrogestan at a higher dose/more days before resorting to Mirena (which I'm not too keen on).  At least with the tablets I can take them for a few cycles and see how I feel and then stop them if necessary.  I would prefer to do this first and then try the Mirena afterwards, I think.  I will seek advice from one of Prof Studd's colleagues about the Ultrogestan dose.  Do you know what is the most common Ultrogestan/Oestrogel regime?