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[TNM45689]

Hi I am 46 and one year without periods and have been on Estradot 50mg and 100mg Utrogestan orally every day now for 4 weeks.

Since starting (virtually overnight) I have ridiculous bloating - looking 5 months pregnant and actually it is actually becoming quite uncomfortable and I was unable to fit in my clothes within a week of starting.

I know it is early days but I am not sure what to do - will this subside, am I am the wrong meds, or the wrong dosage - I am not quite sure what to do - my symptons really related to lack of sleep and I only started down the HRT route due to my age - I feel like I just want to quit as nothing else has changed apart from my stomach expanding!!

Does anyone have any advice? It would be much appreciated.
Tx

[TNM45689]

Can anyone advise on this....

[Robin]

I'm sorry I don't have enough experience to advise you but I'm sure somebody will be along at some point soon who can help. It sounds very uncomfortable. Hope you feel better soon

Robin
X

[Hurdity]

I am pretty much on the same combo but I have never taken utrogestan either orally or continuously. From the start with HRT I adopted a nil-by-mouth approach so utrogestan I use vaginally ( off licence). Also there are more side effects from oral Utrogestan due to the many more metabolic byproducts from digestion and going through the liver. Some women don't get on with taking progesterone all the time also because of these and other side effects.

My suggestion would be to go back to a cycle - and take utrogestan vaginally. Start off with the licensed dose of 200 mg vaginally for 11-12 days per month and see what sort of bleed you get and how you feel. You may get some progesterone withdrawal symptoms for a few days when you stop. If it turns out after a few cycles that your bleed is very light you could lengthen the cycle and/or reduce the dosage a little with the supervision of your doctor. Let your body and bleed be a guide - and ideally have a scan at some point if you vary from the licensed dosage.

Hopefully changing back to a cycle will lessen the side effects and hopefully also you will feel good and sleep better more days than not. If after a few months it's not working for you then I would suggest Femoston tablet HRT (unless you have been advised not to take oral HRT?) 1/10 (gives withdrawal bleed) increasing to 2/10 if you need to - as you are still very young.

Hope this helps

Hurdity x

[TNM45689]

Thank you for your advice - I am still so confused, stressed and feeling anxious about it all. I still do not quite understand why I would have a bleed when my periods have stopped.....it is all so confusing.

xx

[Hurdity]

I suggest you read this article abpout thre peri-menopause which explains about the menstrual cycle: https://www.menopausematters.co.uk/magazine/pdf/Article%20-%20Perils%20of%20the%20Perimenopause.pdf

and also read this section about HRT ( scroll down to progestogens):
https://www.menopausematters.co.uk/perimeno.php.

In a nutshell - oestrogen stimulates the womb lining to thicken ready for pregnancy. Progesterone changes it structurally ready for the fertilised egg. If no pregnancy the lining is shed. If you don't have progesterone of some kind when you take oestrogen the lining will continue to thicken and this can sometimes lead to womb cancer.

Continuous combined HRTs  are for post-menopausal women where you take the progesterone and oestrogen all the time usually (in most women) are a "no-bleed" HRT type although there is often bleeding or spotting for the first 6 months.  So the answer is you don't have to have a bleed - but as I mentioned in my previous posts if you are sensitive to progesterone then going back to a cycle is the other option. I still have a cycle and withdrawal bleed (approx every 6-8 weeks) in my mid 60's because I don't want to take progesterone all the time!

All this information is on the menus above so do have a read when you have time!

Try not to worry and concentrate on the benefits of HRT and working out the best regime that makes you feel better most of the time.

Hurdity x

[TNM45689]

Thank you - I had read alot about it all but it is all still confusing - but thank you for taking to make it clearer.

I spoke to the Menopause Clinic about my excessive bloating and they suggested switching from Utrogestan to norethisterone. Has anyone experience of doing this and how did you feel?

Thanks
Tx

[hereandthere]

Hi
How did you get on?
I am also having terrible bloating on utrogestan. I was fine on norethisterone in Evorel Sequi but it made my hair fall in bucketloads. 

[hereandthere]

Yes agree with the others the cyclical was very good for me except solely the hair thing. Not everyone is so sensitive to the synthetic androgens hair wise so a good system to try. I also found the patch system was very stable for me while others disagree, so you have to try different prescriptions. Good luck!