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[Kirstie B]

Hello all!

I've been in surgical menopause for 2 1/2 years now. HRT has helped me with all physical aspects of the menopause, thank God, but my anxiety levels are through the roof. I was on Evorol patches 75 plus Uterogestan 100 mg orally, but my anxiety was still terrible so I was upped to Evorol 100 and Uterogestan 200 taken vaginally about 2 months ago.

Since then my anxiety has gotten worse and I've been experiencing a constant tension headache. There is no pain just feeling of intense pressure in around my head.

My question is, do you think this is related to them increasing my dose of progesterone?

If so, I would like to go back to 100mg Uterogestan, but a) is this enough progesterone to go with 100 mg of oestrogen  and b) can I take the 100 mg of Uterogestan vaginally even though it's meant to be taken orally? Thank you!

[SueLW]

You say you are in surgical menopause, but I assume you still have a womb if you are using progesterone?

Are you using that progesterone every day?  Or are you cycling it?

200 every day is a lot!

Yes you can use it vaginally.  That's what I am doing, although I only use it every other night.  If your anxiety is that bad, you are probably overdosed on one or the other hormones.  The trouble is, which one?

I would switch to vaginal dosing and if you use it every night, just use 100 and see how that makes you feel.  You get more progesterone directly to the womb when you use it vaginally so you don't need so much of it.  You also loose some in the digestive process when swallowed.  I'd be tempted to drop back to the 75 patch as well, whilst you try the vaginal method.  Too much oestrogen will make me very angsty.

[Hurdity]

Hi Kirstie B

I see from your other posts that you are in surgical menopause due to removal of ovaries and still have your womb?

Could you let us know what your bleeds have been like recently? Also is there any need to take prog all the time ( eg due to endometriosis)? If not I would firstly see how you felt when taking it cyclically - and having a withdrawal bleed. This would enable you to know whether what you feel is caused by the oestrogen or the prog.

Re taking it vaginally - as SueLW says, this is fine - and limited research shows that on average approx half the oral dose can be used if taken this way for the same amount of protection - individual women will vary though.

The only way to know if the progesterone is sufficient is to ask to be scanned - if you are going to vary the licensed dose of utrogestan - which seems to be based on a medium dose of oestrogen but of course, it cannot be one dose fits all because the more oestorgen you take on average the higher progesterone dose you will need to protect the womb.

So - that would be my suggestion - go for a cycle but use 200 mg vaginally for 12 days in the first instance. I use this amount (of prog) for a long cycle (6-8 weeks) - but I am on a lower dose of oestrogen. Then see how you feel, what your bleeds are like before making any other adjustments ie changing oestrogen as well.

Personally I would only change one thing at a time re dosage - ie not the oestrogen and the prog together.

Hope this helps.

Are you having any testosterone too or maybe you don't need it at this point?

Hurdity x

[Kirstie B]

Morning!

Yes sorry I should've been clearer, I do still have my womb. In fact, I had my ovaries removed 2.5 years ago (due to BRCA1) but had to have another surgery 3 weeks ago as on my last ultrasound they discovered they had left a part of one ovary behind! 

I am taking testosterone also, I use a pea sized amount daily rubbed into my inside upper arm.

For the last 2 days I stopped using the 200mg Uterogestan vaginally and changed to 100mg orally and now have come on my period and had no change to my mental well-being.

When I had my hormones increased, as I said it was due to anxiety but also because I'd been bleeding heavily and regularly. So they thought higher mg of Uterogestan would stop that, which it did.
Hope all this makes sense.
I think I'm sensitive to progesterone so will reduce to 100mg vaginally and see how that goes. I'll just have to live with the heavy bleeding I suppose 
I didn't realise eostrogen can also make you anxious? I thought that was the happy one ha!

[Dancinggirl]

I found Utrogestan more problematic than any other progesterone. The best hrt regime i ever had was the Mirena with Oestrogel. If you want to stick with Utrogestan I would definitely change to a sequential regime and put up with a monthly bleed. I also got more headaches on high doses of oestrogen. We are all different and whilst many find Utrugestan great, I certainly didn't.
Some women seem to need an AD or SSRI alongside hrt to really get the anxiety under control but I'm wondering if you might do better on a lower dose- perhaps try 50 mcg patch for 3-4 weeks to see how you feel ? DG x

[Kirstie B]

Thank for the replies everyone. I've been avoiding AD's or SSRI's but I'm not sure why. I'm thinking of trying it now as I'm desperate!
I'm going to reduce the Evorol and the Uterogestan then too I think, get back to a base low then try and increase one a time and see which causes the side effects. 😀

[paisley]

Hi Kirstie
I had a total hysterectomy in 2011. Before hysterectomy I was in Perimenopause & could not tolerate progesterone of any kind at all. I have been trying to find balance all these years & have just started the Evorel .5 patch 2 days ago. I found that when my oestrogen was too high or too low I had much worse anxiety & weepiness. So this time I have gone for .5 patch. I feel for you because I thought when my ovaries were removed it would be a doddle to balance my oestrogen. I think what I am trying to say is yes oestrogen can cause anxiety if it is too high or low for you. Xx

[Kirstie B]

I think I had been putting all my blame on the progesterone, fingers crossed reducing both will help 😀

[Rhiner]

Hi Kirsty, I am in a similar situation to you, ovaries removed. Ive found that high or low oestrogen can cause anxiety type symptoms. I have stuck with a 75ug patch and after a few weeks everything settled, I had increased from 50ug which I was still feeling very faint on (low oestrogen). Try to stick with 75 for a good while if you can and should hopefully settle. I didn't introduce the prog part until 8 weeks later to make sure the dose of E was good.  I am on continuous 100mg Utro but take 2 days on and one day off orally at the moment.
Good Luck,
R

[Kirstie B]

Thanks R. Such a minefield isn't it?! 💣