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[Misstowers]

Hello, I'm looking for some advice/experiences please, this website has been so helpful to me..

I'm perimenopausal at 42, have been for a few years now, I thought I was getting dementia before realising it was perimenopause, so in some ways a big relief to know the problems I was having were hormonal. GPs were useless but I managed to get referred to a menopause clinic at my local hospital which was great (sadly due to lack of funding it has now closed so I'm back to GP). The consultant put me on the contraceptive pill to start with but that didn't work so moved to Sandrena gel sachets (2 x 50m) and 12 days of utrogestan 100mg.

On the whole I feel better and like my old self, but there are times in the month that I seem to slip back to being very depressed, forgetful, tired, angry and lose my sex drive. I feel like a gloomy shadow of my 'normal' self, and that I'm on the brink of losing it. I just read a post on a website called writehealth (which is about menopause health) about progesterone intolerance and it makes a lot of sense to me, as I think my low mood coincides with the days I take utrogestan. (I will start to keep a diary I think...) In the post I mention above, she talks about progestrone suppositories and says that the Utrogestan capsule can be used as a suppository in the vagina,  and that this avoids it going into your system so much, as it goes directly to the uterus...

So, I'm wondering if anyone has experience of progesterone intolerance, what they did about it, and if anyone has used Utrogestan vaginally or has been prescribed a progestrone gel or suppository instead of pill form... has anyone taken Utrogeston that way? I wonder if it would be as effective in terms of the lining of the womb etc, and if there are side effects 'down there' of suppositories...

Thanks!

[Dancinggirl]

Hi and welcome to MM Misstowers

If you were truly intolerant of progesterone you would get far more sever PMT and other symptoms - most of us find progesterone challenging one way or another. 

Though Utrogestan isn't licensed to be use vaginally here in the UK, for some strange reason, nearly everywhere else it is, so I would suggest you try it vaginally to see if it makes a difference. I believe using Utrogestan vaginally is actually more effective at protecting the womb lining and many women find they get fewer problems with erratic bleeding when they use it vaginally. Some women actually like how they feel on progesterone as it can have a sedative and calming effect!!!
I have to say that some PMT is quite normal on the progesterone phase of any HRT and in fact PMT is common for many women during their reproductive years - I think it is unrealistic to expect to feel good every day of the month.
In your case I wouldn't be tempted to move to a continuous HRT regime to avoid having monthly bleeds - it is fine to keep using a sequential HRT regime well into post menopause - it's just a nuisance to have the bleed every month.  Once you are well into post menopause you could possibly extend your cycle (under professional supervision) so you have a bleed every 5-6 weeks to give you longer on oestrogen only.  I had an early menopause and I did a slightly extended cycle from my mid 40s(once I was truly post meno) - so I did 24 -26 days of oestrogen with 10 days of progesterone BUT don't do this unless you get advice from a meno clinic or gynaecologist.

There will be some ladies on this forum who will tell you it's fine to use Utrogestan for just 7 days each month(they are probably seeing a specialist gynaecologist privately) but this MUST ONLY BE TRIED WITH MEDICAL SUPERVISION as there is a good chance the lining will build up and this can result in erratic bleeding requiring investigation.     

Do try using Utrogestan vaginally - it can cause a bit of irritation around your vaginal area but if you use some intimate moisturiser ( SYLK or the YES products are the best and you can get these online ) this may help.  I suspect trying Utrogestan vaginally might well help you generally.   Good luck and keep us posted.  DG x

[SueLW]

Hello

I use Utrogestan vaginally.  I'm post menopause so I use 1 x 100mg capsule every night continuously and it's fine.  It's the same small round capsules that you would swallow.  Just be sure to get into bed and then push it up as far as you possibly can.  if you pull on your vaginal muscles when you run out of finger length it will go right up out of reach. 

I've never had any irritation from it.  I see a private specialist and she is more than happy for me to use it this way.  She says it's more effective for protection of the womb than swallowing it.  When you pass something like this through the liver a lot is lost.  Her view is 100mg vaginally is equivalent to 200mg orally.

Give it a try.  I keep a pack of wet-wipes on the bedside table to just wipe my hands on after I've inserted it.

[Hurdity]

Hi Misstowers

  from me too.

What the others have said!

It is not usually used as a suppository, but as a pessary - ie vaginally. Yes research shows its more effective at endometrial protection (stopping womb lining growing too thick or thinning it when used as part of HRT).

There can be more adverse side effects from oral use of progesterone because there are many more metabolic by-products as it has to be digested and metabolised through the liver. In fact also the licensed dose for cyclical use of utrogestan is 200 mg - but as SueLW says on average you can use half the amount of progesterone vaginally then orally to have the same effect. This has a scientific basis - I have posted abstracts from scientific papers on here several times which summarises this research.

Depending on how regular your periods wer ebefore starting HRT you might be able to get away with less than the licensed dose ( if you are still ovulating reguarly and therefore producing progesterone every month from the ovaries). As ovulation becomes less frequent it is more important to get closer to the licensed dose and as Dancinggirl says - only under medical supervision deviate from this to ensure your womb is protected.

Hurdity x

[Ladybt28]

Hi Misstowers - I have taken my progesterone orally and vaginally and vaginally is way better for me!  I am post meno and take it 12 days during the month with a bleed - I tried continuous and couldn't cope.  I really don't like the progesterone part but I have to have it I have a womb. I am trying to balance what I do but it is trial and error - I think it is like that for many women here which is why they are posting.

Reference what Hurdity just put in her post here (sorry dont know how to copy the sentance out of the post?) I take 200mg for the 12 days vaginally  - she said "200mg is the licencensed dose orally... but as SueLW says you can use half the amount vaginally rather than orally for the same effect"

So can I cut my 200mg vaginally to 100mg vaginally for 12 days?

[Misstowers]

Hi everyone, thanks for replying, I only just logged back in as, I don't know why, I was expecting an email to say I had replies, so I thought none had replied.  So thank you for taking the time to write, some really helpful advice and experiences.

I've had a really crap week, very depressed, tearful and lethargic, thus throwing the theory of progesterone intolerance out the window, as not had it since 12 nov. Have now been reading about Estrogen dominance and low testosterone and hence I now am so confused!

I went to my GP last Tuesday to ask about pessaries and she has prescribed me cyclogest but she had to look it all up and said she wasn't an expert. My husband wants me to see a private gyno, but it's a lot of cash and no guarantee it will help?? What do you think?

I feel like I'm still on an emotional rollercoaster, and whilst I don't expect to be happy and energetic all the time, it would be nice if it were a ‘bad week' or the odd bad day. Instead it feels like it's one day to the next, only had a handfull of good days this month, and this recent spell is going on and on. I couldn't face  work today which is really unlike me, I'm scared tbh that it will continue or get worse.

Any advice? On the private clinician, low testosterone, Estrogen dominance or depression?? (Sorry if this is the wrong thread....)

 

[l1zzi313]

Hi I am Progesterone intolerant. I have to take natural remedies. I get severe abdominal pains, I have tried patches.
I still ,not sure I am taking all the right  things to help.

[Ladybt28]

Cheers StellaJane - I really want my progesterone to be a low as possible but as you have probably read in other posts I am convinced I need testosterone and that is the missing piece of the puzzle (fingers crossed).

Hi Misstowers - you don't necessarily need specific pessaries for the progesterone element - its just here in the UK Utrogesten is prescribed to be taken orally when in fact in practice they can be used vaginally as a pessary and lots of UK consultants say to use it that way and loads of women on here use it that way.

I too am struggling with depression, lethargy and lack of motivation despite being on 4 pumps of gel which is considered a high dose, hence my comment above but I am just coming to end of my first 3 months on the gel/12 days utrogestan regime so I still might need some more time before I can try testosterone if I can get anyone here to prescribe it.  The thing is you are quite young at 42? and still peri which means you are still getting your own homones "chiming in" and providing surges on top of what you are taking which adds to the rollercoaster effect.

[Misstowers]

Ladybt28, thanks for your comments and sorry to hear you are suffering too,  it's crap isn't it. yes you're right, I'm on the young side and peri meno so my own hormones are up and down, so there are times when I have surges and dips, with hrt on top of that, I don't know if I'm coming or going.

I've done a lot of research on the biology of all this yesterday plus reflected back on my own symptom diary and I've come to the conclusion that I personally possibly need a little less Estrogen and slightly more progesterone than the oral 100mg was giving me.

I think what I'm going through right now is really severe pmt (caused by my own rampant fluctuations and the HRT Estrogen on top with not enough Progesterone) and that I will have a natural (not utrogetson-withdrawal) period at the start of December... we will see...

I'm thinking if I reduce HRT to 1 sachet of 0.5 sandrena gel per day, and use the utrogeston as a pessary (effectively doubling the efficacy) I might even things out a bit, giving me enough of both not to send me too far either way... I've made an appointment with a gyno in any case and will float this idea to them, see what they say.

The other interesting thing that I read about yesterday was supporting your body to get rid of any excess Estrogen (if it needs to), as much of it it stored in fat and reabsorbed in the bowel, so it ends up building up. I didn't realise this until yesterday but too much Estrogen can wreak havoc and cause the similar symptoms as not enough.

So I'm getting some milk thistle, magnesium and flax seed to support my liver and bowels. I already take B vitamins everyday, and sea kelp to support my thyroid. Whilst I'm no doctor and don't claim to understand what's going on inside my body, especially at the minute, I want to help myself as much as poss.

There are supplements etc that you can take to help you to produce testosterone -  Vitamin D is a major one, I take it as an oral spray, tastes minty... you may be deficient especially at this time of year most people are due to a lack of sunlight...just a thought.

Good luck

[xjb]

Misstowers i must agree about the high level of oestrogen having a detrimental effect.  I started using oestrogel at the beginning of August after taking tablet sequi hrt for 6 months. 

I was given only vague instructions by the meno specialist i saw and started with 1 pump.  Increased to two cos i thought that was equivalent to the tablets and then got carried away and started 3 doses.  When i took the utrogesten i started to feel really dizzy.  Absolutely terrible and blamed that.  Stopped it after 2/3 days and thought i felt better but didn't really.

Ultimately i reduced the gel right down to only half a pump over about six weeks and then after another 2 stopped altogether.

I feel much less anxious,  bad tempered but am sleeping badly and having lots of hot flushes during the night.

My conclusion is it takes a long time for your body to get used to levels.  Don't rush it.  Be patient.

I felt the benefits physically for at least 3 weeks after i stopped the gel and then noticed more vaginal driness and hit flushes etc. more severely  than before.
 I'm going to see a specialist this afternoon.  My main concern is loss of libido and sensation and i find it totally depressing but I'm in such a quandary whether I'm actually better off without meds and less sex.

[Ladybt28]

Hi Misstowers - yes my body loves sunlight and hates the winter but I have been on very high strength vitamin D 5,000iu which a doctor recommended when he told me I had fibromyalgia (which I am pretty sure I don't just I had very lax muscles due to lack of oestrogen causing the aches and pains) but to be honest it doesn't really seem to make any noticeable difference.  I wonder if the oral spray absorbs better though instead of going through the stomach?

I think your own balance will be a little harder to achieve because of your own hormones and unlike us post meno people maybe you need to vary your does of oestrogen through the month - I'm sure a pattern will emerge - like when you are jittery or when you have PMT or when you think the progesterone is causing problems.  I think I read in post a while back - sorry cant remember where or when but she upped her oestrogen to counter progesterone problems for a few days a month and then dropped it again when she wasn't on the oestrogen - she said it provided better balance and she just added what she thought her body was asking for rather than stick to a strict regime of same oestrogen dose etc every single day.  She said it helped to deal with her own fluctuating hormones - bit of a faff I know but it may be the answer to the roller coaster?

[Misstowers]

Xjb it's so hard isn't it, the original gyno consultant I saw told me it is a hard balance to achieve, but I guess you need to have the progesterone in order to have a period so you don't build up the lining in the womb...

I have also considered completely coming off hrt and seeing what happens but I'm worried about returning to night sweats, brain fog, low mood and complete loss of libido which is where I was at before I started HRT!!! It's such a difficult one, damned if you do, damned if you don't... this is why I'm considering moderate amounts of both, rather than overloading my system.
Good luck with the specialist this afternoon, let us know what they say.

Ladybt28, I think the spray is better, and more goes into your system, but ultimately it may not be the cause of your muscle pain as you say and you are on a high dose anyways... If you go privately I think they can test your testosterone levels and will prescribe gel if you need it. Thanks for the reco on the other post, I'll look for it, but I think the Estrogen gel doesn't have immediate effects, it takes a while to build up in your system, so I won't feel the effect of having less on bad days until some weeks later...? Right now I'm ready to try anything!

I have to say that I've never been on a forum before, even with my babies, but just writing her has been really helpful, so thanks!

[Ladybt28]

Yes Misstowers - the oestrogen does take a while to build up unless you are very very sensitive which some women report - a minimum of 3 months is always required for everything to settle into some sort of pattern - even if it isn't a beneficial pattern if you see what I mean.  What I meant was that once you actually have a clear idea of what is happening which will take a good 3 months maybe 4 - then you could start playing around a little with the doses to even out the peaks and troughs.  I know it sounds a long time but I have read that sometimes it is 6 months for women in peri before they can get some sort of levelling out.

[Hurdity]

Hi there Misstowers - just to say I am VERY  sceptical of all of this stuff on the web about "supporting" various organs etc, and sites persuading you that you need all of these supplements etc to counteract all the negative stuff. I mean I've never heard that about oestrogen - except that yes estrone is stored in fat so the fatter women are the more oestrogen they will have and this provides a reservoir for estradiol in the body. NOT a reason not to lose weight as the health benefits of lower fat are immeasurable! Personally I wouldn't get any of those things - flax magnesium and milk thistle but concentrate on getting a really good diet full of natural ingredients, cook from scratch, get outside, take exercise, reduce alcohol etc  lose weight if necessary - and you should really notice the benefits and will help your health longer term.

Inceindentally if you want to even out the fluctuations between oestrogen and progesterone, as you are still young there are combined cotraceptive pills that are like HRT but only have a few tablet free days - they give you oestrogen but supporess your cycle. These tablets are called QLAIRA  and ZOELY. Just a thought - and then you could transfer to regular HRT when you get older. Obviously these are tablets not transdermal but maybe worth thinking about if it's the hormonal fluctuations that are causing you the most symptoms as it can be very difficult to dampen down thse with regular HRT if your cycle is still strong?

Hurdity x

[Misstowers]

Hi Hurdity,
Thanks for the suggestion I will speak to the consultant about them. They did try me on the contraceptive pill first but after 5 months , I came off as it wasn't working. Then I went onto HRT. But I haven't come accross the ones you mention so I'll ask about them. It makes sense that it would better to switch my cycle off completely and replace with the pill, but in practice it didn't help my symptoms of night sweats etc and my libido disappeared! I think I was on Lucida or something like that.

Re vitamins etc I'm an active person and run, I eat really well as me or my husband cook most nights from scratch, BMI is well within the proper range and I drink within recommended levels (mostly!),  I do think that vitamins and supplements help me with certain things, certainly lots of Vitamin B and high doses of vit C have helped my immunity to viruses etc so I'm going to give the milk thistle etc a shot, can't hurt I suppose - it's all from a high street pharmacy and I'm not paying for expert advice etc, I too am wary of that! It's not for everyone though I understand.

Just really want to give my body what it needs, hormonally as well as nutritionally, and to get to the bottom of what needs adjusting so I can feel normal again.

Ladybt28 I see what you mean and will ask about that too when I return to the clinic.

Thanks for all your help ladies!