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[SueLW]

Hello, it's me again!

I'm on Oestrogel and Utrogestan vaginally.  I've been using 3.5 to 4 pumps of gel a day but still getting horrible mood swings and with them comes physical exhaustion and loads of fluid retention.  I feel pumped up with water.

I don't know now to tell which hormone might be the culprit.

Dr Newson suggested I might need to go up to 6 pumps of gel a day because she thinks I'm not absorbing it well.  We are waiting on the return of blood test results taken at my review last week. 

Today I tried adding an extra pump of gel this morning, so 3 in total with the aim of using 2 more tonight.  I was OK for several hours, then suddenly, after eating, wham!  Horrible palpitations. They have calmed a bit, but are still there, heart is still too fast and beat is wobbly. 

Is this telling me that 3 pumps of gel in one go is too much?  Or is it just coincidence?  I'm not feeling good at all this week anyway.

I am going to change from Utrogestan.  I have developed a kind of dermatitis on my arms that is not pleasant and she thinks it might be the Utrogestan that's causing it.  I'm considering a Mirena coil in January.  Could the Utro be the cause of the fluid retention?

Does anyone have a view on the fluid retention and the palpitations.  They cause me great anxiety because I get atrial fibrillation from time to time and I always think that it's that nightmare that's starting. 

I'm 55, post meno and my HRT is continuous.

[Ladybt28]

SueLW - I have been on oestrogel and utrogestan for 4 months now but I cannot take continuous progesterone in any form.  I am 56 and post meno.  My GP put my dose up to 4 pumps from the 2/3 I was using because my symptoms were not under control continuously.  All my anxiety, panic attacks, nausea, feelings of doom, palpitations, headaches are gone.
From what I have heard about her I would trust Louise Newsom to be on the right track but obviously the bloods will tell if you are not absorbing the gell properly.

I have to say I didnt/dont have any fluid retention but we have heart problems in our family some atrial fibrilation, cardiomyopathy and 3 of my husbands sisters have pace makers and internal defibs.  One of the things I know is that there can be a build up of fluid due to the heart doing strange things. Things can get out of wack quite quickly if there is an underlying condition and there are lots of colds and bugs around at the moment.  My sisters-in-law start by complaining they are getting tired quick and then it sort of progesses to them upping their fluid tablets because it starts to "collect" (thats what the docs call it).  Are you on meds for the fibrilation and any frusimide or water tablets? Have you even been advised  to up your water tablets?  It may be that the gel and the palpitations are just a coincidence.  I know some women say they are very sensitive to the gel but like anything not the majority.

I dont know if what I have to say is any help, I can only comment on what I know from my own family (there are loads with heart and kidney problems - oh and the women are all post meno) but it might put something else in the frame other than the hrt meds.

[SueLW]

Thanks Ladybt28

I'm not on any heart of water tablets.  The fluid comes and goes with the mood swings.  My atrial fibrillation is random and not continuous.  My BP has gone up over the past few years and I'm on Amlopidine for it now, but it seems OK on the meds.  I daren't measure it today though, I'm very stressed over the palpitations that are still going on and of course the blood pressure cuff will show up the wobbly beat and that will stress me even more. 

The only thing I've done differently today is to take that extra pump.  Dr Louise is lovely, but I fear I won't get the blood results and her thoughts before Christmas now, which is why I took an extra pump today as I've been so tired and sad this week. 

She did tell me off when it came to light that I had been spreading my gel on and letting it dry.  She said we should rub it in well as if it were a cream and that I may not have been getting the full benefit of the gel I have been using.  So perhaps the change to rubbing it in and increasing the dose all within a week was too much.  I'd best drop back down to 3.5/4 pumps a day I think, and wait and see.

I don't know what causes the water retention but I fear it's the Utrogestan.  When I first tried it by mouth a few years back the first morning I felt OK but tired, the second I felt desperately depressed and the third I was tearing at my skin because I itched unbearably all over.  I never took anymore after that and the symptoms went.  Now I take it vaginally.  When I did 1 capsule every other night I was OK, occasional itching on my arms but not much.  I had to move up to every night because I was bleeding all the time.  Since then I have become more physically exhausted, more bloated and certainly more water retention.  I hadn't really put 2 and 2 together.

In the past I used a progesterone cream (compounded) with a similar oestrogen cream.  I was told I could use as much of the progesterone cream as I wanted and to apply throughout the day if I needed a boost.  I did.  I filled with water and couldn't hardly pee.  I was so exhausted I had to do a little bit of a job and sit for half an hour, try again, repeat.  Hm, I wonder...

[Dotty]

Hi I thought you were supposed to let it dry and not rub it in. I've been applying it and letting it dry. It's all so confusing! X X

[Ladybt28]

AAh there you have it Amolodipine - that's the culprit!  I have been on 3 blood pressure meds when I have been on HT.  The first was lisinopril and I had been on it for years whilst I was on Prempak C HRT then one day out of the blue I took it and my tongue swelled up inside my mouth and I ended up in hospital so it got changed to Amolodipine.  Everything was fine until my HRT regime changed to oestrogel and utrogestan and then my feet and ankles started to swell and I needed to pee a lot at night.  And when they did they were massive and I looked like I had 2 oblongs on the end of my legs and ankles like an elephant.  I could get my shoes on but once I had stood for half an hour they were awful.  I left it for quite a bit because it was the summer and when its hot my ankles do swell a bit and I was wearing sandals as well cos if it had been winter I wouldn't have been able to go anywhere. I had a nurses appointment at the GP's anyway and I brought it up with her and she went "oh yes that's well known!  I will get your GP to change your blood pressure medication".  And that's what happened my blood pressure meds are now Lercanidipine - its a fairly new one but from the first day I started no more problems!  Apparently swelling is a common side effect of amilodipine and it appears to interact with the hrt in some women.  I couldnt be specific if it's the gel or the utrogestan but I can't take any progesterone continuously anyway without terrible side effects.

I reckon that's where the problem is SueLW blood pressure meds.

[Ladybt28]

Oh another thing - you usually get bleeding if the gel level isn't high enough to balance the continuous utrogestan , thats if I have read other posts right - You probably need Hurdity for that one and... I also read somewhere is quite difficult to balance continuous utro and gel where as continuous regimes on patches are easier I believe.  I'm probably with Stellajane continuous progesterone can be a real probem. Itchiness means the liver doesnt like something and you were taking the utro orally so it goes through the liver and the stomach.  Now you are doing vaginally not so much of a problem.  I reckon if you were doing on a cycle only 12 days (some of us do 10 and some do 7 - varies) then it would'nt be so much of a problem.

When I was on continuous Provera - I nearly went of my head with panic, doom anxiety, breathlessness, nausea - post is listed as "screaming inside"! and outside to be honest!  I find the gel and utrogestan the easiest regime I have used (I've had 5 altogether) because it is flexible and you cant do much damage when you play around with it.  No keep going to the Dr to increase decrease or move to a cycle if you want.  The only thing which can cause a problem is that if you dont take enough Utro and have a proper bleed womb lining can increase but other than that - its pretty flexible and I found you can get a certain level of control which seems to help.

I learnt something from your post too - need to rub in my gel!

[SueLW]

AAh there you have it Amolodipine - that's the culprit!

I reckon that's where the problem is SueLW blood pressure meds.

I actually don't think it is.  I read the PIL front and back and took onboard the swelling ankles side effect.  But I was already bloated and suffering from puffy feet in the summer before I began the BP med, or the gel and utero (I think) and the swelling does go down sometimes and then back up randomly, as in mood swings.  The swelling in my legs is upper calves and knees and my arms and belly.  Not really the way the PIL describes it.   

I take the Utero vaginally.  I only tried that swallowing method for 3 days and that was several years ago.  I wouldn't touch the stuff for years after that.  But this year I got desperate as the compounded creams were no longer helping me and costing me a fortune.  I wanted body identical on the NHS and so braved trying it again, this time vaginally.  I actually felt much better when I could use it only every other night.  But the bleeding wasn't fun.  I spoke to Dr Newson at the beginning of October and she said I needed to take it every night.  The bleeding has slowed, but not stopped.

I mentioned moving to a cycle last week when I saw her but she said she didn't think that was the right thing to do.  A bit in limbo without the blood test results really. 

The palpitations have just stopped.  I feel I need to sleep now!

Don't know what to do.  Tempted to just stop using it.  But that means I'll give myself a period for Christmas!  I've never had an HRT regime that was oestrogen only.  I'd quite like to try, just to see if it helps me work out what's going wrong.

[SueLW]

Gosh it does sound as if progesterone doesn't suit you.  I would be careful if I were you.  Your body seems to be sending out clear unhappy signals - ie itching.

Is there any reason why you couldn't just leave off the Utrogestan (you may have a bleed after a day or two) and see how you feel on the Oestrogen only? You could then carry on with the dosage you feel happy at if you decide to try the Mirena.

You may be like several of us - much better maintaining a cycle and minimising exposure to progesterone.  Long cycle may be the way to go if you are post meno.

Thanks for your ideas.  I can't be sure it's the progesterone though. The palpitations this morning started a few hours after increasing the gel dose.  But the bloating and itching precedes me starting the gel, or the Utrogestan actually.  It's just got worse recently.

I'm not sure, if I came off the Utrogestan would I suffer headaches and even worse mood and bleeding for Christmas?  I can't have a coil fitted before the end of January, would that be safe enough without progesterone?

[Kathleen]

Hello SueLW.

So sorry that you are suffering.

Unfortunately I can't help  with your query but I am in a similar position regarding Oestrogel. Despite using the gel only for about two weeks I am still experiencing hormonal surges and palpitations etc. I will be back to Utrogestan vaginally tonight so that may change things, who knows?

I completely understand your predicament and you have my sympathy. Hopefully one day we'll be all sorted and this frustrating roller coaster ride will be a distant memory!

Take care and sending hugs.

K.