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[EleanorB]

Hi,

I'm 51, two years into meno. I've had a mirena coil in for 3 months, I use an evorel 50 patch for my oestrogen. I feel rubbish, reoccurrence of dreadful painful reflux, re occurrence of lower back problem, fatigue, nausea, a general feeling of low mood. I now have shoulder pain and a trapped nerve causing arm pain, which I realise isn't progesterone per se but is just part of an overall rubbish health picture.

I was on unnoposed estrogen for 6 months prior and felt so much healthier, but still have a womb and with my second endometrial polyp removal the no progesterone party was over. I was allowed to try unopposed due to severe migraine history.

I wrote to my gynae who I will see for post polyp removal/mirena insertion  follow up at end of jan (feels like an eternity) and she said it can take 6 months for mirena to ‘bed in.'  I feel pretty despairing, anyone either ditched a mirena and done better with a different progesterone ( utrogestan vaginally gave me viscious thrush) or kept a mirena in and the side effects subsided?

I have testosterone gel but never used it wonder if that would help?

Any thoughts very welcome, at wit's end.

[Mary G]

EleanorB, I'm afraid my post may raise more questions than answers.

Firstly, do you know what your migraine trigger is?  Is it progesterone, oestrogen spikes, low oestrogen, generic hormone instability?  Did you suffer with progesterone intolerance/PMS pre menopause and did you suffer with hormonal migraine pre menopause?  Do you have migraine with or without aura?  The type of HRT regime you eventually settle on would depend on answers to those questions.  Do you mind having periods?

I had no history of PMS or progesterone intolerance until I hit the menopause.  I had a Mirena coil for contraception without any problems until my own hormones started to drop.  To begin with, I kept the Mirena and used oestrogen patches but I was not getting enough oestrogen out of them to combat the sweating.  I also suffered with silent migraines (migraine aura without headache) so I had the coil removed and went onto Angeliq initially (not strong enough) then cyclical Oestrogel (latterly Lenzetto) Utrogestan and testosterone but I still suffered with silent migraines.   

For years I wrongly assumed I had suddenly developed progesterone intolerance at menopause and so I limited the Utrogestan to 100mg for 7 days each cycle and it worked well enough for a number of years.  However, I was still having to put up with migraines and the actual process of bleeding was making me feel ill so I considered a hysterectomy thinking it would be a silver bullet.

Just over a year ago, I decided to have one last attempt at finding a solution before opting for a hysterectomy and I'm so glad I did.  I consulted my migraine specialist once again and after much discussion, it was decided that my problem was hormone instability not progesterone intolerance per se.  She said I needed to find an HRT regime that balanced my hormones and that I must stop bleeding.  I was then confronted with the problem of finding a form of progesterone that didn't give me nasty side effects and did not unbalance my oestrogen. 

After a long search, I found a private clinic that offered bespoke progesterone so with a heavy heart, I made an appointment following recommendations.  I went with a pile of notes and blood test results thinking it would take hours for the doctor to understand my problem but she 'got it' immediately.  I was shocked!  She immediately identified my problem and agreed with my migraine specialist (I took the consultation notes with me) that I needed hormone stability and to stop bleeding.  She then said I must take progesterone every day and I was absolutely horrified!  I told her that the Mirena coil was a no-no and that I could never, ever take Utrogestan again and she said 'no problem, the type of progesterone I am going to prescribe for you will be nothing like either of them'.  I didn't believe her.

At the time, I was using Lenzetto (Evamist in the US) oestrogen spray which I have to say is absolutely brilliant but both she and the migraine specialist were adamant that I should stop using it because it is not stable enough for migraine sufferers although they did say it's a great product for most people.  It was a double blow.   

I was prescribed 1 pump of Oestrogel (which I thought was way too low)  50mg progesterone and testosterone every day.  I didn't think it had a hope in hell of working but guess what, it did and that was well over a year ago.  I'm still in shock to be honest because I really thought I was progesterone intolerant but now I feel as good as I did while on the oestrogen only phase of HRT and I have the added bonus of feeling the same all the time with no periods. 

The reason I started having migraines at menopause is because I no longer had the protection of my own progesterone against spiking oestrogen levels.  I now know that progesterone administered at the right dose with the right delivery system complements oestrogen and actually makes it work better.

My experience may help you and others reading it but it is important to establish whether or not you are progesterone intolerant and what you migraine trigger is before settling on an HRT regime.

I hope that helps. 

[EleanorB]

Thanks so much for your reply. I'm definitely clear for me that progesterone has to be continuous, fluctutions and change will cause my migraine to spike. I'm not sure if it's intolerance or more likely intolerance to this type of progesterone. I had a bad time with other oestrogen formulations prior to evorel which I had no problems with.

Would you mind telling me which clinic you went to? Is the progesterone something only they give out. This sounds very interesting. Please do message me if you'd rather discuss in private message. Not sure if we're allowed to talk consultants etc, apologies if not.

[Mary G]

EleanorB, I've sent you a PM.

[3isenough]

Sorry to bring this thread back up but Mary or Eleanor I would really appreciate the clinic info too. I'm struggling with cyclical utrogestan and estradot combination and my worst migraines are two days into Utrogestan and then again a few days after I stop. Plus the utrogestan makes me feel dreadful even on 100mg vaginally. I'm torn between trialling a Mirena (but i was so depressed on mini pill) or hysterectomy to avoid the progesterone entirely. Thanks

[Mary G]

3isenough, I'm sorry to hear about your problems with the dreaded Utrogestan and migraines.   

It sounds like your migraines are caused by fluctuating hormones and you need to stop having a cycle.

There is a lower dose progesterone coil (Kyleena) that you could try.   Blue Kingfisher on here had one fitted about a month ago and it seems to be going well.  You might want to read some of her posts.
 
I'm afraid I can't give you the name of my clinic on here but I will happily do so via PM.   I think you can receive PMs after 10 posts so keep posting!

In the meantime, please read my thread on compounded hormones in the Alternative therapies section on here.   I'm going to bump my thread to the top.

I'm pleased to say that after nearly two years, my regime is still going extremely well. 

Keep asking questions!

[3isenough]

Thanks Mary, I will keep posting and look up the lady with the other coil type.

[Tinacros]

MaryG which progesterone did u end up using at 50mcg.  I think my problem is similiar to yours. I’m post menopause and can’t get levels right.

[Mary G]

Tinacros, I use a bespoke 50mg progesterone.  The full story is on my thread in the Alternative Therapies section on here so I bump it up for you.  I'm now almost two years into this regime, it's going extremely well and I'm period free which is sheer bliss!

Please send me a PM if you have any questions.