Hi shoppingqueen. The progesterone issue can be an absolute pain, I agree & HRT seems to be more complicated for those of us on both T4 & T3.
If you felt well on Femoston & don't on HRTs containing other progestogens, can I ask why you stopped the Femoston? Was it just because your pharmacist warned against the possibility it would interact with your thyroid meds, or were you on Femoston pre-hypothyroidism diagnosis i.e. before starting thyroid replacement?
I agree, SHBG is another complicated issue for hypothyroid women & tbh I've not had mine measured to date, reasoning that thyroid replacement at the right dose is not negotiable i.e. we need what we need & that has to be balanced with whatever we find is the right HRT combo & dose for us. By that I mean that I don't want to be worrying about what my SHBG is doing at this stage as I can't take an incorrect dose of thyroid replacement or an HRT combo that feels wrong, simply in order to get SHBG within a theoretical optimal range. I may get it tested for elucidation at some point but right now it's a way down my list of priorities. Having to get these tests privately also gets costly, so I try to keep it to what seems essential. I can post links on SHBG if you want to see them, but there are so many associated factors that can be beyond our control that I think trying to take all that into consideration just further confuses matters for us.
As a migraineur on thyroid replacement I'd avoided oral oestrogen until there were few other remaining options, afraid it would have adverse effects on one or other of these conditions. As I was scraping the bottom of the barrel for prog types, I then had a short trial of Femoston Conti ultra low dose but by week 3 began to get moderate daily headaches with some migraine features, bloating & gut transit slowed to a virtual standstill. I didn't want to risk a return to frequent full blown migraine & continuing with gut transit that slow was not an option, so I stopped the Femoston after a month. Gastric stasis can be a feature of migraine but slow gut transit is also classic for low thyroid as you'll know. Had I not had the return of migraine type headaches I would probably have tweaked my thyroid dose to compensate for the oral oestrogen likely binding up too much of it. So that's perhaps something you could think about doing if you can't find an acceptable progestogen to go with transdermal oestrogen & want to go back to Femoston. Maybe discuss a retrial with your doctor/pharmacist if you want to continue HRT & there's no other alternative? If it messes with your thyroid & you can't tweak your dose to compensate at least you'll have tried. If you find a Femoston- thyroid combo to suit you, you can then add in testosterone if need be.
I forgot to ask whether you're on conti or sequi, but if you're on cyclical HRT it seems to me even more of a challenge to find stability on thyroid replacement.
Wx