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[Treehugger]

Hi, just wondering if anyone can help.
I’m 48, have had no periods for a few years due to having an endometrial ablation. Started with menopause symptoms a couple of years ago, and tried to manage with supplements etc but they didn’t really help.
Decided to try HRT in February this year, and was prescribed Evorel Conti. After about a month on the patches I was feeling down and irritable, and decided to stop for a while.
Couple of months later I was feeling pretty rubbish and after researching decided to ask GP for Oestrogel and Utrogestan.
Felt pretty ok for a few weeks on this, 2 pumps of gel and 100mg Utrogestan orally nightly,but then started feeling a bit depressed again, and was having indigestion from taking Utrogestan orally, so switched to vaginally 100mg every night. Definitely felt better taking it this way, but then about 3 weeks ago I started to get itchy all over. This then developed into a nasty red rash all over my body. I decided I had better stop the HRT as it seemed to be an allergic reaction.
The rash started to ease after a few days, and I thought it might have been caused by the Oestrogel, so asked GP if I could try Lenzetto. Apparently she wasn’t allowed to prescribe this so I ended up with Evorel 50 oestrogen only patches to try, and try the Utrogestan again. Put a patch on yesterday and felt fine. Rash had pretty much disappeared by last night.
I tried a Utrogestan capsule vaginally again last night and woke up covered in a bad itchy rash all over again this morning. Antihistamine has taken the edge off it. I am still wearing the Evorel patch but know I should probably take it off as I can’t use them on their own, and looks like I can’t have the Utrogestan.
I have messaged my GP, (they aren’t very clued up about HRT)
So what do I do now? I could try the Evorel Conti again but it’s a synthetic progesterone which I’m not overly keen on having.
Or is there any other body identical progesterone option?
I can’t afford to pay for private consultation.

[Flossieteacake]

Hello Treehugger. I am sorry you have reacted to this. I would ask your GP to refer you to an NHS menopause clinic. You will not have to pay at all so do not worry about that.

There are more options with the HRT so do not despair as another one may be more suitable for you. This link has some more information about different HRT types.
https://www.menopausematters.co.uk/pdf/HRT-Doses-Sep2021.pdf

[Treehugger]

Thanks Flossie, I’ve checked and nearest NHS clinic is 70 miles away. I would happily make the trip if they could help though. I will ask my GP. Have taken the Evorel 50 patch off and will wait for the rash to clear up before I do anything else. It’s so frustrating, I just want to feel well again! Have felt really low and tired today ☹️

[Flossieteacake]

Thanks Flossie, I’ve checked and nearest NHS clinic is 70 miles away. I would happily make the trip if they could help though. I will ask my GP. Have taken the Evorel 50 patch off and will wait for the rash to clear up before I do anything else. It’s so frustrating, I just want to feel well again! Have felt really low and tired today ☹️

You can have phone appointments if the clinic is far away. I have phone appointments.

I am really sorry to hear today has been such a difficult one. I hope you can get an early night to unwind.

[Treehugger]

That’s interesting, a phone consultation would be helpful, I just want to speak to someone who actually knows about HRT etc. The GP I saw the other day wasn’t much help at all. I seemed to know more about it than she did tbh. I have a phone call with a more experienced GP in a few days so fingers crossed she will be able to help me better. Thank you for your kind words Flossie.

[Flossieteacake]

That’s interesting, a phone consultation would be helpful, I just want to speak to someone who actually knows about HRT etc. The GP I saw the other day wasn’t much help at all. I seemed to know more about it than she did tbh. I have a phone call with a more experienced GP in a few days so fingers crossed she will be able to help me better. Thank you for your kind words Flossie.

I think phone consultations are great because it saves the anxiety of waiting around for the appointment. I understand you wanting to speak to somebody who understands HRT. GPs often do not know much at all.

You are most welcome. 

[Treehugger]

Thought I would give a quick update a couple of weeks on…
The GP I spoke to on the phone wasn’t helpful, she said they don’t do referrals to an NHS menopause clinic, and didn’t have any advice other than to stop HRT. I tried to explain I wanted to try and continue but she didn’t seem able or willing to help me at all!
I decided to do a trial of using Oestrogel on its own for a few days, as I was feeling pretty rough after stopping it. The rash had faded by then, and for a couple of days I seemed to tolerate it ok.
The rash then started up again, pretty much all over my body, and as I hadn’t used any progesterone for a week or so it seemed obvious the Oestrogel was the problem.
I used antihistamine which helped a bit but I was still covered in itchy rash and decided I would stop the Oestrogel and try the Evorel 50 patch again.
Hurray! Itching and rash both started to reduce, and after a couple of days of just wearing the patch, I thought I would try taking the Utrogestan orally at bedtime again, with a good drink of water to wash it down, hopefully to avoid indigestion starting up again.
This seemed to work ok, no indigestion, slept fairly well, and woke up with no flare up of rash and feeling alright!
Really hoping things go ok from here, going to continue with the patches and Utrogestan orally each night, fingers crossed!

[Flossieteacake]

Thought I would give a quick update a couple of weeks on…
The GP I spoke to on the phone wasn’t helpful, she said they don’t do referrals to an NHS menopause clinic, and didn’t have any advice other than to stop HRT. I tried to explain I wanted to try and continue but she didn’t seem able or willing to help me at all!
I decided to do a trial of using Oestrogel on its own for a few days, as I was feeling pretty rough after stopping it. The rash had faded by then, and for a couple of days I seemed to tolerate it ok.
The rash then started up again, pretty much all over my body, and as I hadn’t used any progesterone for a week or so it seemed obvious the Oestrogel was the problem.
I used antihistamine which helped a bit but I was still covered in itchy rash and decided I would stop the Oestrogel and try the Evorel 50 patch again.
Hurray! Itching and rash both started to reduce, and after a couple of days of just wearing the patch, I thought I would try taking the Utrogestan orally at bedtime again, with a good drink of water to wash it down, hopefully to avoid indigestion starting up again.
This seemed to work ok, no indigestion, slept fairly well, and woke up with no flare up of rash and feeling alright!
Really hoping things go ok from here, going to continue with the patches and Utrogestan orally each night, fingers crossed!

Thank you for the update. I am shocked your GP does not do menopause referrals as I think that it is your right to see one if you wish. If possible I would ask to see another GP at the practice and if that is not I would think about moving to another practice. I know that can be difficult.

You have done so well to figure this all out on your own. I really hope this regime works out for you.

[Treehugger]

Thanks Flossie, yes I have decided I’m going to ask to speak to/see a male doctor at the practice who I spoke to recently. He was very kind and understanding.
I put a new patch on last night, and the rash has flared up a bit, mostly around my neck and shoulders this time, rather than my whole body. I’m going to try and continue, unless it gets really bad again.
Wondering if it’s a histamine intolerance thing? Have read a bit about it. I’m allergic to permanent hair colourants and get hayfever in the summer but am generally very healthy!

[Flossieteacake]

Thanks Flossie, yes I have decided I’m going to ask to speak to/see a male doctor at the practice who I spoke to recently. He was very kind and understanding.
I put a new patch on last night, and the rash has flared up a bit, mostly around my neck and shoulders this time, rather than my whole body. I’m going to try and continue, unless it gets really bad again.
Wondering if it’s a histamine intolerance thing? Have read a bit about it. I’m allergic to permanent hair colourants and get hayfever in the summer but am generally very healthy!

I am glad there is a nice GP there and you can speak to them next time. It could be related to histamine. I get hay fever but have found my symptoms are worse since menopause. Maybe you could keep a food diary and see if there is a connection to what you eat and the rash?