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[Penguin]

Hi, I'm in perimenopause and started estrogel / utrogestan at the end of December. It's been going well, a few side effects, but it has definitely helped level out the severe anxiety to a more manageable level, get rid of brain fog and the flushes. Recently however, I've been feeling worse AFTER my withdrawal bleed / period than before it. I always used to have bad PMT for about two weeks before my period so this is odd. By day 5 of the bleed for the last two months and onwards, I'm feeling jittery, anxious (which then makes me tearful), head pressure-like full and in general like I have too much estrogen. I put my one pump of estrogel on in the morning and this horrible feeling peaks and then by mid pm I'm generally feeling okay again and this lasts until bedtime. However, I am now back to waking up super early (any time from 4am), feel okay for about 20 seconds and then back to feeling anxious again. By 10am I am exhausted and want to go back to bed. In the night my eyes are so dry my eyelids are sticking to my eyeballs and having to use special gel on them. If I wake up in the night I am filled with anxiety / dread / irrational thoughts. Both the early waking and the dryness at night were previously signs I thought of as low estrogen. I also take 10mg of citalopram every morning too, started that in August last year - I know I can't take that at night as it gives me nightmares.

I really need to get through the next week comfortably as I have my surveillance colonoscopy next Wednesday (where they are just checking that I haven't made more polyps), but at the moment I am so tired and anxious and just don't know what to do with myself. I wasn't even worrying about the colonoscopy as I know rationally I'm so low risk of there being anything given was only 11 months ago I had the last one, but the physical nature of the hormonal anxiety very quickly turns to mental for me, and I am scared of it escalating again as my thoughts are already starting to loop.  I was wondering whether to split the estrogel into am and pm, so that I don't dip too low overnight / into the early hours, has anybody tried that?   I wouldn't want it to make my sleep any worse as I am tired enough now as it is and I am so scared of spiralling before next week. Please help!!! I was also wondering about starting the utrogestan early as I seem to be one of the rare people who feels better on it, but I don't know if that is dangerous to do? How early would be too early? I usually take it vaginally days 15-26 and I am only on day 8 today).

Any suggestions welcome, or even just some reassurance please. I am very scared of being back where I was last year in terms of mental health and need to get some perspective.

Thank you
Penguin x

[Nik2502]

Hi Penguin

I’m sorry to hear about your anxiety. I’m similarly suffering at the moment with severe health anxiety.

I’ve actually seen my doctor this morning to discuss my anxieties and she was very understanding. She can’t do much but her listening to my fears really helped me rationalise them.

It wouldn’t do any harm to split your oestrogen dose so why not try it? One pump is a very low dose - you could possibly need an increase?

I can’t comment on utrogestan though as it didn’t agree with me at all!

Nik x

[Ermin2trude]

Hi Penguin,

I’m sorry you are having such an awful time at the moment.

I completely relate to all the symptoms you have described. I started on estrogel/utrogestan and it was ok for a few months, then it all went haywire. I couldn’t seem to get the dosage right….was it too much/too little? My anxiety was through the roof and I felt dreadful until the utrogestan part, when life improved dramatically.

I was taken off the estrogel (histamine intolerance exacerbated by oestrogen and also the alcohol in the gel was diagnosed) and I started on patches. Firstly evorel 50 (too much for my cycle to handle) and then estradot 50 which is fantastic. I also kept a chart of my symptoms which clearly showed I am so much better with utrogestan, and now I’m on it continuously.

For the anxiety I take magnesium before I go to bed and have an Epsom salt bath. The dry eyes are awful and I have found sea buckthorn oil supplements help, plus omega 3 to balance out excess omega 6.

I know it’s not an immediate fix, but it can and does get better. I really would consider changing to a patch, it stopped the head pressure, jitteriness etc and that feeling of too much oestrogen. I just ‘felt’ I was getting an even and balanced dose which was immediately calming.

Good luck with the colonoscopy next week. I’m having a hysteroscopy next Tuesday 😔. I will be upping the magnesium and Epsom salt baths between now and then to knock me out.

Best wishes.

[Gnatty]

If you feel better on utrogestan then take it early, as you say, anything to get you through. If you consider women take it continuously most menopause then it isnt going to harm you to take.  Also consider increasing your oestrogen. You can go up to 4 pumps a day. But slow increase. If you are only on one a day that's hardly anything. Add one in and see what happens together with some more utrogestan. And keep us posted. x

[SarahT]

Hi Penguin,

Sorry things are so bad for you right now. You give others so much support and good advice and I am glad others are already able to reply to you with advise.
I had a dreadful time with anxiety, I was all over the place each and every day and It was severely impacting my day to day life. Since I began get (estradot patches) in September I have gradually increased my dose and am currently on 100. I have to say the last few weeks my anxiety has improved greatly.
I still wobble on any unexpected changes through the day, as I find I need to plan my day as best I can to keep anxiety at bay, but on this higher dose I am a lot more ' stable.' as such.

If as others suggest you increase your dose,I do also find I am better increasing gradually. I can get jittery sensations when I first do a small increase but this passes after a couple of days as My body gets used to the new dose. Then I am happy to go to the entire new dose as so know what to expect.

I wanted to say this in case you find new, hopefully temporary symptoms if you increase, as sadly we all know changes will only add to our anxiety So be prepared.

Wish you well Penguin, you are a great support to others

[Penguin]

Thanks everyone, really appreciate your replies, seems I am not the only one struggling to get the right balance.

Nik2502 that's exactly it, having someone to listen to you and help you rationalise is so important. My husband really tries, but given I am the only one worried about the colonoscopy, I think he is finding it hard. My fear is out of proportion to the risk, I know that, but I still need someone to talk me down and that is hard when people don't get it and think you are worried over nothing.

[Penguin]

Ermin2trude, you may be onto something there. The eyes have been really bad these last few nights, and it is possibly because I have had to stop my omega3 supplement prior to the colonoscopy. It is quite a high dose one and apparently can thin your blood so needs to be stopped (alongside most of the other lovely supplements that support me) 10 days in advance. I haven't heard of sea buckthorn tho so will definitely look into that too. I do take magnesium and luckily can continue that right up until the day before so hopefully that'll help. And of course maybe the extra estrogel tonight will help too, fingers crossed. At least I feel like I have options now!
And good luck with your hysteroscopy too, the waiting for it is the worst isn't it. I got a call this pm asking if they can do mine a day earlier to help with scheduling and I've said yes so at least this time next week itll be over.

[Penguin]

Thank you Gnatty, it honestly hadn't occurred to me to increase my dose as I'd thought my issue was too high estrogen during the day and too low at night. But perhaps one pump am (as I have been doing) and then gradually increasing from an extra squidge in the evening alongside 1 x utrogestan from now until day 15 may help. I wondered if there was a risk of doing that but given women in peri can have the coil which releases progesterone all month, I just can't see what a downside would be. Will try the estrogel tonight, then add in the utrogestam tomorrow then. At least then by colonoscopy date I should have had some good sleep!
Do you know what the standard dose of estrogel is by any chance, my container says 1-4 pumps?

[Penguin]

Thank you SarahT, that's very kind of you to say ❤️
I'm going to try and increase slowly I think, starting tonight. Will add in the utrogestan tomorrow.
I do like the idea of the gel, but wondering if something that releases over 24 hours might be better for me as i don't seem to handle the peaks and troughs so well.  Does the estrodot include progesterone too? Are you able to cut small amounts off to tweak the dose? Whenever I increased estrogel, as well as the jittery feeling, I got very bad indigestion which scared me as triggered my health anxiety so I always dropped back by the second or third day. I wonder if I should have given it a bit longer given what you're saying, and a couple of ladies above have said one pump is low. I certainly had more energy on the slightly higher dose, although max I've ever done is two pumps. Maybe if that was split across the day it wouldn't be so bad jitteriness and tummy wise. I did realise after Ermin2trude said above re Omega3 that my body has taken a double hit in past few days as I've had to stop a number of my supplements 10 days prior to the colonoscopy. I bet that's impacted my sleep too. Gosh I don't know what to do for the best. I am defo going to start the utrogestan earlier tho as it really does help me sleep.
Lol could do with it not being half term this week, I need some space for self care x

[Stella2]

Hi Penguin,
Sorry that you have to go through this. I also think that a patch might be better as I used to be on sandrena and Estradot seems to work better for me. I am also fearful that the unbearable anxiety might return but, I think you said that you had some CBT and although maybe not cured, you now have tools to deal with it.
I also have dry eyes that became itchy. I was given eye wash in the pharmacy and I helps me. I wish you all the best xx

[SarahT]

Hi Penguin,

The estradot are oestrogen only, and I choose the mirena coil for my progesterone part. I did not get on  with the utrogestan, too much instability and side effects for me, though I know others get on so well with it.

When I was increasing my dose from 50 to 75, I used a 75 patch and cut a tiny sliver off, so for a few times I was on about 62.5. As I say the jitters went after a few days. I did the same when I went up to 100 a few weeks ago, took a 100 patch and cut a tiny bit off. As I felt fine I straight away  went into the 100 and do feel improvements.
The patches are changed twice a week. I find them convenient,and they seem to me to release a steady dose, I think the same of the coil too,  a low but steady release of progesterone.

As you say you have had to cease your supplements too, and along with the colonoscopy due soon, of course your anxiety is going to be made worse.

Seems many of us need to tweak our hrt and find supplements to support too. Lucky there are so many who can offer the advice on here.

Take care,  let us know how you get on. X

[Losingtheplot]

Hi, I'm in perimenopause and started estrogel / utrogestan at the end of December. It's been going well, a few side effects, but it has definitely helped level out the severe anxiety to a more manageable level, get rid of brain fog and the flushes. Recently however, I've been feeling worse AFTER my withdrawal bleed / period than before it. I always used to have bad PMT for about two weeks before my period so this is odd. By day 5 of the bleed for the last two months and onwards, I'm feeling jittery, anxious (which then makes me tearful), head pressure-like full and in general like I have too much estrogen. I put my one pump of estrogel on in the morning and this horrible feeling peaks and then by mid pm I'm generally feeling okay again and this lasts until bedtime. However, I am now back to waking up super early (any time from 4am), feel okay for about 20 seconds and then back to feeling anxious again. By 10am I am exhausted and want to go back to bed. In the night my eyes are so dry my eyelids are sticking to my eyeballs and having to use special gel on them. If I wake up in the night I am filled with anxiety / dread / irrational thoughts. Both the early waking and the dryness at night were previously signs I thought of as low estrogen. I also take 10mg of citalopram every morning too, started that in August last year - I know I can't take that at night as it gives me nightmares.

I really need to get through the next week comfortably as I have my surveillance colonoscopy next Wednesday (where they are just checking that I haven't made more polyps), but at the moment I am so tired and anxious and just don't know what to do with myself. I wasn't even worrying about the colonoscopy as I know rationally I'm so low risk of there being anything given was only 11 months ago I had the last one, but the physical nature of the hormonal anxiety very quickly turns to mental for me, and I am scared of it escalating again as my thoughts are already starting to loop.  I was wondering whether to split the estrogel into am and pm, so that I don't dip too low overnight / into the early hours, has anybody tried that?   I wouldn't want it to make my sleep any worse as I am tired enough now as it is and I am so scared of spiralling before next week. Please help!!! I was also wondering about starting the utrogestan early as I seem to be one of the rare people who feels better on it, but I don't know if that is dangerous to do? How early would be too early? I usually take it vaginally days 15-26 and I am only on day 8 today).

Any suggestions welcome, or even just some reassurance please. I am very scared of being back where I was last year in terms of mental health and need to get some perspective.

Thank you
Penguin x

Hi Penguin

I just want to say big hugs to you hunni so so sorry your going through this awful time.  I totally get you being scared as I too found my mental health and anxiety so bad recently before HRT and some other meds helped. But I am still not there fully.
I hope you taking the utrogestan early really helps you xxxxxx

[Penguin]

Thanks everyone. So I took the extra estrogel at 6pm and I definitely slept better, still woke up at 5am but was more relaxed and able to get back to sleep after awhile. I did have a 'high' feeling before I went to sleep though so perhaps I need to take it even closer to bedtime so I sleep through that bit. And I had very weird psychedelic dreams, buying a bright pink cat type dreams, which were actually okay. I am going to take later tonight and add in the utrogrstan as well, looking forward to that as it basically traquilises me within half an hour.

I am also going to talk to my doctor about whether the dot would be better, but as long as I can keep the utrogestan. I'm quite scared of having the coil as I've heard people say doctors then argue with you about taking it out, I don't know why, but I'd be so worried about having side effects and then having a struggle to get it removed.

Thanks everyone, really supportive and helpful. I woke up to these messages and it is so nice to feel listened to. I haven't told anyone apart from my husband and one friend (who is out of the country atm) about the colonoscopy as I lost the plot so badly last year that I thought maybe telling less people in real life would be better so its great i can tell you lot.

I'm feeling a lot more present today. Osteopath this morning then taking my son out for lunch and a milkshake, while my daughter goes out with a friend and her mum. Really trying to enjoy this week.

Surgeon's secretary phoned me yesterday to see if I could go in on Tuesday instead of Wednesday and I've said yes, and actually speaking to her helped as she is so relaxed and friendly and it just seems it's a normal thing to go for these follow ups.

I'm trying to use all my tools Stella2 and I have my diazepam if it gets really bad but I think even getting more sleep last night has helped.

Thank you too Losingtheplot, an defo taking the utrogestan tonight. I've been reflecting on the comments that my estrogel is very low and thinking perhaps if I raise both estrogen and progesterone it'll help.

Lol I am a work in progress!

[Penguin]

Just an update for those who supported me last week. I had my surveillance colonoscopy and it was all good, one tiny barely there polyp, which surgeon said was most likely an overgrowth of normal bowel tissue than an actual polyp. Surgeon happy now that I'm not a rapidly forming polyp person! Recall 3-5 years, I am so relieved!!!
Thank you very much to everyone who replied xx

[SarahT]

Great news Penguin. You are such a boost and great advisor to many of us, so am extra pleased you had a good result.😍