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Author Topic: Lack of libido and tiredness on combined hrt  (Read 315 times)

Nici_j

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Lack of libido and tiredness on combined hrt
« on: June 16, 2024, 03:31:30 PM »

Hi there

I have been on sequential HRT since I was 50 (now 60) and just recently had a scan and hysteroscopy and all was well. However GP and NHS Gynae have encouraged me to take combined oestrogen and 200 mg Utrogestan daily. Unfortunately I need 200 mg Utrogestan daily to stop bleeding.

I have been on this regime for 6 months with two hiccups. We were overseas for 2 months and I miscalculated the amount of Utrogestan to take so had to return to sequential for one cycle. Secondly I tried to cut down to 100 mg Utrogestan as it makes me a little itchy down there but this induced a bleed.

Both times I had either no or less progesterone I felt much better, had better libido and more energy. I am in a new relationship and getting married next year and so I am more conscious of how I feel.

On this continuous regime I feel quite tired/drowsy, itchy downstairs, my libido is not what it was and I just generally don't feel very attractive (sorry bit of vanity there but conscious due to new relationship)

So I can either try a mirena coil and poss increase oestrogen/add testosterone or go back onto a sequential regime. I always felt great on sequential so am very tempted.

Any shared experiences of either effect of Mirena or daily 200 mg of Utrogestan much appreciated.

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bombsh3ll

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Re: Lack of libido and tiredness on combined hrt
« Reply #1 on: June 16, 2024, 06:03:16 PM »

The ONLY issue with remaining on sequential over the long term is a VERY SMALL increased risk of endometrial hyperplasia, which if left can progress to endometrial cancer.

Sequential has however been shown to have lower rates of breast cancer than continuous, so the argument is not one sided, and of course your quality of life is important too.

If you are willing to have regular scans to monitor your endometrial lining, which you may have to pay for as the NHS doesn't offer this, there's no reason you couldn't go back to sequential.

The NHS may not agree with this though, however once a prescription is dispensed it is within your control if, how or when you take it. You would have enough on your prescription that you could do this without having to get into any arguments.


This doesn't mean you wouldn't also benefit from testosterone, you can always try this as well.
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sheila99

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Re: Lack of libido and tiredness on combined hrt
« Reply #2 on: June 16, 2024, 06:06:08 PM »

I have stayed on sequi because utrogestan makes me dopey. They said there's a slightly higher chance of endometrial cancer this way. The mirena seems to be like marmite, people either love it or hate it. I'm considering one too, she said it doesn't have the same doping effect as utro but I'm not too keen on something I can't remove myself. For me neither increased oestrogen nor testosterone stopped utrogestan side effects.
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