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[NaomiD]

I'm 51, in peri menopause and have increased my dose of Progesterone cream (Wellsprings) from 1/8 tsp twice daily 24 days/4-6 days break to 1/4 tsp twice daily same cycle timings, due to heavy bleeding/flooding, insomnia, anxiety, joint pains etc.

For the last couple of months I've started shedding lots of hair - handfuls! Also noticed that my breasts are swollen and tender and I wondered if that could be caused by the increased progesterone. My GP won't test my levels so I don't know what they are at any point in my cycle.

I have big intramural fibroids so have been nervous to add any form of oestrogen to my cycle as it seemed that my symptoms were pointing towards oestrogen dominance - although I know some people don't believe in that, I have read compelling papers to suggest that it does play a part in fibroids, heavy bleeding, breast swelling etc. due to impaired excretion.

Does anyone have any wisdom to share or experience of this. I've always had long, luscious hair and it's very thin on the ends now :-(

x x x

[SaFa]

Hi NaomiD
I have just joined because of wanting advice about dosages of estradiol gel post menopause but I thought I would reply to you as my perimenopause was very similar to yours. I “discovered” perimenopause due to very heavy bleeding, periods that never stopped basically- A gynaecologist I knew via a friend advised me to have the Mirena coil fitted- I had heard so many horror stories but I went ahead. I’m now on my second one- I discovered I had developed fibroids when two or three years after the first coil had been fitted the bleeding returned. I sought advice from the same gynaecologist and he advised an ablation and explained also that contrary to popular belief estrogen doesn’t make fibroids grow as such, they just become engorged at the time of your cycle when estrogen is at it’s highest.They cause the womb lining to bleed by irritation and inflammation and the dosages of estrogen based HRT are lower than you would have in a normal cycle so doesnt affect the fibroids drastically.I subsequently went onto the Esradiol gel to control the other Menopause symptoms like insomnia,weight gain,thinning hair etc etc 😉 I hope it helps complete the picture
My issue now, if anyone has advice..post menopause, I have had bleeding the last six months. I read up on this and most advice was that my estrogen was too high in relation to progesterone. I stopped the gel( 2 pumps a day) and the bleeding stopped but other symptoms returned 😭 noticeably, painful sex. I subsequently started back on 1 pump a day about 6 weeks ago and things improved but I have gained weight rapidly,especially around my hips and belly and my legs ache! I have a puffy face and feet..all things I recall all too well. I do NOT want to go backwards but neither do I want the constant bleeding. Is this a residual effect of too high a dose of Estrogen over the last few months or is it because of too low a dose? 🤷‍♀️

[bombsh3ll]

Progesterone has very poor absorption through the skin so the cream is unlikely to be playing any part in your symptoms other than possibly delaying appropriate treatment.

Estrogen levels can be very erratic during perimenopause which can lead to heavy bleeding and breast tenderness.

If you don't feel you need estrogen added presently, some oral or vaginal micronised progesterone alone, or a mirena could help with the bleeding at least.

Hair loss is challenging and has no good treatment - I have a form of alopecia since adolescence, but you could see your GP for some basic blood tests to check iron, thyroid etc to exclude anything treatable.

With regards to the bleeding on HRT, assuming this has been investigated and is benign, increasing the progestogen is generally the best way to treat, rather than reducing the estrogen, which is presumably at the level you need to adequately relieve your menopause symptoms.