Which HRT makes you slimmer, sleep well and have an increased libido?

[PhyllisDietrichson]

LOL, just kidding! But if it does exist - do lemme know :P

[Ilikesweetpeas]

Haha, I'd like to know too!!

[5BlueHydrangea]

I'll have some!

[Backingvocals]

yup. I don't really understand how the menopause causes weight gain but then using HRT to address menopause causes....weight gain.

Fat sigh.

[PollyPerky]

The good news is that HRT doesn't cause weight gain. There is no scientific evidence at all that shows HRT causes weight gain. On the other hand, middle age is time when metabolism changes so assuming you can eat the same as you used to up to age 45 -ish and not put on weight is wrong. Many of us have to reduce our food intake by a third to stay the same weight and also exercise.
I've been on HRT for almost 8 years and am the same weight (within 4lbs) that I was at 21 (under 8st.)

[Backingvocals]

Weight gain is listed as one of the side effects on the HRT I've just started but I'll be happy to hear that that's not the case.

[IDismyname]

I have changed shape in the last 4 months since I started having HRT (patches). Ive definitely got more of my waist back. Sadly not losing weight, but feeling a trillion times better than I did 6 months ago, and people say how well I look!

[Backingvocals]

That sounds good Ishould. I lost my waist (always my best feature) in about a month, literally, as I lurched into menopause. I'm really hoping to rediscover it over the coming months.

[PollyPerky]

It's worth reading this, written by DR Currie, consultant and founder of the website www.menopausematters.co.uk/weightgain.php

Some women may find they retain some extra fluid on sequential HRT which can mimic PMS but it ought not to be permanent. I 'd take what it says on the leaflet with a pinch of salt to be honest.

Side effects have to be listed even if only 1 person in all the hundreds of thousands of people in drug trials experience them.

[StickTheDMWhereTheSunDontShine]

How the heck can you reduce your food intake by 1/3 when your 10 times as hungry as you were at 21?[sigh]

[Dorje]

My hrt is amazing.
I use transdermal bio identical oestrogen gel, and bio identical progesterone.

I rub the gel into my upper arms every morning, and take the progesterone for 14 days in the month as well.

I haven't felt this well in years.

No weight gain, no weird moods, no itching, hot flashes, bone aches, I have proper sleep and increased libido.

Get your GP to prescribe it. Oestrogel and utrogenesan are the names of the oestrogen gel and the progesterone.

[PhyllisDietrichson]

Dorje, that's what I'm talking about!!! Thanks it does exist then?

[PhyllisDietrichson]

StickThem...... yes ditto food is what's to live for not on!

[PollyPerky]

Phyllis- being a bit serious about this (!) no HRT will make anyone lose weight except by giving them more energy and maybe better sleep so they feel like exercising. HRT is only part of all the lifestyle measures needed in middle aged to stay fit and healthy!
Different types of HRT suit different women. Loads of women get on well with tablets, but some prefer gel or patches ( as Dorje describes). It's a case of trying to find the right 'fit' for you, personally. Some women don't like the 'faff' of applying gel, others don't like wearing a patch. The ingredient - estradiol - is the same in all of them, but they come in various doses.
Unless you've had a hysterectomy then you also need progestogen each month to keep the uterine lining thin, and this is the hormone that tends to cause 'problems'. There are around 4 different types. Some women find some kinds make them feel bloated and think they are gaining weight. It might also make you hungrier like PMS can so you eat more then 'blame' HRT for weight gain!

The type of progesterone Dorje mentions is natural micronised progesterone - brand name Utrogestan - and it's thought (not yet fully known) it may be safer for women on HRT long term re. breast cancer risk. But it's not a one-size fits all! Some women hate it- it has to be taken at night because it can make you dizzy or sleepy. I once took it an hour before bed and when I stood up almost fell over!

All I'm saying is, there is a huge range of HRT to choose from. I've felt great on my sort for almost 8 years. But what suits me or you might not suit someone else - it's finding the right fit for each woman.

[PhyllisDietrichson]

Agreed and I do know really, I was being flippant. The whole meno business has been draining and not fun at all so wanted to laugh in it's face just this once!

[HormonalHeap]

Dorje I'm also on Estradiol gel and usteogestan and although my skin's looking better i'm still waking at 5am and knackered. How many squirts do you use a day?

[Dorje]

HormonalNeap, I use two squirts of the gel in the morning, and take the progesterone capsule before bed.

I have a white noise / fan going on low and now I'm not having night sweats, I have got lovely new silk nightclothes in TKMaxx. I sleep through the the night and wake in the morning ready to go.
It's been years since I had a full night sleep before hrt.

My oestrogen levels were low, and FSH high that's why I'm on two pumps a day. One thing I've noticed now is that my skin looks fantastic, and my boobs look perkier.

I would say that it might take some time to get your levels up if they were very low, and even longer if you're only using one pump, I'm not sure though about info that so maybe get back to your meno doctor and ask her for advice.

I'm not a doctor, and I amn't qualified to give you advice about your dosage.
Do you know your blood test readings? Was your oestrogen low like mine?

I think I read that you can have up to four pumps a day if needed. Contact your doc and see what she says?

[HormonalHeap]

Thank you Dorje so much, sounds like you have the right balance. Problem is as our levels fluctuate, what's the right balance one week may not be the next! I increased to 2 squirts around 3 weeks ago. Have started splitting the dose am/pm but still no sleep. The one thing I don't like about Ustrogestan is that you have to take it on an empty stomach- so no food for 2 hrs which means no snacking after supper!

I guess it's another round of blood tests for me- I know you can have up to 4 squirts but I'm worried about taking too much. Thanks again x

[PollyPerky]

The beauty of the gel is that you can adjust the amount you need- but not on a daily basis! Read the instructions that come with it- they tell you the dose is from 2 -4 squirts. Use what you need to control symptoms. You need to stick with a dose for a good couple of weeks or more , not chop and change too often, until it's built up in your system. Most women get on fine with 2 squirts, but during peri if you are young you might need 3.

Utrogestan- the taking on an empty stomach is not that critical- I asked my consultant. Taking it with food actually increases the absorption rate, not lowers it. I don't find it a problem because dinner is 7-7.30pm then I tend not to eat anything more that evening and take it at 11pm. A tiny snack maybe an hour before using it is fine.

To be honest, there is no point and no need for blood tests. I've never had any except the very first time I saw my consultant. Your oestrogen levels will vary during peri but the point of using HRT is to try to stabilise them by giving you a standard amount.

[HormonalHeap]

Thanks Polly. Nearly 49, no peri spring chick here. My meno consultant was adamant Ustrogestan wasn't effective unless an empty stomach. As we don't eat till 8.30 it's not great.

I'm just loathe to take an extra squirt as I like the occasional drink and don't want to push up my odds for breast cancer.

What do people do regarding gel timings when travelling somewhere with an 8 hr time difference? Gradual change or short sharp shock to give the jet lag a boost?

[PollyPerky]

If you read the info on Utrogestan, it says ' taking with food increases the bio availability'- that means more is absorbed.

Here www.medicines.org.uk/emc/medicine/19895
Under 'Precautions' it says :
. Concomitant food ingestion increases the bioavailability of Utrogestan 100mg Capsules.

This means you will absorb more, not less, which is not necessarily a bad thing when its role is to act on the endometrium.

My consultant says it's fine to take it either way and makes little difference.

A slightly higher dose of oestrogen won't raise your breast cancer risk- it's synthetic progestogens that are linked to breast cancer, not oestrogen. And at 49 your risk doesn't 'start' with HRT until you reach the age of the average meno- 52.

The 'occasional' drink is ok but it depends on what you mean by that! Ie one glass of wine a week would be fine but one glass or more a day is going to increase your risk, regardless of HRT or not.

If you are travelling then isn't it best to keep to UK time and use when you'd normally use it?

But if you can't do that, just miss one dose or apply one extra that day and apply it later or earlier- whichever works.

[HormonalHeap]

Thanks so much again Polly for your advice. I also have the Minera coil so wondering if my gynae advised me not to take Ustrogestan with food as that would be too much progesterone altogether. She simply prescribed it to help me sleep, not that it's working!

Unfortunately can't keep to uk time as away for 3 weeks and not practical, so will literally have to sweat it out. Thanks again and sorry for hijacking thread!

[PollyPerky]

Sorry but that's really weird.
What's your consultant thinking of, doubling up a Mirena and Utrogestan? That's simply not done, nor necessary!
The risk is you will think the lining too much and end up with an atrophied endometrium- worst case!

From what you've said, I'd not have much faith in her. Prescribing two types of different progestogens- one is synthetic (in the Mirena) plus natural progesterone is really not on.

Utro should not be used as a sleeping aid! You'd be better off getting something herbal like valerian if you need something to help sleep!

Also- not sure how much you drink- but alcohol does cause poor sleep .
Have you tried cutting it out altogether, and also caffeine drinks?
Have you tried eating earlier? How long after having dinner are you going to bed? It could be simply that you are not allowing enough time between eating and giving your food time to digest, and going to bed. I know that if I eat later than 8pm I sleep badly, and that's when I go to bed around 11pm.

Re the time difference- surely all that happens is you will miss or double up on one dose until you get into the new time zone?

[HormonalHeap]

I don't think my lining can be that thin as I still have the odd period! It could explain my bloating though.. think she wanted to keep the mirena for contraception but I'm going to ask her to take it out. To be honest though, I don't like being dictated by the pill by what time I have to eat, eg on holiday one tends to eat later. Hardly drink at all as just seems to give me a headache now. Thanks again for your advice.

[PollyPerky]

The Mirena plus Utrogestan is 'overkill'. You don't need both and tbh it's a bit shocking you have been given both. I can't quite get my head round why a dr would would prescribe a powerful hormone like Utrogestan for sleep issues? Has she suggested 'sleep hygiene' and self help measures re. sleep? Utrogestan doesn't help everyone with sleep anyway; the first couple of nights or more that I use it I tend to feel very hot and am restless. It makes no difference to me being able to sleep longer or more deeply.
Just for information, atrophy of the endometrium can show itself as spotting- I've read about this on other forums. The lining becomes so thin it can bleed. Doubt you have this if you've not been on Utro very long, but worth knowing about anyway!

[HormonalHeap]

It is definitely worth knowing about, thank you. She's a consultant gynae specialising in the menopause. I don't think it was her intention to leave me permanently on both,

As for self help measures, we all react in our own way to symptoms of menopause, and my own sleep deprivation was/is so severe that it's way beyond self help.