Some advice please.

[TheGingerTree]

Have been on Estradot 25mg and seperate Utrogestan for 5 weeks.

Been quite up and down with it. Especially down during my withdrawl bleed 3 weeks ago. But for the last 2 weeks have felt great on just the patch. Sleep really good again. No low mood or anxiety etc.

Finally saw my GP yesterday. She said my patch was too low a dose. She would prefer me on 50mg. Said 25mg would really help much with my symptoms. But it was a very qiuck appointment and I was whisked out of there without her actually giving me a new script for the higher dose patch.

I also mentioned about my mood dipping last time, and wanting to avoid it this time as it will be just before we go on holiday. She just told me to stop taking the Utrogestan (had already taken it for 3 days) and just start it again when we came back.

But last night my mood dipped, and I had dreadful insomnia. Feel anxious and uptight again today. Was like this last month on the Utro phase, though it settled down after the first 5 days or so.

Not sure what to do about higher dose patch. As a temp measure I am wearing two 25mg patches until see my GP next week to ask for his advice and possibly a script.

But will this higher dose alleviate my symptoms over the next few days? And I don't know whether to stay off the Utro until after our holiday? Very confused.

Sorry, meat to say saw my CONSULTANT yesterday. Not my GP.

And she said 25mg WOULDN'T help much for my symptoms. Sorry about typos, am on my phone.

sounds like good advice to me.
25mgs is a tiny amount- well, it's the equivalent to 1mg in a pill, and maybe that is not enough for you.
If you have been advised to stay off the Utro then do that- you have nothing to lose and plenty of women use long cycle HRT anyway- up to 12 weeks- so it's not going to hurt you having a longer cycle as a one-off.

I think you need to try to stop worrying and monitoring every mood change so much because most people have a few moods now and then as well as the odd sleepless night. They might be down to the HRT or they might not be!

I don't feel great on utro but to be honest I just suck it up because I know for me it's just 10 days in every 7-8 weeks and it will pass.

Thanks pinkfrocks. The previous two times I saw my consultant she only spoke in terms of a 50mg patch. But I assume my GP started me on it a few weeks ago because it's policy to always start you on the lowest dose?

I do know that I tend to panic and over analyse every new twinge and I wish I didn't. It's just that when my mood dips it's not just 'feeling fed up' it's really horrible. More like despair. So it's very hard not to panic.

But I have actually just had nearly 2 weeks of feeling perfectly fine. But that was during the first half of my cycle, when I have usually felt much better anyway since all this peri menopause hassle started.

In fact it was the best 2 weeks I have had in a long time. I'm wondering if that's because I was having extra oestrogen from my patch? But now I'm into my second half 25mg just isn't strong enough?

I also want to know that if I don't take anymore Utro this month, will my hormones still give me PMS symptoms and still give me a period?

These are all things I wanted to ask my consultant yesterday, but I was in and out within seconds

I also want to know that if I don't take anymore Utro this month, will my hormones still give me PMS symptoms and still give me a period?

If you are peri then it's impossible to say- you might or you might not. Not predictable.

The reason you need more oestrogen (via HRT) when you are younger is that you'd normally have high levels compared to someone older (on their early 50s) for example. But everyone is different and their natural levels will be different.

Thanks pink. I will pack plenty of protection for the holiday just in case, although if my body does keep to my normal cycle then hopefully if I have a period it will come and go just before we fly.

Honestly, I wish I could just have the whole lot removed with a hysterectomy.

Just to let you know, after putting the extra patch on yesterday lunchtime I started to feel better by tea time. By bedtime I felt quite good and slept well. Woke up this morning feeling 95% normal again.

So I assume this demonstrates that I do need a 50mg patch to control my symptoms rather than just 25mg?

The GingerTree - as pinkfrocks says if you are peri-menopausal you cannot prevent your own cycle of hormones - the dose of oestrogen in HRT just isn't enough for that. You are asking the impossible.

If you can tolerate synthetic progestogens then the only way you can do prevent your cycle breaking through iso to use a contraceptive pill - there is one called Qlaira which contains estradiol (ie bioidentical oestrogen) but a synthetic progestogen (for 22 days) which can itself cause side effects. This suppresses the natural cycle, and there are only 2 tablet free days so may well prevent the dip that occurs with the conventional pill. You may find someone in your position on the main boards who has tried it?

Here is some information
www.netdoctor.co.uk/sex-and-relationships/medicines/qlaira.html

Otherwise you should expect still to have dips in mood despite taking HRT, while you are still peri-menopausal. The problem with dosage is that during normal ovulation the oestrogen leves can be quite high and sometimes adding a med dose patch to this may be too high (not sure what the symptoms of this would feel like). Whatever happnes the constant oesrtrogen dose will prevent the extreme dips in modd you would have experienced without it - so try to think of that!!

Thank you bellacio.

My GP did mention taking the Pill as an alternative, and I would happily do it if it evens out my mood during the whole month.

If I feel that the higher dosage of oestrogen patch isn't doing the job after a few months then I will certainly talk to my GP about it.

Basically I am prepared to do anything to stop these extreme lows that creep up on me out of nowhere. Because they don't just make me feel very fed up. They're a whole other ball game. I feel so low and despairing that it quite frightens me.