HRT - Breasts suddenly swollen, etc

[Nightfury1]

Hi, I'm new here and new to HRT!
I'm 34 and started taking 2 pumps of Oestragel in the morning on the thighs and 1x 100mg of Utrogestan nightly. My breasts were slightly tender but over the last two weeks, they have significantly increased in size and are very swollen, hard, tender and painful. My weight is suddenly increasing too and I feel quite tired and down. I also have water retention. Will these symptoms fade out over time as I settle? Is two pumps of the gel too much or do I need to increase the Utrogestsn dosage? When I first started taking it, I felt great, full of energy, thought it was the best thing and now I feel the opposite (This could be because I'm PMS). However, people say I look great in the face! One positive is my libido has returned! I'm feeling really down about the other symptoms I've mentioned above and tempted to come off it despite some of the benefits.

P.s. I forgot to mention that I'm on them continuously without a break.

stupid question... no chance you're preggers? My cousin thought she had early menopause, was being formally investigated. 5 months later she had a baby.

I'm definitely not preggers, for sure! I'm out of action! Lots of my friends ask me this when I describe my symptoms! :D

Are you under a consultant- assume so as you have POF/POI ( premature ovarian failure.)
If so, you should ask them.

Not sure why you are using a continuous regime-which is usually for women post menopause ( age 54 or no period for 12 months.)

Younger women who have some ovarian function usually use HRT on sequential- ie following a 28 day cycle.

You'd then use Utrogestan for only 10-12 days a month.
This would lessen the side effects. 2 pumps of gel is the average and would normally be higher in someone your age if you are POI.

Can't really help much more until you say what stage of peri or meno you're at, but you need to talk to your specialist.

Hello PollyPerky,

Thank you for your response and information :)

It's quite complicated, the Gyno at the hospital was seeing me for something else smear test and bleeding and asked me a few questions which led me to tell her that I suffer from premature menopause. She suggested I try HRT (so many hospital staff in the past have told me but I was too afraid). She said that I would feel more energetic and I am not at risk of the major side effects because I am under 50. Also, she did mention I could gain 1kg in water retention plus tender breasts. Seeing as she isn't my main Gyno for HRT, it's not so simple to see her for advice but I have a follow-up appointment in two months time for the original procedure when I can ask her additional questions. But, I often find medical staff are biased and have not experienced the actual effects of taking HRT. My doctor, as wonderful as he is, does possess the in-depth knowledge required.

I was originally diagnosed with premature ovarian failure when I was in my early twenties when I would have a period twice a year. My last period was two years ago and before that, there was a four-year gap. My gyno asked me if I wanted to have a period and I didn't see the point, so I said no. So, she prescribed me on a continuous cycle. She also opted for the low dosage and a more natural route.

If I chose the sequential option, wouldn't the oestrogen build up and cause me more side-effects? Also, at present, I'm not sure if two pumps of the gel is too much! I've reduced it to one pump, but I'm not sure if that is a wise choice to make. Prior to taking HRT, I never suffered any of the major menopause effects, only non-existent libido, tiredness and low bone mass. I was and still taking Alendronic tablets for the bone problem.

It's worth mentioning, my breasts are suddenly lumpy and painful, feel like fibrocystic lumps and I am waiting for a scan appointment- not too worried about it, because it's very sudden and I've only been on HRT for three months (breast cancer doesn't run in the family either).

Thank You :)

So do you already have osteopenia/ osteoporosis- if you are using Aledronic ?
If so, the minimum dose for oestrogen to build bone is 2 pumps of gel.

You definitely need oestrogen at your age. Do you know how low your bone density is now? It's not just for your bones but also for your heart.

You are not at risk using HRT at 34- your are replacing what should be there will age 52.
I don't know why your dr said you'd retain fluid. It's a bit of a nonsense. I've used gel and Utrogestan for years and never gained fluid. If you do, through the Utrogestan, it's similar to PMS symptoms. The only way to prevent it is to use it less- sequentially.

Oestrogen won't build up - you're still using the same amount. But you would have a period each month. The reason for using Utrogestan daily is to stop the uterus lining growing at all - so ne period.

Any side effects should ease soon.

Have you heard of the Daisy Network? It's a charity for women with POF run by consultants. I don't know where you live but some of the best consultants for POF work at the Chelsea & Westminster, London - any chance you could get a referral to the clinic there?

Thank you so much for replying :)

Until the age of 32, I spent all those years being ignorant to feel like a normal person - I didn't suffer from any of the meno symptoms, only those mentioned in my previous response, therefore I didn't start taking Alendronic until I was 32. The reason I found out I was suffering from Premature Menopause is because my periods were becoming non-existent. My scan revealed a very thin bone mass in my hip area. If I am sure he also said something along the lines of a 70-year-old! I was shocked, despite not experiencing any bone problems. That is when my doctor prescribed me those tablets. Fast forward to September 2016, my gyno was shocked and concerned and explained my low-risk effect, hence choosing to go on HRT. So, to answer your question, in short, I don't currently have Osteoporosis yet, but, if I am not careful, I will suffer from it.

I am currently suffering from PMS and I get it worse than when I wasn't on HRT. During normal days, I constantly feel like I am going through an experience of mild PMS. With that said, if I do choose the sequential option, I will definitely experience less of the symptoms/side-effects I mentioned in my post? I would happily change my cycle for this reaon! I think I will go back to 2 pumps!

I really hope the side-effects subside, the large painful breasts are the worse and I was already large to start with. The weight is annoying, I'm naturally slim, so my clothes feel tight! Also, I use to be happy and now I feel moody and a bit depressed! I'm really not use to all this!

May I ask if you gained any weight or enlarged breasts?

I have heard of the Daisy network many years ago but chose to be ignorant - I know, bad choice. However, I will look into it, thank you for reminding me. I'll also see if I can have better contact with my gyno, so she can be in charge of my HRT journey, failing that, I will look into the Westminster area :)

Thank you so much :)

It sounds as if your consultants aren't talking to each other and there is no joined up thinking about your care. :(

Are you seeing a rheumatologist and a gynae - or 'just' GPs?

There is controversy about the use of Alendronic . Some drs won't use it for young women who only have osteopenia (and not established osteoporosis.) They'd prefer lifestyle changes and HRT to begin with. There is also (sometimes) a time limit on the use of that drug ( 2-5 years) due to possible side effects. These are all issues you need to discuss with the consultant. You also need a bone scan every 2 years to check if it's working.

The side effects from HRT are common and should tail off if you carry on. But it's the progesterone that can cause PMS not the oestrogen. (Think of a natural cycle.) You might want to try changing to a cycle which is also usually used for younger women anyway. Or you could have a Mirena coil plus the gel. maybe you should reduce the gel to 1 pump for a month and see if that helps then gradually go back to 2 pumps.

No, I've not gained weight or grown huge boobs!

Hi Polly,

Sorry for the delayed reply, I've been doing lots of research but it's all so conflicting!

My gyno was treating me for something else and suggested I try HRT and prescribed it to me, I'm due to see her again for the original procedure in April, after that I will be discharged. It's worrying because my GP is, well, a general practitioner and doesn't have the required depth of knowledge. He was against the idea of me going on HRT and that's why he suggested Alendronic. I rarely had any Menopausal symptoms, just low bone density, low libido and absent periods. My weight was perfect and metabolism was fast. I lost weight easily.

Since starting HRT, I've gained 3kg, but I think that is due to water retention and enlarged breasts ( I look so out of proportion). I am exercising a lot and should be underweight! I would've lost 3kg in a week!

The PMS symptoms aren't so bad. My only concern is the water retention/weight gain and enlarged breasts. I'm trying to figure out if it's the ostrogel or utrogestan (100mg) that is causing it. Because if I go sequentially, I will suffer from estrogen dominance and even more weight and bigger boobs! Plus, I'm always hungry, non-stop and I am controlling my eating. So, I spend most of my time feeling hungry- I eat healthily too.

Everything else is good, my mood is amazing, I sleep well. But, I am considering coming off it if I can't go back to my normal breast size. If it weren't for that, the HRT would be perfect and the other side effects are bearable most of the time.