Oestrogen and Progesterone or progesterone only?

[swingofthings]

I've been in perimenopause as confirmed by blood tests for over 2 years. During that time, my health has gradually deteriorated to the point of really struggling to continue working and participating in normal activities. Most of my symptoms are not the usual ones experienced by most during that time. No hot flushes, no real night sweat, no vaginal dryness, no mood swings. My main issue is a crushing fatigue, lightheadeness, tinnitus, buzzing, pins and needles etc...

I've been to the GP a number of times and got a number of blood tests done and MRI, but all came normal. Vit B12, thyroid, iron levels, brain scan clear and my GP has put it down to the perimenopause.

I started hrt 2 1/2 weeks ago, on 50mg patch and I have never felt so badly. In addition to an increase of the above symptoms, especially pins and needles, I suddenly started to suffer from painful muscle aches all over, which I've never experience before. It's been very distressing. However, four days ago, I started with Utrogestan and suddenly the symptoms have significantly reduced, I've slept better than I've had in months and feel so much better. It's made me think and remembered that the only few months I have been feeling almost myself in the last 2 years has been when I know 've ovulated (can feel it), that is 4 times.

I've tried to read about it but haven't found much. Is it possible to be mainly affected by the lack of progesterone rather than Oestrogen? If so, could I consider stopping the patch (now cut in half) and only take progesterone? If so, would I have to switch to 'natural' progesterone?

So confused and when I asked my GP, he actually told me to come here!

No. To your question.

HRT is wonderful but it doesn't work in hours :) or 2.5 weeks.

Give it time. Your GP ought to have said you need to allow 3 months (though you ought to feel some difference before then.)

Utrogestan is known to be sedating- that's the downside. After 12 days on it I could sleep for England! Some women hate it for that reason.

If the patch doesn't suit you, and it may all settle down, you could swap to estrogen gel which is the same type of estrogen but in a gel which you can use as much of or as little of to control your symptoms (within the 1 to 4 pumps a day dose.)

Thanks Polly I do understand this (I think :)), it just that unlike most perimenopausal women (from what I gathered), I seem to do so much better with progesterone.

I do plan on continuing with the patch but is it normal to feel not better but much worse on it to start with? I wasn't expecting an instant cure of my symptoms but I also didn't expect to feel so poorly on it. I don't think I could bare it for another few weeks late alone months.

I think my question was whether some women do fine on progesterone only.

You really can't make a judgement on using Utrogestan for 4 days. :)

I have used it for 6 years. Some cycles I feel fine on it, others it makes me hot and restless at night for a few days, other times I sleep like a log on it.

Also, you can't have 'progesterone only' . That's not HRT and it's not possible to prescribe it on its own.

I dont know why you feel worse on the patch but one thing to consider is it's a relatively high dose (medium dose) to start with. You could have had a 37mcg patch. You could try cutting it in half and seeing how that goes for a few weeks.

Thanks Polly. I know it sounds like I'm jumping to conclusions, but that's because I have been so unwell for so long, and the last 5 months have really been a case of surviving on a day to day basis. What makes it so hard is not just the symptoms themselves although they are horrible, but that I just don't know what is causing them. For me, just knowing that they are all down to the menopause and that I just needed to be patient would be a relief but because my symptoms are not atypical, it's still only a possibility. As it is, I can only go through elimination and when I get a week that I get a glimpse of feeling better and then crash back to not knowing if I'll be able to get to work, it's totally disheartening, so yes, I am very desperate which is leading me to build as much information as I can to try to make sense of what is happening to me. That and the fact that I'm fascinated by medicine anyway, wish I'd gone to medical school!

This site is great (and indeed, as said my GP recommended to come here for info) and your support is invaluable. I do take what your advice and will just wait and somehow, once again, hope that the future is brighter and that hrt is going to finally help me.

Can I ask though, again, for information, why progesterone can't be taken alone when oestrogen can be and from what I understand, progesterone is mainly prescribed to counteract the negatives of the oestrogen rather than as a beneficial hormone alone.

from what I understand, progesterone is mainly prescribed to counteract the negatives of the oestrogen rather than as a beneficial hormone alone.

No. There is a bit of a Chinese whispers thing going on I think via forums where information gets muddled :)

Estrogen has no negatives if it's the right dose and the right type. It's the feel good hormone. Meno symptoms are caused by loss of it.

Progesterone is added to HRT in women who still have a uterus. It's needed to stop the uterus lining overgrowing when it's stimulated by estrogen. Without it, 20% of women would get hyperplasia in 12 months. That's a thickened lining. This can develop into cancer.

Progesterone changes the effect on the lining when you take it. It blocks the effect of estrogen. If you take it for part of each cycle, the lining is shed a few days after the last dose.

You can also take it continuously- 'no bleed HRT'.

You do not normally have progesterone in your body anyway- only after ovulation, for around 10-12 days a month. Post meno we have none.

If you use progesterone only post meno, (which no one would anyway) you can get something called an atrophic endometrium. This is when the lining gets very thin and atrophied, and can bleed. Women who have the wrong balance of HRT- to little estrogen to the amount of progrogesterone used- can get this too and have odd bleeding.

Hope this helps explain it and you feel better soon!

Hi, I know this is an old thread but am intrigued to know how you got on. Your symptoms sound very similar to mine and am considering HRT options. In particular the tinnitus. Did you start to feel better OP? X x