HRT with less progestogen?

[Branleuse]

I still have periods but am in peri. Ive been on elleste duet now for 3 or 4 months and mostly its been great, especially when im on the oestogen white pills, but more and more im finding that when im on the progestogen green pills, I feel angry and cross with the world.
Id still say im better than I was before HRT, by quite a long way, but there is nearly 2 weeks of these green pills and its just so long to feel like I have PMT for. I feel like im snapping at the children, snapping at my dp.
Has anyone had the same and found a better one, or is this as good as it gets? As I said, id still say that im better than pre-HRT, as at least I can "think" again, and brainfog gone, but I feel so normal on the oestrogen and just crappy on the progestogen

You can't use less progestogen unless you were to be monitored under a private consultant (a few GPs might be happy to help you) and do 'long cycle' HRT. This is where you take the progestogens at less frequent intervals. This might be a 6 week cycle rather than 4 weeks.

What you can do though is try a different type of HRT.

emoston has a different progestogen which some women find better, or you could swap to two separate hormones- estrogen as a pill, patch or gel, and micronised progesterone.

*emoston= Femoston

thats interesting and helpful, thanks. I will try and go back to my doctor and discuss it. I really want to get this sorted out, as the oestrogen part of the HRT so far has been more helpful than any antidepressant ive tried, and yet that second half of the month it all starts to fall apart again. I do seem to be really sensitive to hormones in general

Bran, I am having this problem too. I don't think my body likes the progesterone part of the cycle. It makes me feel depressed and I cannot function. I feel like the world is going to end. I am going to try and take my progesterone (Utrogeston) vaginally as advised by many women on it on another site as apparently it bypasses your liver and is not metabolised possibly resulting in less symptoms and failing this I am considering a Mirena coil.

I'm wondering the same.

I am only 2 months into HRT and the first month I had Evorel 50 patches only to see if they resolved my main issues - and they did! So then the plan was to see how to introduce progesterone as I'd had a bad time with a Mirena a few years ago and worried I'd be intolerant.

200mg Utrogestan orally by day 5 I was shouting at the neighbours through the wall for having a pizza delivery over my garden fence again and next day I went out without my phone, then the next day without my purse and generally back to feeling grotty, tearful, anxious and not sleeping well.

I've used them vaginally for the past 4 days and I don't feel so rage-y or anxious now but the chalky mess in my undies isn't cool and I don't think I can look forward to doing this for 12 days of every month for the next 10 years.

I'm wondering if as I seem to have tolerated the Utro better vaginally I might be ok with the Mirena too- although I know they are different hormones.

Has anyone done this after having a bad time Mirena before? The GP I see (menopause specialist at £85 a pop as my own GP refused to treat me at all..) says I may have reacted badly to the mirena as my oestrogen was already dropping when I had it.

orangefoot, that is interesting about the effects dropping after using it vaginally. I got zero sleep last night (and I mean zero) even though progesterone is meant to make yo sleep like a log. Now that my anxiety and depression switch has been flipped it seriously affects my sleep.

I took the Utrogeston vaginally last night even though it was day 11/12 on that. I'll take chalky pants over feeling terrible any time. I am giving it ago next cycle if I survive this one.

I’m on the evocol 50 combi patches

3 patches just oestrogen
4 patches oestrogen and progesterone combined

Seems fine
How much oestrogen and progesterone are you getting?

Sorry that should be 4 patches just oestrogen and then 4 patches combined. I change twice a week

Chalky pants- use a panty liner on those day?

I hate plasticy panty liners and I haven't used any disposable sanitary products for 15 years.

My daughters and I have decided that instead of just throwing our bloody or sticky or chalky undies in the washing basket, we'll put them in a shoe bag I found in a charity shop and we'll refer to the golden lettering on it as Gucky not Gucci.

This way we can tip the bag inside out into the machine and none of us has to touch them!

There are some panty liners that aren't plastic- Natracare.

Organic & natural. With organic cotton cover. Plastic, perfume and chlorine free. Nordic ecolabel. USDA certified biobased product - product 87%. Ethical Award - The Ethical Company Organisation. Vegetarian Society approved.Why natural liners?

Many gynaecologists have advised women with sensitive skin to use natracare panty liners to reduce their contact with chlorine bleaches, synthetics and superabsorbents made from petrochemicals. Natracare Curved pantyliners are soft, absorbent, and shaped for extraordinary comfort. Made with certified organic cotton and plant cellulose the liners allow your skin to breathe and stay dry. The pantyliners are totally chlorine free and do not contain any plastics, perfumes, dyes or fragrance making them kind to your skin and the environment.

The Curved pantyliner is over 99% biodegradable and compostable. The liners can be used daily as a protective liner, for extra protection when using tampons or when travelling.

My GP told me that it's recommended you take progesterone in the earlier stages - 2 years after you last had a period I think? Something about the uterus 'needing' a bleed. I'm on femoston conti now as I'm past that stage. I think you're right that my mood is more stable but i also get serious bloating. That could be Christmas though

My GP told me that it's recommended you take progesterone in the earlier stages - 2 years after you last had a period I think?

No. If that really is what your GP said they are very wrong.

Progesterone has to be taken along with estrogen for anyone with a uterus, for as long as you use HRT.

@NOtfinished

You will find that Femoston conti contains both hormones in one tablet. Have a read of the ingredients on the pack :)

Maybe you are confusing sequential and continuous regimes of HRT.

I had real problems with the progesterone in Femostan. Saw a consultant privately who changed me to estrogel with vaginal progesterone only for 12 days every other month. Absolutely wonderful. I’m at the same stage as you- peri with periods. No way would go back to oral tablet Hrt.

@Victoriapestis do you have to see the consultant regularly?

Oestrogel and Utrogestan are available on the NHS.

The use of Utrogestan vaginally is not licensed in the UK but the actual oral product is the same.

There is a 200mgs capsule which is for vaginal use for fertility (you could get this from a private consultant as part of HRT) but most women use the 100mgs capsule- either orally or vaginally.

Obviously your GP won't say it's for vaginal use, but they can't stop you using it that way.

The vaginal dose is 2 capsules- same as oral. 200mgs each day.

Hi peridot I’m going to try to go every 6 months. He also prescribed me testosterone and I want to keep that up. One pump seems to last that long. I felt extravagant doing it but he was hugely resssuring and I’m glad I did.

After reading all the risks about uterine cancers and then also about the Pill being ok to take continuously with the break only created to make women feel 'normal' by bleeding I am wondering if the progesterone part of HRT is really worth the grief it's giving me.

I don't understand.
Progesterone is necessary with HRT to prevent uterine cancer. It doesn't cause it.

@orangefoot. The Pill and HRT are totally different.

The Pill does not make the uterine lining thick. That's why there is only a light bleed with it.

Estrogen used in HRT makes the lining grow as if you were fertile.
Progestogen is to keep it in check- it makes the cells change from proliferative (growing) to secretory. Then when you stop it, the lining breaks down.

The stats show that for women who used to use estrogen-only HRT (decades ago mainly in the US), 20% would get uterine cancer in one year.