Supplements on top of HRT?

[SilkenTofu]

Since I am peri-menopausal and on HRT I have been advised that I am still going to be all over the shop at times as my own hormones will be going up against the HRT.

I have had a great few months but this and the last cycle have been hell. I think something is changing in my body as my periods are now further apart and lighter, but the PMS seems to have intensified. Either this or my body does not like the progesterone leg of my HRT cycle.

Anyway, I cannot cope with the peaks in anxiety I get anymore and am considering St. Johns Wort or 5-HTP. If I am in Holland and Barratt I may as well go the whole load. So....

What else are you taking/ is safe to take on top of HRT?

Rather than supplementing the HRT, can you get your doc to do a new blood draw and adjust what you're getting?

Best to talk to your pharmacist about what is safe. There could be some contraindications.

However, you'd be better off getting your HRT 'right' as the ups and downs should not be so extreme.

What type of HRT are you on?

If it's gel, you can increase up to 4 pumps a day.

If it's a patch you can have a one with more estrogen. The increase in symptoms is down to low estrogen.

You shouldn't need to add in other things.

But at the same time, you may need to think about lifestyle; lots online about what to eat / avoid that can make PMT worse ( such as sugar, refined carbs, caffeine) and really focus on cutting out anything refined, masses of fruit and veg and daily exercise.

I am on tablets, cyclical type but I have no periods on them and my gyn suggested that maybe I need more estrogen.
Actually I have no symptoms and feel good but he said that my estrogen is low. So he said that I can take red clover with my hrt for 3 months and see.
But I don’t think that it is a good idea and I will avoid it.
I think that if you give to your body more time it will finally adjust.

I am on 2 pumps of Estrogel a day and Utrogeston x 2 tablets from day 15-26. I am a bit inconsistent with the Estrogel and use it after a shower which can be morning, noon or night. I have 2 pumps of this and swipe one up the inside of one arm and one up the other.

TBH I don't know if I am using this properly or absorbing it properly. I am going to start and insert the Utrogeston vaginally to see if that makes a difference. Last night I used 3 pumps of the gel to see if that makes a difference. I am wondering if I am applying it properly.

TBH I have seen a meno specialist twice but don't feel I have a lot of info. I did ask her if I should up the gel when I feel bad and she said no as it would make me feel pregnant. I am 49, peri-menopausal and have a regular cycle which fluctuates not by days but by length of flow. I went for HRT as I was flooding badly and having really bad PMS, terrible anxiety and feeling depressed.

Do I need to ask my Meno GP if I can up it? I feel like I shouldn't mess with the dosage without her approval. She said no and if I ask her I am going to have to make another appointment which will take a few weeks and pay a lot of money.

Not sure that your 'specialist' is up to speed tbh!

The advice I was given by mine (one of top in UK) was that you increase the gel until it controls your symptoms.

The time you use the gel is not critical BUT the instructions in the box do talk about what to do if you miss a dose for more than 12 hours, so if you did use it in the morning then not till the evening of the following day, you've had an 18 hr gap.

Try to get into a routine. I apply one pump in the morning after a shower and one pump in late evening after a shower.

If you are still very much peri, HRT may not control your cycle or the amount of blood loss straight away.

It will take time to re-set and override your own cycles.

But you need to be consistent. Increase the gel to 3 pumps (or at least use two and use them at regular times.) If you do go to 3 pumps, give it a few weeks to see if it helps.

Using the Utrogestan vaginally may well help and reduce the PMT side effects of that.

You don't need to ask your dr about upping the gel unless there is something in your medical history that would make is unwise.

TBH I don't like the sound of your specialist! If every woman would feel 'pregnant' on more than 2 pumps, why would the instructions say the dose can be up to 4?

What I don't understand is you say your periods are further apart and lighter.

On a cyclical regime of HRT which you are doing, are you not getting a regular withdrawal bleed at the end of the Utrogestan phase? (About 3 days after the last one?)

My natural cycle has always been between 21 and 24 days. I started taking the Utrogeston on day 19 and more lately on day 25. By the time I get to between days 22 and 24 I have usually started my period and I still have the Utrogeston to take for a few days. My periods are still very regular but became much longer and heavier and now seem to have gone a bit further apart and lighter.

No wonder I am feeling shite eh?

Jingling

Can I just ask why you do one pump in the morning and one at night? Do you think that is better than 2 in one go? I am concerned that I am not absorbing the Estrogel as well as I could.

Did your dr tell you when to use Utrogestan?

It seems slightly weird the way you're timing it (sorry!)

Normally, there are 2 ways:

1 On the first day of each calendar month (so it sets a cycle.)
2 In the middle of a cycle (ie the latter half as would happen with a natural fertile cycle.) That's why is says day 15 x 12 days.

Your timing doesn't fit with either. If you own cycles are very short, then midway would be around day 12 (half way of a 24 day cycle.)

The aim of Utrogestan is to thin the lining/ stop it overgrowing with the added estrogen.

If you are taking it while you are bleeding with your own period, it's not really working in an HRT 'cycle'.

If you still have regular cycles you should take it in the middle- so roughly 12 days after the first day of your period.

If you are not having a period each month, you can try to re-set your cycles by choosing any day of the month and always starting the utro on that day. ie - the 1st, the 10th...etc.

As you are in peri you might get your own light period as well as the withdrawal bleed, occasionally.

Really, all this should have been explained by your dr! What are you paying for if they aren't communicating?

The reason I split my dose is a) I find it dries easily b) initially when I increased to 2 pumps from 1, I did feel slightly nauseous. This was very early days- I've been using it now for 11 years.

However, when I increased to 3 pumps (this was ages ago and only for a while) I didn't feel nauseous at all.

I don't know about HRT but I do know that St John's wort is a bugger for j tera ting with a lot of medication and other supplements. It's really potent, I'd double check you can take it when on HRT.

j tera ting - interacting