Starting HRT

[omgmumma]

I have been given HRT - oestrodose gel and utrogestan 100mg tablets. I'm a bit nervous and confused about starting as doctor didn't give much advice.

So gel says 'one measure twice daily'. So should I take it morning and evening? (It seems like most people take 2 pumps in the evening?)

And tablets say 'take 200mg (2 capsules) orally for 12 days at night (cyclical)'. At what point do I start the tablets? Can I start those at any time? Or should I wait a couple of weeks. Will I bleed during these 12 days?

(My periods are fairly erratic and last one ended 2 weeks ago.)

Is the cycle suppose to be 28 days? So 16 days with just gel and 12 days with gel and tablets?

Hope someone can help me out here!!

Sorry you haven't had much explanation. Can you go back and ask for more advise? Two gel pumps is usually a fair starting point. I do my two. In the morning. As for urogestsan I think I took mine before bed from day 1 of the month to day 12. I'm not on that anymore do hopefully someone else can help. Why were you put on hrt, do you feel you need it?

So gel says 'one measure twice daily'. So should I take it morning and evening? (It seems like most people take 2 pumps in the evening?)

Is this your dr's advice? You can apply it whenever it suits you.You can use 2 pumps at the same time (one to either upper arm or inner thigh) or you can do 1 pump am and 1 pump pm. Bear in mind you cannot swim, shower or bathe within an hour of applying.

You use gel EVERY day- 365 days a year.

Utrogestan- you can start any time. If you are having periods still it's a good idea to start it mid cycle. Otherwise, choose the same day each month- ie 1st June then 1st July.
You will have a withdrawal bleed 3 days after the 12th capsule.

There is a lot on information on the leaflets in the packs of utrogestan and gel- maybe you will find this info there too?

I think you need to go back and speak to your doctor or pharmacist who can advise you appropriately

@PeriMisabastard

I think you need to go back and speak to your doctor or pharmacist who can advise you appropriately

A pharmacist will simply read the info on the patient leaflet in the packs. The OP has been given the right info already other than when to start Utrogestan.

@omgmumma Go to the website of Dr Louise Newson and on the menu choose Resources- there is a fact sheet on using Oestrogel and Utrogestan if you are still unsure.

(I've used both for over 12 years.)

@omgmumma.. hi, I was about to post exactly the same thing as you! I was prescribed exactly the same as you 2 months ago..I read the leaflets and immediately chucked the lot into the back of the cupboard! Since then my symptoms have got gradually worse and I got it all out of the cupboard again yesterday and applied the gel last night..2 pumps. I then spent most of the night feeling like I'd taken drugs. I couldn't sleep, felt itchy all over and had a headache. I'm in bed now feeling like I've been hit by a truck! Like you I have no idea when to take the tablets. I started my period yesterday. All along I have asked for the coil to stop the period but they say no they're not doing coils! I'm at my it's end!
I hope the HRT works for you. I'll keep watching this thread.. good luck x

Wit's end, not it's!

Thanks for your replies!
@iminthegarden - I started this morning with one pump - but I may well do both at the same time else it's just another thing to forget! I've been put on it for bad headaches, night sweats, insomnia and dizziness. So hoping it will sort me out!

@JinglingHellsBells - thanks - that's helpful - exactly what I needed to know! I read the leaflets but there wasn't anything about when to start. But I guess I'll pick an easy date to remember and make myself some kind of reminders! And thanks for the Louise Newson tip - I'll check it out.

@BooseysMom - I'm the same! I've had this in a cupboard for 6 months - too scared to get started. I'd think about it - read the leaflets then get put off again and hide it away. But after another night wide awake at 4am and feeling another headache come on, I thought it was worth a try - so took my first pump today!! Hopefully it will work for you - fingers crossed this will be the answer!

@omgmumma.. thanks for your reply. I'm not good at all today after the night from hell. Phoned the gp and she suggested dropping dose to 1 pump and still do it before bed or early evening. How are you feeling after your first pump?! I think if's funny the fact we just thought, right, it's now or never!! We can be HRT buddies

@BooseysMom - Ha ha- I'm sure there are more of us out there scared to take the plunge! I feel ok on one squirt - well no different from normal. Hope you can stick with it and make it work for you.

I have just started the same. My doctors instructions were:

Start oestrodose gel straight away (one or two pumps rubbed into arm or leg after a bath if shower once a day) every day of the month.

(I started this immediately on collecting my prescription which was the middle of the month)

Then in the 1st of the month I will start taking the utrogestan tablets (1 in the evening because sometimes they cause nausea and it's best to be asleep) I will take these from 1st - 14th of each month. (Roughly 14 days on 14 -16 days off each month)

She said she would not like me to use the oestrodose gel longer than 14 days before starting the utrogestan (something to do with the womb lining thickening...)

After stopping my first 14 day cycle of utrogestan I will expect a breakthrough bleed.

Hope this helps you and you start feeling better soon. I've not noticed any change after a week of oestrodose gel yet but it's still very early days.

@sunnyblackwidow Are you sure your Dr didn't mean take 2 capsules? On the regime where it's 12 days per cycle, the dose is 200mgs.

@sunnyblackwidow

Copied from the patient leaflet.

*

For women receiving hormone
replacement therapy in conjunction
with oestrogen with an intact uterus
(womb), the usual dose is 200
mg/day at bedtime on days 15 to
26 of your cycle.

You will usually
have a few days withdrawal
bleeding (like a period) after this
time. Alternatively 100 mg can be
given at bedtime, from days 1 to 25
of each cycle, withdrawal bleeding
being less with this. [that's for women post menopause rather than in peri]

@JinglingHellsBells I've just read the instructions on the box and you are correct it's two capsules not one :-) (I'm only planning to start on 1st June, so I hadn't gotten that far yet)
Thank you

I started HRT a month ago and its been brilliant so far. Sleeping better, no hot flushes , ever so slightly less irritated (that could only be improved if i moved into a beachside condo on my own with no dogs, kids or husband 😂😂). I had the Mirina Coil fitted and have the patch which i change every sunday and thursday. There are lots of options and combinations available to you so i would go back if what has been described feels daunting etc. Xx

• prescribed not described!

Thanks @sunnyblackwidow and @Jonjojobs123 - all very helpful.

I'm 2 days in now - nothing to report. But feeling more confident about how to take it. Fingers crossed it sorts me out!

@omgmumma.. thanks I'm on day 3 of the gel and I'm still waking at night with sweating. It's early days though. Hope you're feeling ok.

@Jonjojobs123.. your experience gives me hope

@sunnyblackwidow.. Good to read your experiences. It's early days for me too and I haven't seen any changes yet either. I really didnt want HRT but was so bad this month that I was willing to take anything and everything to feel better!

I think how you are treated by the GP greatly effects the process. First GP i saw completely dismissed peri menopause as i was 'too young' and I should 'try and deal with it using alternative methods' before i ended contemplated HRT. Next GP said ok tell me all your symptoms, reeled them off and she was like yep definitely PM. Heres your options and let me tell you HRT is like a wonder drug, we get it right and you'll be feeling brilliant in 2 weeks!

omgmumma I was prescribed HRT yesterday by my GP – HURRAH! – and like you have been given oestrogel and utrogestan 100mg tablets. As per the advice JinglingHellsBells posted, I have to start the tablets x 2 on the 15th day of applying the gel, then stop on the 26th (while still applying the gel every day). Then carry on like that going forward - 15 days of gel, gel and tabs together, another 15 days of gel etc etc. I do think you should double check with your GP though before starting.

I had my first pump of gel this morning after a lengthy bit of consultations, blood
Pressure checks and a couple of
Blood tests. My symptom list has been length but the biggest for me is upper body aches and pains and night, flushing, hair loss, mental fog and a general lack of vavavoom.

How long before we notice a change?!

So many typos - sorry.

[quote JinglingHellsBells]@sunnyblackwidow

Copied from the patient leaflet.

*

For women receiving hormone
replacement therapy in conjunction
with oestrogen with an intact uterus
(womb), the usual dose is 200
mg/day at bedtime on days 15 to
26 of your cycle.

You will usually
have a few days withdrawal
bleeding (like a period) after this
time. Alternatively 100 mg can be
given at bedtime, from days 1 to 25
of each cycle, withdrawal bleeding
being less with this. [that's for women post menopause rather than in peri][/quote]
My GP said I could do either method for the tablets but here it says post menopausal women... do you think it matters? It sounded simpler to take one a day 25 days a month!

i had my first pump of gel this morning after a lengthy bit of consultations, blood
Pressure checks and a couple of
Blood tests

This is most bizarre as I have been prescribed exactly the same without having blood tests and BP check. I'm 49. I was prescribed it over the phone!

I started the gel on Thursday eve and will start the tablets on Tuesday so it's always first of the month, felt easier that way. Put the gel on night one and then spent the first hour paranoid if I slept on my arm would I rub it off ??!? And also a lot seems to come out for one pump so I put some on my arm and some on the inside of my leg. Does that sound ok?

MiniCooperLover I thought the same about the amount of gel there is to rub in, but I watched this on Dr Louise Newson's website and I've been rubbing into the tops of my arms as suggested.

www.newsonhealth.co.uk/resources/apply-hrt