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!!

Aaahh help.
I started the gel about a week ago thinking that my period was due imminently but it still hasn't started. I've also mixed up my dates and I'm
Nearly 13 days late. I've skipped a period about 3 times in the last year.

The question is, when do I start taking the progesterone?

Can i join the party please?

GP has prescribed Estradiol gel (1 pump at bedtime, but i can increase this to two if i feel i need to) and 100mg Utrogestan daily 25 days and 5 days off. I am however a little confused now! Im 46 but i think ive only actually had 3 periods in the last 10 months....

@McFarts

Can i join the party please?

GP has prescribed Estradiol gel (1 pump at bedtime, but i can increase this to two if i feel i need to) and 100mg Utrogestan daily 25 days and 5 days off. I am however a little confused now! Im 46 but i think ive only actually had 3 periods in the last 10 months....

what are you confused about?

If you are still in peri, it's usual to start hrt on a sequi regime ( monthly regime) but if you are almost post- menopause some drs suggest going straight into continuous. It's usually 25 days and 3 days off (working on a 28 day cycle.) That's to allow a withdrawal bleed after the 25th day if it's going to happen, but not all women do.

@BlackAlys

Aaahh help. I started the gel about a week ago thinking that my period was due imminently but it still hasn't started. I've also mixed up my dates and I'm Nearly 13 days late. I've skipped a period about 3 times in the last year.

The question is, when do I start taking the progesterone?

Forget about when you started the gel. The Utrogestan has to be taken for 12 days (200mcgs) every calendar month. You can't time it around your periods if you are having them now and then. Eventually, the HRT will be 'your cycle' so you need to establish a monthly pattern.

So when you have used the gel for 2 weeks, start the Utrogestan for 12 days and follow that next month.

eg 12 June, 12 July, 12 August. etc.

@McFarts

Can i join the party please?

GP has prescribed Estradiol gel (1 pump at bedtime, but i can increase this to two if i feel i need to) and 100mg Utrogestan daily 25 days and 5 days off. I am however a little confused now! Im 46 but i think ive only actually had 3 periods in the last 10 months....

Ahh got you! I was confused about why i was starting on 25 days when despite so few periods i dont think im post menopause. Also all the planning that others seem to have needed as to when to start taking the Utrogestan, my GP didnt mention anything, but i guess thats because it could be several month before i actually have a period.

Hi, How's everyone doing? I'm on the last couple of days of the Utrogesten pills and am using 1 pump of the gel and am on the 4th week. Happy to report all going well so far.The only symptoms I'm getting is very sore heavy breasts. I'm coming up to when the period starts and in the recent past these have been debilitating so I'm hoping this HRT sorts that. Has anyone had any positive experiences with periods being lessened with HRT?

@JinglingHellsBells Thank you

Hopeful bump

Hello all. I'm a couple of weeks into this (thanks @JinglingHellsBells I followed your recommendation for a dr...).

My question is: My sleep has gone to pot since taking Oestrogel and Utrogeston - I am waking every night at 3am without fail! (My insomnia before was a symptom but not the same as this). Should I up the Oestrogel to 2 pumps? Should I take it in the morning instead - would that help my sleep.

On the upside I do feel much less tired during the day now and have more energy.

@HelenHywater.. hi, I'm not the op and I don't think anyone's interested in this thread any more after my previous posts. Anyway I wanted to say i'm on the same hrt as you and keep waking up at 3am too! I always used to anyway. I started with 2 pumps of gel and had a really bad night so the gp said to reduce to 1 and I still wake up. The gp said to use at bed time and take the utrogesten last thing at night too.
I'm on my second month of it and I think I feel better, certainly not as low and depressed, but my physical symptoms aren't improved as i get a really annoying tingling sensation down below and ache all over every day.
It's good you feel you have more energy though. Its It's weird that everyone has different experiences on HRT.

Could I just ask, what tests do you have to do if you go on HRT? I mean blood, ultrasound, smears etc Which ones are extra important when on HRT?

I am thinking about asking my GP for it for hot flushes.

@MrsKypp.. I didn't have any tests. They didn't even do my bloods before prescribing HRT. I think it might be because of my age and the symptoms I have. I'm awake now after having a bad hot flush and the HRT doesn't seem to be helping.

They're meant to prescribe without tests @MrsKypp - if you present with symptoms. There's a link to the NICE guidelines somewhere here.

I didn't have a good experience with my GP who did all the tests (oestrogen levels mostly I think) and because I had very high levels and regular periods, he refused to prescribe me despite me having some symptoms of perimenopause and being 51.

I should have logged on at 3am @BooseysMom - I was awake too. Again.

@HelenHywater.. it's a never-ending nightmare, isn't it?! I feel horrendous today after about 2 hours sleep. How are you feeling?

starting to flag a little now @BooseysMom! Dragged myself out to a yoga class this morning.

I take my oestrogen in the morning (along with testosterone) and do have alot more energy now than a few weeks ago. I just wish my sleep was sorted.....

[quote BooseysMom]@MrsKypp.. I didn't have any tests. They didn't even do my bloods before prescribing HRT. I think it might be because of my age and the symptoms I have. I'm awake now after having a bad hot flush and the HRT doesn't seem to be helping.[/quote]
Hi BooseysMom

Thanks for your reply. I'm really sorry to hear your HRT isn't helping with the hot flushes. Could it be that you need to be on it for longer before the flushes improve? or the dose needs adjusting?

Hot flushes are horrible, it isn't just the burning heat is it, but also the feeling a couple of minutes before the heat comes out - my body feels unbearable. I now recognise that feeling as a pre-hot flush sign, but it is truly horrible.

I hope your hot flushes do improve

@HelenHywater

They're meant to prescribe without tests *@MrsKypp* - if you present with symptoms. There's a link to the NICE guidelines somewhere here.

I didn't have a good experience with my GP who did all the tests (oestrogen levels mostly I think) and because I had very high levels and regular periods, he refused to prescribe me despite me having some symptoms of perimenopause and being 51.

Hi HelenHywater

Thanks for your reply.

That's good to know about being prescribed just with symptoms rather than the 'right' levels for treatment (like thyroid where you need to be extremely hypothyroid till you get treatment).

Sorry to hear your GP was like that. Is it possible to visit someone else, like a different Dr at your practice or 2nd opinion?

I think a lot of women are post menopause at 51, so he was being ridiculous.

Good luck!!

Once you are on HRT, which checks / tests will a GP want to do?

Do they monitor anything?

I am soooo close to asking for HRT.

@HelenHywater.. you're good going to your yoga. I gave up exercising months ago as my energy levels were that low that I feel like I'm climbing Everest just walking upstairs! I can't understand why the gp won't check bloods when my 83 yo dad seems to be in there every week having his done!

I hope we're not in for another bad night..

@MrsKypp.. thank you. The thing is I only get them as bad as last night every now and then. I did think the HRT was helping generally. It's early days tho. I get an awful burning sensation down below too and have told the gp several times but get no response

[quote BooseysMom]@MrsKypp.. thank you. The thing is I only get them as bad as last night every now and then. I did think the HRT was helping generally. It's early days tho. I get an awful burning sensation down below too and have told the gp several times but get no response[/quote]
Are you happy with your GP apart from when they are like that with HRT? they don't sound particularly patient friendly.

Years ago I had a complete idiot GP who was as arrogant as hell and rude. He was a bigwig at the local hospital and maybe that went to his head. It was so frustrating and upsetting.

I changed practice and now have amazing doctors, it is a different one each time but from the people who work there permanently and I have felt well looked after by each of them. When I compare these ones with that arrogant piece of work, I can hardly imagine they are doing the same job (GPs).

I think a lot of Doctors are sexist against women. Either through their own attitudes or because so little research has been done on women's health for things that don't affect men (menopause, thyroid, endometriosis etc etc).

@MrsKypp.. to answer your question am I happy with my GP, well no, not really, but I am cynical re gps in general ever since asking one about whether I could take a certain medication whilst breast feeding and he has to google the answer ..then you hear the endless advice to not Google things! I find googling or asking on mumsnet far more useful than asking a gp.