HRT Headaches

[Middicat]

Hi, I would be very grateful if anyone can give me some advice please as I am abroad at the moment and possibly for the next few weeks in a country where English is not spoken much!

I started Estradiol Gel 2 pumps every night and Utrogestan 100mg oral nightly on days 1-25 of each 28 day cycle. I have found that I am now experiencing palpitations at night after the Utrogestan and headaches during the day. I had a period back in April but have not had one since - I have a long history of menstrual migraine and the headaches feel a bit like a mild migraine.

My question is could this be the Oestrogen? If it is should I cut the pump down to one a day or is it the Progesterone - what can I do before I get back to see my own GP please?

Hi there. This sounds like something you should discuss with the GP. Are you able to do an online consultation from where you are?

Would be very difficult to do from here unfortunately.

I had this when I started hrt too and it went away after 6 months eventually 😳

Eloisedublin - wow, 6 months you have some staying power there - don't think I could ride it would for 6 months though.

Estrodiol and Utrogestan combo was unsuitable for me. One of the reasons was that I had very frequent migraines when using this HRT, where as prior to using this HRT combo, I hadn't had a migraine for absolutely years.

I had several other side effects too and despite the above HRT combination being promoted as 'the best' it doesn't suit everyone.

You said it would be difficult to contact your GP, so it's not impossible. I think that the only way forward is for you to contact your GP.

To be honest, your GP is unlikely to be of much use unless they have trained in HRT and menopause. It's more a case of trial and error.

It's unlikely to be the estrogen. Most women find it's the progesterone that causes issues.

The usual side effects from Utrogestan tend to happen when you stop it- so the 3 day break. (By the way, there is no need for that break any more- have a look at the video on Dr Louise Newson's website on using it- it's a video by Dr Sarah Ball- and there are fact sheets on the site too.)

There are various options which is to swap to a cyclic regime (usually used by women who still have periods but can be used by anyone) where you only use Utrogestan for 12 days per cycle.

The other option is to use them vaginally (pop one in at night) which can reduce side effects.

It's often a better idea when first using HRT to start with estrogen only for a few weeks and see how you feel on it before adding in progesterone.

The video I mentioned is good, but at the very end it mentions halving the dose if used vaginally. This is not actually 'mainstream' recommendation and the Dr in the video does say there is 'some evidence' it's safe (but maybe not enough evidence yet to be sure.)