What HRT combination am I asking my GP for?

[CharlieFarl1e]

Any help would be appreciated @JinglingHellsBells especially from you if you're around and don't mind - I've seen how helpful you are to others and how knowledgeable

I am just 50 and I assume in peri. Periods heavy and flooding, fatigued, a bit achy and I 'feel' a bit different! No hot flushes and I can get by with the symptoms I do have - bar the flooding every month

Im on the long waiting list to see the Newson clinic and I'm pretty sure I'd like to give HRT a go. I'd like the gel as can't use any patches on my skin due to allergies and don't fancy tablets. I understand I also need progesterone

Anyway, my GP won't see me (emergencies only for the next month can you believe) but I'm 'welcome to send an email to my doctor'

So I'm going to do that and ask for what I'd like. I don't actually need to see her face to face. But before I email I want to be sure I'm asking for the right thing so I don't get fobbed off.

So, am I right to ask for Oestrogen gel and progesterone tablets? Anything else I need to ask for? Do I describe my symptoms?

Any advice from anyone appreciated

You need to list your symptoms. A lot depends on how your GP thinks about meno. Some are a bit picky and won't prescribe unless you have hot flushes or irregular periods. Have your cycles changed at all?

Be aware that HRT could make the bleeding worse. You are adding estrogen which thickens the lining. On the other hand you are also using progesterone regularly, which controls the lining. In peri, often cycles are anovular- no ovulation- so you get a lot of build up of the lining and no progesterone (sorry if you know this but progesterone is only produced as a result of ovulation.)

The products you fancy are Oestrogel and Utrogestan. This is listed as micronised progesterone (Utrogestan is the trade name.)
You use 2 x 100 capsules 12 days each calendar month, starting mid cycle if you have natural periods.

Hope this helps :)

That hugely helps thank you. I've been called to book my Newson appointment today and I've had a wobble at paying £250+ when I think I'm just a decidedly average case. I just can't make my mind up if it's worth the money

My periods are monthly still but they come whenever they feel like now - used to be 28 days on the dot for decades and now they can be anything from 20 days to 36.

I think I'll email my GP with a list of symptoms and ask for those items. I may fling in the hot flushes but although I have periods of feeling very hot suddenly, it's not a flush as I understand it to be

Thanks ever so much

@CharlieFarl1e A period of feeling very hot suddenly sounds like a flush to me. Why do you think it isn't?

@Spodge I often get a sudden feeling of hotness! One minute I'm cold with the heating on, the next I'm feeling too hot and it sort of feels like a sweat I suppose and then dies off after a short while

But my understanding of a hot flush is something that creeps up under your skin and is unbearably hot as it 'flashes' through you and I don't have that? Mine is definitely bearable

I emailed the GP and politely asked if she would prescribe for me - amazingly I got a message back saying a doctor will call me tomorrow so that's something! Fingers crossed

I've started on Elleste Duet 2mg following hot 'surges', thumping palpitations at night and insomnia. My periods were infrequent.

I already feel so much better. I'm sleeping a full 8/9 hours a night and the mid-sleep panic and anxiety has definitely subsided. My doctor got me to list all of my symptoms and matched me to a medication. It was a telephone appointment and she really took me seriously. I wish I hadn't put it off. I'm 49

And my experience of hot flushes were exactly as yours are. One minute ok, then next minute wondering why I was roasting.

@CharlieFarl1e I definitely think what you describe counts as a hot flush. My daytime ones tended to start in my lower back and stay in my torso. They'd build and then fade and were not unbearable by any means, just annoying and unpleasant. I think the people who get a really hot face probably feel it worst. Good luck with the phone call tomorrow.

@Readthestandingorder are you also taking progesterone too? How do you find this? Good you've found something that works.

I always said I would never take HRT becomes it's a natural process and I'd just battle through, eat properly and take some expensive vitamins

I didn't stop to think about the fact that none of the above replaces diminishing oestrogen which we actually need

@Spodge maybe you're right then. I'd definitely describe it as one moment I have the heating on and my blanket and the next, I've got the back doors wide open!

And thanks. Fingers crossed she will prescribe what I'd like ...

Does anyone know what the pros and cons are of gel and tablets? I can't use patches so they're out the question and I think I want something that is transdermal as opposed to going through my digestive system or does it not matter?

Yes mine is both...I think! I have scoured the Internet for reviews on the medication before starting. I actually left it in my glove compartment for weeks as I wanted to put it off, but then two of my friends started theirs and I thought I would too. Reviews are good, and I feel like me again. I had previously gone to the doctors about my low mood and anxiety, and now I'm wondering if that was peri menopause instead of low mood and anxiety.

There was no gel option for my medicine so it was patches or tablets. The Dr put me off the patches - I can't remember why, perhaps the bathing dilemma - and so I took the tablets. I've had no issues at all, and no side effects apart from the good ones. I have noticed a decrease in appetite and also I've gone completely off wine - it tastes weird! No idea if it's linked but both are good for me, as I was drinking too much booze.

Err I'll take a decrease in appetite all day long!!

Sounds like it's suiting you so far. I was reading on here about the progesterone tablets and you can take them vaginally. This means they are immediately at source where they're supposed to be and it bypasses any usual side effects

I need time to work up to that one! Sounds like yours is combined?

[quote Spodge]@CharlieFarl1e A period of feeling very hot suddenly sounds like a flush to me. Why do you think it isn't?[/quote]
To be fair, I’ve had this too and didn’t think it counted as a hot flush! I thought it was only when a flush and redness crept up your neck and face and you got so hot that you were drenched in sweat!

I've just googled and yes, mine is both. "It has two active ingredients, which emulate the two female sex hormones: a natural version of oestrogen (estradiol) and a synthetic version of progestogen (norethisterone)."

I'm just going with the flow. The weirdest thing is having a proper bleed, as I've not had that in years.

I'm recently on the combo you are looking for OP. I found I knew more about what was available for perimenopause than the two GPS I spoke to (even though they knew that this was what I was calling about). I put on get at night, usually two pumps but am experimenting with three (can go up to 4 I believe). That's more than you get in a patch. I have utrogestan tablets, you've reminded me to take one actually. I changed from patches, and the different GP I spoke to suggested I come off HRT and take anti depressants. This is not current best practice and would do nothing for my bones or vagina. Oh, I have ovestin cream for internal use too!

Transdermal is meant to be better OP so yes, you should probably ask for the gel rather than tablets.