Please recommend the best HRT for me.

[RosieSun]

I’m a regular poster but have name changed as I have never started a thread and nervous about this. I’d be glad of advice.
I have my 2nd GP appointment the day after tomorrow for menopausal symptoms, where I am expecting to be prescribed HRT. I suspect I have been peri for 4 years, but I didn’t realize, as my symptoms accumulated gradually as follows:
20lb weight gain; hair thinning; tiredness; vertigo; mild hot flushes; stress incontinence ; back ache and stiffness; low mood; general rage and now high anxiety with frequent chest soreness and shortness of breath. The anxiety is dreadful and the worse symptom by far. I am on the mini-pill, married but no sex life to speak of, but I want this to change once I’ve sorted myself out.
I stopped the mini pill at the start of the year when I wanted to check if I was menopausal. I had no periods for 4 months, then the heaviest two of my life (could barely leave house some days) and so I went back on the mini pill.
I have read up on HRT and I think I would like gels/patches but I got the impression at my first appointment that they were going to give me a combined pill instead, which will be disappointing if true. I don’t want a mirena coil fitted as I had one before and encountered problems with its removal.
My bloods have been taken twice with FSH readings of 72 and 70.
Until all this my health was good. I am 47, a bit overweight (BMI 26/27), diet not bad. I don’t smoke and gave up alcohol in the summer as I was feeling so lousy. I had covid in Sept 2020 and I thought I had long covid before reading up on the menopause.

Sorry for the long post, just trying to jot down any significant factors. If anyone reading this is has experience of HRT and can recommend a prescription for me that would be great. (I have read many websites, including Louise Newson’s.)

Morning, really glad to hear you are seeing some benefits now @RosieSun it's still been such a relatively short time. I think even keel sums it up well.

I'm on the same time frame as you know, I have had some much better nights and my night sweats have been so much better. I have had some terrible insomnia this week though.

This latest patch is at the top of my buttock and is already holding on better than other ones have done. Not brave enough to have a bath until I have a bigger supply of patches.

I do feel overall more positive about life in general, am not finding myself feeling anxious and worrying about stupid things. I have also been less tired and not in bed by 10 every night which DH thinks is a miracle in itself.

Am interested to see if any other benefits are obvious with the new combi patch.

Oh also at the risk of tmi I have a rotten cold and have managed to sneeze for 2 days without peeing myself so definitely think there has been some improvement to my pelvic floor and I am soooo thankful for that!

Am interested to see if any other benefits are obvious with the new combi patch.

I don't think adding in the progesterone brings any other benefits. It's to stop your womb lining thickening (or is it thinning?) for cancer prevention.

I get spots on my progesterone fortnight, and they take two weeks to go so I now have permanent spots.

I've got my 3m review Monday. I'm on the low dose estrogen (gel, not patch) so I'm going to ask for the higher dose.

@VanGoghsDog ah yes you are right, I forgot that. Maybe the brain fog has not quite gone!

Re baths, I've been having them on days I know my patch needs changing so if it does come loose or off it's not a problem. I like a hot long bath and not prepared to risk one whilst I'm mid patch (iyswim).

Today I start my second box so should have a bleed soon. I feel like its on the way!

@VanGoghsDog sorry to hear about your spots. I've been getting those too, for the last year or so. I was hoping that HRT would help clear them up, but no sign yet. Is there anything that helps yours?

[quote bluejelly]@VanGoghsDog sorry to hear about your spots. I've been getting those too, for the last year or so. I was hoping that HRT would help clear them up, but no sign yet. Is there anything that helps yours? [/quote]
Last spring the skin on my face started flaking off in big chunks. First on the right side of my jaw, spreading, then on my chin on the opposite side, then the left side of my chin just under the jaw.

Nothing would make any difference. I tried literally everything from hydrocortisone, anti fungals, betnovate, anti histamine, anti septic, Nivea, nothing.....stopping suppliments, starting suppliments ....

It wasn't itchy, it just sort of caked over at night and peeled off leaving a flaky red raw patch that flaked all day, in big chunks. It was starting to get quite sore. It was very visible and I couldn't cover it up with make up because it just clung to the flakes and looked worse. I'm a picker too, so I'd sit and peel at it without realising.

And it was spreading - not in an infectious impetigo/ring worm sort of way, but just new bits were popping up.

The HRT significantly improved it within a week and it was gone in two. It was obviously an androgen over production in response to lower estrogen.

Anyway, I'll take a few spots over having that again (and over uterine cancer). But no, nothing really helps them tbh. But I've had spots all my life, I'm just used to it.

Hormones huh???

Hi everyone. I knew I shouldn’t have name changed to start this thread because now I keep missing notifications there are new posts and I’m missing all the action!
@bluejelly. If I’m 6 week from serene I will be overjoyed 😄.
@IDidntFloatUpTheLaganInABubble. That’s good your feeling benefit (particularly the sneezing - not TMI at all -I’m a cross my legs before sneezing gal myself 😂).
@RavenT. I’ve been having a bath every night, I don’t have it really deep, have the patch on front of my thigh and keep knee up/arrange legs so it’s not submerged much.
Crikey @VanGoghsDog. Your skin condition sounds worrying, thank goodness you got it cleared up.

So I’m looking at the responses and all seem very positive so far. This is great. No scary side effects for anyone. I didn’t read up on the side effects in case it messed with my mind and I would start imagining them all. I had one crappy thing. I started a diet club last week, stuck to the plan completely but only lost half a pound, which was pretty demoralizing, but I hope to do better this week. Im not blaming the HRT, I think I just ha terrible metabolism! I will need to shift the old carcass a bit more I think. Have a lovely weekend all.

@PaddingtonsHat

Gel plus micronised progesterone tablet (also known as utrogestan). You need to have 2 weeks of just the gel, then 2 weeks with the progesterone tablet at night. I’m a GP and this is what I’ve decided I’m having!

I have exactly this plus 2mg testosterone gel once every second night. The testosterone is what changed everything for me! Hello again libido!!!

@VanGoghsDog so glad to hear the HRT helped your skin (bar a few spots). And you're so right, spots are really nothing compare to uterine cancer! Hope you are doing ok.

@RosieSun yes I haven't had any side effects really, apart from slightly swollen boobs during the second half of the month. Am hoping the serene feeling continues- and the sleep gets better too, am sick of being wide awake at 2am

Hello.

I'm 40 and have just had a full hysterectomy. Any recommendations of HRT estrogen only? I don't want to get old 😞

@bluejelly. Oh dear 2am is early to be awake. I’m still waking in the night to wee, but I can usually get back to sleep without too much bother. It was much worse before I gave up alcohol.
Welcome @JacinthS. Nice to have you join the thread and really sorry you’ve had a hysterectomy. That must be very traumatic. I’m afraid I don’t know estrogen recommendations as too new to all this. You might get more replies starting a new thread about it so people see your query on the thread list. Best of luck.
Hi @beachcitygirl. Welcome! How did you get testosterone if you don’t mind me asking? I keep reading it’s not licensed/ approved as a prescription for women but I don’t fully understand what that means.

@PaddingtonsHat

Gel plus micronised progesterone tablet (also known as utrogestan). You need to have 2 weeks of just the gel, then 2 weeks with the progesterone tablet at night. I’m a GP and this is what I’ve decided I’m having!

I’ve just been prescribed this but wasn’t told to take it in this way.

@DDMAC

It's gel every day, and Ultrogestan for 12-14 days (at some point your cycle, but I don't have a cycle so I've created one!).

I think that's what the poster meant by "just the gel", she meant you add the progesterone for half the time.

[quote VanGoghsDog]@DDMAC

It's gel every day, and Ultrogestan for 12-14 days (at some point your cycle, but I don't have a cycle so I've created one!).

I think that's what the poster meant by "just the gel", she meant you add the progesterone for half the time.[/quote]
Thanks! I was told one a day for the progesterone, says it on the packet too. I might ring them to check their instructions because I just started taking it not knowing this. So glad I spotted the post.

Is it the same one though - Ultrogestan? Mine is def two a day for 12-14 days (GP told me to do fourteen as women find it 'easier', she obviously thinks I can't count or something so I'm going to ask if 12 would be OK as it might reduce the skin problems a bit).

Just going to quickly moan again about the fact it comes in packs of thirty when noone will use thirty a month, and the estrogen comes in packs of 28 so isn't even a full month's worth.

@VanGoghsDog

Is it the same one though - Ultrogestan? Mine is def two a day for 12-14 days (GP told me to do fourteen as women find it 'easier', she obviously thinks I can't count or something so I'm going to ask if 12 would be OK as it might reduce the skin problems a bit).

Just going to quickly moan again about the fact it comes in packs of thirty when noone will use thirty a month, and the estrogen comes in packs of 28 so isn't even a full month's worth.

This is the one I have

I was on oestrogen only patches with Mirena coil which worked well until I was diagnosed with breast cancer last year. Because my tumour was very oestrogen driven I had to ditch the HRT and I’m now taking oestrogen blockers.
I was dreading it but actually going cold turkey and simultaneously stripping my body of oestrogen is ok. I don’t get hormonal mood swings, a lot of the symptoms have disappeared particularly the anxiety and palpitations which has become a real problem despite HRT.
I think the transition from pre to post menopausal is the really difficult time and actually being post menopausal with stable, if rather low, hormonal levels is actually ok.
I know that oestrogen is the great anti aging drug and being very low oestrogen has its drawbacks but I don’t have a choice.
As for libido, it is lower but during peri menopause it was zero. In fact DH and I have sex at least twice a week whereas during perimenopause it had dwindled to once every couple of months. I think we are conditioned to think that everything stops after menopause. In actual fact once it’s done the fog lifts and symptoms disappear.
Perhaps there is a case for women who are not able to take HRT to have oestrogen blockers so they don’t spend years with wildly fluctuating hormones, which is the underlying cause of many of the symptoms.
I will not lie the aches and pains are a problem but in isolation are so much easier to deal with. And when I have recovered from radiotherapy fatigue I will be increasing exercise to try and combat this side effect. The ageing process is the result of so many factors, the most influential being genetic. I was post 55 before going into menopause so have a biological advantage over women who are early 40s. HRT may hold back time if your in your 40s but it won’t work forever.

@RosieSun
I just demanded it. Read loads & loads, luckily I have a female doctor. I'm in greater glasgow area.

Had my review this morning - estrogen dose doubled to see if it helps with sleep and libido. Changing progesterone to twelve days instead of fourteen to see if that means less skin problems.

Vaginal estrogen added as I'm getting sore there recently (she did say this often lags other symptoms).

We talked about testosterone for libido if the estrogen doesn't help. It's a tricky one because acne is a common side effect and as I have skin problems anyway I'd rather avoid that. But also I'm single so having a low sex drive shouldn't be an issue - but it is because I don't want to be single so low sex drive stops me from pursuing relationships, and also, well, orgasm is good for you even if it's on your own!!

@DDMAC - yes, that's the same. The BMJ has information on doses so might be worth checking that. There could be a reason yours has been prescribed differently so worth checking with GP.

@VanGoghsDog

Had my review this morning - estrogen dose doubled to see if it helps with sleep and libido. Changing progesterone to twelve days instead of fourteen to see if that means less skin problems.

Vaginal estrogen added as I'm getting sore there recently (she did say this often lags other symptoms).

We talked about testosterone for libido if the estrogen doesn't help. It's a tricky one because acne is a common side effect and as I have skin problems anyway I'd rather avoid that. But also I'm single so having a low sex drive shouldn't be an issue - but it is because I don't want to be single so low sex drive stops me from pursuing relationships, and also, well, orgasm is good for you even if it's on your own!!

@DDMAC - yes, that's the same. The BMJ has information on doses so might be worth checking that. There could be a reason yours has been prescribed differently so worth checking with GP.

Thank you o

Hi @Angrymum22 (love your username, there are a lot of us on the meno threads with anger issues lol). I just wanted to say all the best for your treatment. I hope you make a speedy recovery.
Thanks @beachcitygirl. I didn’t know if they even prescribed it to women up here so that’s a help. I’m going to give the patches time to work on all my symptoms then re-evaluate.

@VanGoghsDog interesting that you've upped your dose to try and help with sleep and libido. I have issues with both that haven't been helped by HRT so far. Mood and joints are definitely better but would love to be a non-insomniac with a sex drive too!

[quote bluejelly]@VanGoghsDog interesting that you've upped your dose to try and help with sleep and libido. I have issues with both that haven't been helped by HRT so far. Mood and joints are definitely better but would love to be a non-insomniac with a sex drive too! [/quote]
Might fall asleep mid shag! (Chance would be a fine thing!)

Anyway, be careful what you wish for ;)

I'm now in week 3 and stuck on the 1st Conti patch yesterday.

Thoughts so far after 2 weeks of Evorel 50 is there have definitely been some minor improvements but still a long way to go in terms of hot flushes, rage and libido but no negative side effects at all.

My work concentration and brain fog is a bit up and down plus I've had some interesting moments domestically - forgot I out a pan of eggs on to boil and let them boil dry in spite wandering in and out of the kitchen the whole time, put the detergent in the fabric softener bit of the washing machine, set the coffee pod machine off with no mug under it, cleaned the mess then did same thing again....

And rage is still there... DH and DS are treading very carefully 😳😳😳🥴