When does the miracle happen on HRT?

[mo4p1]

Hi all,
Would love to hear of similar experiences and what you did?

Aged 50
Iregular periods previous two years plus menopause symptoms
Awful anxiety, heart racing, broken sleep, night sweats etc
Last Christmas had enough and GP noted I should be on HRT
On estrogen patch and two weeks progrestrone now.
Had no bleed after the two weeks for two months.
Last month had a bleed while on the progestrone.

First month on HRT sweats definitely stopped and anxiety reduced, sleep I felt was better.

However fast forward month 4 and I feel I am dragging myself and although not as anxious as previously I feel like I am just going through the motions of the day and the magic 8 hours of sleep - forget it!!!

When is this fab new lady to appear on HRT?

Is the dose too low maybe of one or the other, or is it too high?

I did go back to doc after 2 months but she said stick with it and give it time.

Thanks everyone!

No advice, but just seeing whether you get informative replies. I have a Mireya coil and have been using oestrogen patches since January. I don’t feel any different, apart from slightly less achy joints.

It's not that your HRT isn't working but that you may need to change it.

It's a common misunderstanding that the first type of HRT is the best!

What you are on may need tweaking or you might need another type of progesterone.

Are you using Utrogestan? The dose is actually 12 days per month not 14 days. Many GPs seem to be saying it's 14 days when in fact the leaflet says 12 days. Also, some women (under specialist advice) go for more than 14 days with only estrogen before taking Utrogestan.

The reason is that any progestin can interfere with the 'good benefits' of estrogen. So it's important to find the right one for you and the right dose.

Most specialists suggest 12 days of Utrogestan per calendar month, so that 12 days per 30 days.

If that doesn't work for you, there are other options like the Mirena coil, patches with Norethisterone (a different progestin) or the tablet Femoston ( yet another different progestin.)

Don't 'give up' and think it's not working- it's all about trying to get the right one.

and depending on the dose of your patch you may need to increase.

Most omen start on a 37 or 50mcgs patch.

Thank you SO MUCH!

Yes I am on 50mcgs patch and the urestrogen every 14 days but did see that leaflet said 12. I think that definitely is something I can ask Doc about. I was going to give it one more cycle before going back to GP and then see . I do feel its working a bit but as I say its just like I am dragging myself - no pep to the step so to speak. I guess a one size doesn't fit all.

Take care and thanks!

Hi both!

I have just spoken to my GP having started this regime in 1st March & she has told me to take it for fourteen days!

jinglinghellsbells I had seen on the leaflet with the meds that it said 12 days hence the phone call. mo4p1 it is annoying isn't it?

Definitely strange why they note 14 instead of 12 as recommended?
I will be asking GP too on that one.

Tx again and onwards and upwards

I don't know why GPs are saying 14 days.

It's cropping up day after day on the forum.

I can only assume it's because tablet form HRT is a 28/30 day pack and the progesterone in it is for half of those days. GPs aren't used to prescribing two different items, so I think they are muddled.

Most specialists would tell you to take it for 12 days and choose the same starting date each month. Mine suggests women choose either the 1st of the month or the 15th just for ease of remembering.

jinglinghellsbells
Based on your last comment would you suggest I take it for twelve days from 15th month?

This is what it suggests on insert with meds

I started 1st month oestrogel

The miracle never happened for me. All it did was take the edge off the horrendous symptoms.

@everythingisgoingup

jinglinghellsbells Based on your last comment would you suggest I take it for twelve days from 15th month?

This is what it suggests on insert with meds

I started 1st month oestrogel

Yes.

TBH you can start it on any day but if you have periods still start it mid cycle which is when your own progesterone kicks in too.

Ha my GP said 23 days out of some unspecified period for utrogestan - go figure. I am 6 months in and dragging myself through each day too, despite some improvement. Had one change of method so far but it seems to take years for some women to find something that works.

I think it's to help women remember. So they say take from 1st of month to day 14, or from day 14.

I follow a leaflet i found by nhs Liverpool and take 12 vaginally starting on a Saturday and after that nothing for 2 weeks, over a 4 week period. I'm still settling into it though,

The patches weren't strong enough for me, I find the gel much more effective.

I started with patches last Christmas (between christmas and new year), and it was one day mid February that I had my lightbulb moment. I realised that I felt well, and that I had forgotten what that was like. I couldn't remember the last time i had felt well, it had been so many years! Been on it over a year now. Not working as well as it did initially, but still a world away from my existance before HRT.

I've had a similar pattern and while periods were regular hrt sent them packing initially. It was the booster that brought a period on. They've since been regular ( yet to see this month) but I've found timing with progesterone wonky. I was told to carry on and it has begun to fall in line.

Did you have a 3 month review? Ideally if you still had symptoms I believe you should have raised the hrt.

The other issue I've had is that both the booster and a bad bout of covid about 7 weeks ago seem to have both knocked hrt's effectiveness a bit. the covid has been worse as despite raising patch slightly 3 weeks ago I'm having some break through night sweats and joint pain etc.

about a month after the booster I did suddenly start to feel great and then promptly came down with covid.

I'm going to have to just see how the next two months go.

Gp said if I was till having symptoms I needed more oestrogen. So I'd perhaps ask about this.

Isn't it interesting that there are so many variables with HRT? Its not like you take a paracetomol and pain stops. I really battled with taking it for lots of reasons and then in some ways felt pressured into taking it as it was going to be the answer to all my ailments. Plus once you hit 50 everything seems to come down to menopause. The awful tiredness and anxiety and sleeplessness were my biggest issues. I could deal with the irregular and heavy periods somewhat but I just felt I wasn't enjoying life to the full and as I said too "dragging myself". I feel now on HRT a little calmer definitely but its like I am a few seconds behind in my actual real time life. Even when I do get sleep its not refreshing. I am really glad I posted here because its great to hear so many experiences and know your not alone in waitIng for the "miracle". A couple of girlfriends have been on it for years and are always saying go on it - its a miracle the way your life will be after taking it. Interestingly none have said the struggle they were on at anytime on it. So hence the miracle finding journey my side. I am going to make an appointment to see my GP and review all. Thanks

To me it doesn't sound like you're on enough or a different one could help.

Also worth looking at some of the Newson (now balance I think) factsheets. I've personally found the histamine one interesting and notice some symptoms in myself.

There's also the case for testosterone... which I have no clue of but is some people's holy grail.

All the best!

Hi all just thought I would pop back in to give an update. My GP has reduced the progesterone to 12 days and to take one capsule vaginally for one month to see if that helps with the "dragging myself". Some people she noted cannot tolerate progesterone and feel sedated on it all the time, so this is another way of getting it into me - literally. I have so far this month now had a bleed when I came off the progesterone, so perhaps things are kicking into place a bit. I feel slightly better this week too on the oestrogen. So it will be interesting to see if the progesterone reduction and delivery helps when I go to take it at the end of next week. Thanks everyone! My GP also recommended Balance App and LN podcasts. Take care all

good to hear that your gp listened to you. Just to be aware that the recomended dose for sequential utrogestan is 200mg even when used vaginally and it isnt recomended to reduce to less than that unless under specialist supervision with regular scans. You may want to discus this further with your GP if this is going to be a long term change of dose.

I am taking Divigel and find it is really good but there is a shortage of it here and had to ring around chemists myself and lucky got 3 boxes so hopefully stocks will come in next few months. Am on 200 Utrogestan for 14 days on/off. Love the way I can sleep when on the progesterone but do get spots that time of month so am guessing is the hormone surge. Only my 1st month of it so feel a little bit better but it takes a few months and sometimes your meds may need to be adjusted. The gel I am on is meant to be better as take it daily instead of the patches 2x a week. It is great that we can hear other women's stories on here and those with more experience and advise so helpful.

I agree Boots52 its great to have these conversations and share stories and advise , good luck too on your journey.

Thanks Ecosralayce my GP had said 100mg every night but I did look up Balance and it noted

^Local progesterone – released into your vagina or womb
Another way to take progesterone is to insert the capsule vaginally, at nighttime. This then works locally
near your womb, where it is needed, and is not digested or absorbed into your whole body, so there is
less chance of side effects. The dose of using progesterone is usually half the oral dose (so, for example,
you can use one 100mg Utrogestan capsule vaginally alternate evenings). While the drug is not licensed
to take in this way, it is usually safe to do so and there is limited evidence to support its use this way ^

I won't be starting for another week so i will talk to my Pharmacist too and perhaps ring the GP just to be sure. My Pharmacist is a mountatin of information and has just started the HRT journey .

Have a nice weekend everyone!

Thank you mo4p1 yes I did read you can take it that way if you have adverse effects of taking it orally. So much information to take in and you will get there and there are lots of different options as many women give up as the support not there for them. Why did we all not have this knowledge years ago. I went to docs in mid 40's and he dismissed me twice. I went again after a big radio talk show here which I did not even listen to but my sis told me about as women ringing in with their shocking stories and the doctor the last time I went to him went on a rant about that Joe Duffy radio show and I just told him calmly I did not listen to it and listed my symptoms but he is arrogant male doc. So I made myself an appointment to the WellWoman Clinic which is not expensive and free to medical card holders and women doctors amazing and got hrt but took me another few mths to take it as was so anxious starting it. Wish had started 4 years ago, am 52 now still have periods but just have lost my mojo but slowly will get there and we are all also protecting our bones by taking hrt so is lots of positives. Wishing you well also and really does help to hear other women's stories and support along our journeys. xx

@mo4p1

I agree Boots52 its great to have these conversations and share stories and advise , good luck too on your journey.

Thanks Ecosralayce my GP had said 100mg every night but I did look up Balance and it noted

^Local progesterone – released into your vagina or womb
Another way to take progesterone is to insert the capsule vaginally, at nighttime. This then works locally
near your womb, where it is needed, and is not digested or absorbed into your whole body, so there is
less chance of side effects. The dose of using progesterone is usually half the oral dose (so, for example,
you can use one 100mg Utrogestan capsule vaginally alternate evenings). While the drug is not licensed
to take in this way, it is usually safe to do so and there is limited evidence to support its use this way ^

I won't be starting for another week so i will talk to my Pharmacist too and perhaps ring the GP just to be sure. My Pharmacist is a mountatin of information and has just started the HRT journey .

Have a nice weekend everyone!

Regarding vaginal use of Utrogestan guidelines from the British Menopause Society (updated in Oct 2021) states that:

Based on current evidence if progesterone was considered for vaginal administration (out of license use) in women who experience side effects with oral intake, this should ordinarily be given in similar doses and durations as suggested for oral progesterone intake with HR

This is the link, the relevant bit is on page 4 thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf?fbclid=IwAR1Zloq-lVwEJEImiP6VLXJgesnENNL-e6FLzUjspWOsy7ORgTqtZ4R8dp0

I thought that Dr Newson had changed in line with this?

Regarding vaginal use of Utrogestan guidelines from the British Menopause Society (updated in Oct 2021) states that

Based on current evidence if progesterone was considered for vaginal administration (out of license use) in women who experience side effects with oral intake, this should ordinarily be given in similar doses and durations as suggested for oral progesterone intake with HRT

This is the link, the relevant bit is on page 4

thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf?fbclid=IwAR1Zloq-lVwEJEImiP6VLXJgesnENNL-e6FLzUjspWOsy7ORgTqtZ4R8dp0

I thought that Dr Newson had changed in line with this?

She ought to have!

@over50andfab
I posted that link here as a separate thread about 6 weeks or so back.

I still see a lot of posters here quoting the 'oh it's okay to use half.'

I've used Utrogestan for many years and more recently changed to vaginal use. My consultant prefers it that way (for his patients!) and has never once said reduce the dose.

@BOOTS52

I am taking Divigel and find it is really good but there is a shortage of it here and had to ring around chemists myself and lucky got 3 boxes so hopefully stocks will come in next few months. Am on 200 Utrogestan for 14 days on/off. Love the way I can sleep when on the progesterone but do get spots that time of month so am guessing is the hormone surge. Only my 1st month of it so feel a little bit better but it takes a few months and sometimes your meds may need to be adjusted. The gel I am on is meant to be better as take it daily instead of the patches 2x a week. It is great that we can hear other women's stories on here and those with more experience and advise so helpful.

@BOOTS52 Are you outside the UK (in the US?) Divigel isn't prescribed here but may be under another name.