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!

Girls thanks a million for the update and link. Now I feel actually more empowered to ensure I am given the correct dose as I was very like Boots52 with the scary factor on taking HRT to even begin with. I think we are getting there with learning more about HRT and menopause but I honestly wouldn't have known this information this evening without the kindness of this group. Thanks again and take care everyone

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

“She ought to have!”

Yes it’s odd. I checked the Balance website - 2 factsheets and one video with Dr Sarah Ball from last September saying Utrogestan vaginally can be used less/half the dose of oral. BMS changed their guidance last October so either Dr Newson doesn’t agree with the results of the study or it’s an oversight in not changing the information.

Newson Health take a very much individualised approach to treatment, however this should be general guidance. For this NICE Guidelines or BMS should be followed as I’m sure you agree.

As it happens when I had bleeding I tried Utrogestan vaginally instead of orally taking it every night hoping it would be more effective. However I bled even more so after a month swapped back to taking it orally which I prefer. My vagina gets enough attention with Vagifem!

@over50andfab Yes I agree. I posted the link on 3 Jan- see this. www.mumsnet.com/Talk/menopause/4443510-Utrogestan-dose-dont-reduce-it-vaginally-is-new-advice

But the message doesn't seem to be getting through as on here and other forums women are still referring to 'half doses'.

My understanding of it is that there was some limited research done on using half doses, (think it was Swiss research) and that prompted some drs to suggest the dose.

Most of the advice was for women who were private patients and who could be monitored as part of their HRT treatment, where regimes can be tweaked around doses, cycle length, etc. (This is all 'off-label' as the specialist can monitor it with scans etc.)

Compared to you my own experience has been more favourable with vaginal use. It has its downside, (I wake up feeling hot in the night!) but the bleed is more predictable, coming 3-4 days after stopping it. Orally, I sometimes bled before using all the capsules.

Hi all, . I have an appointment with my GP again tomorrow. I had a really dreadful weekend with lack of sleep and honestly felt like a zombie. Of course lack of sleep will do that. But I felt absolutely wired in bed trying to fall asleep etc. and felt so nauseated. Last night out of pure exhaustion I slept but today I feel still nauseated and just flat so I think HRT and me are really not working. I also want to confirm the dosage vaginally that I am due to start. I am so tempted today to pull the patch off and give up on it all and put up with symptoms that I had but at least I felt I wasn't a zombie and low mood and when I had a bad night sleep at least I would get a couple of hours. Thanks all. Have a good day!!

@mo4p1 I'd caution against a knee-jerk reaction after such a short time on HRT.

There are many different types and it may be that Utrogestan doesn't suit you.

For example, there are patches that have a different type of progestin, and there is also the Mirena coil.

One thing that some specialists do (mine did) is to start you off on estrogen only for several weeks. (I was on it for 3 months at a time.) That enables you to fiddle with the dose and find what helps.
This is easier with gel, compared to patches.

It's probably safer long-term to have longer cycles with estrogen only then take the correct dose of progesterone , compared to the usual 4-week cycles with a low dose of progesterone.

Making the point again that Dr Newson's patients are private. They can pay for a scan the next day (almost!) if there is any hint of an issue with the endometrium. Also, private drs are allowed to prescribe off licence, which GPs can't.

It does sound as if Utrogestan is not for you if it's making you feel so tired. There is nothing wrong with someone your age (under 60) using some of the tablet forms of HRT, like Femoston, which is almost as body-identical as Utrogestan.

There is also the tablet from Tridestra which is a 3-monthly cycle, so the progestin (Norethisterone) is 12 days per 3 months.

All of there are option :) !

I also want to confirm the dosage vaginally that I am due to start

This depends on what your GP has read!
If they are following the guidance of Dr Newson, they will say 100mgs is okay.

If they are following the BMS guidance which me and @over50andfab posted (and supersedes Dr Newson) then it's 200mgs.