Hrt after ablation confusion.

[Anniewanny11]

hello …this is my first post. I have just started hrt two weeks ago . I had an endometrial ablation last year. My Dr prescribed the combined dose so 1 sachet estrogen in the morning and 1 100mg utogestan at night. I am feeling much worse than when I started with extreme tiredness , I’m finding it hard to function….and there seems to be some confusion when I’ve looked into it if I should be taking it sequentially after an ablation but the internet is short on info for women taking it after ablation.

Can anyone in this situation advise? My pharmacy told me to ask Dr but haven’t been able to speak to her directly . She told the receptionist that I should have the dose of each every day. I reacted badly last year to the progesterone side of things when I was taking it only for two weeks , that’s why she has put me in this …although I know I’m on a smaller dose everyday ,would I be better just taking it for 14 days and would it be safe to do so? Things I’ve read suggest my Dr has got it wrong prescribing continuously please can anyone help?I was having regular periods but for 14 days a month and suffering anemia that’s why I had the ablation , but advice seems to be directed only at women who do or don’t have periods, but not to those of us who have had this operation!

thanks so much in advance x

You need to make an appt with your GP. It's not right for her to pass messages on something medical and confidential via a receptionist.

It is unlikely you need progesterone but in some women the lining does grow back and the ablation is not successful.

If you were being treated privately, my guess is you would be asked to have a scan now to check the lining and a scan again in 3-6 months to see if the HRT had made any changes to it.

You could still go outside the NHS to a private gynaecologist for this. You could also contact the secretary of the dr who did your ablation and ask the question about hrt.

OR your GP could do this! They are the dr who is dealing with you and they will have access to a consultant for advice.

If you put 'hrt after ablation' into google search, you ought to find the info on the balance app site.

It says that even after an ablation you need progesterone as some of the endometrium may be left behind.

balance-menopause.com

thank you yes I am very aware that I do need the progesterone as I still have a womb. The confusion is how and when you take the progesterone in this instance . I have typed exactly that into the google search and every answer is conflicting or unclear .I think I have an issue with progesterone and I hear because of this there are many ways of timings it can be taken , some women may not take it 3 monthly or go have progesterone sensitivity , but nothing is black and white clear.
thank you again I will check this to see if it has firmer answers

I do have a Drs appointment but have to wait 2 weeks so thought worth asking on here in the meantime if anyone else is having the same issues
i appreciate you taking the time to respond thank you 🙏

Sorry, I misunderstood.

I expect your GP may go by the book. That is that most GPs believe that progesterone daily is the only option for women post menopause, (or in your case with no lining.)

The reasons for using it daily is that there is a tiny risk of overgrowth of the lining (hyperplasia) using sequential HRT used very long term.

A specialist would tailor your dose to your symptoms and needs.

Some women carry on with sequential all the time as they can't tolerate daily progesterone. There is also a slightly lower risk of breast cancer with sequential.

You also could try other types. Utrogestan has become popular but there is Femoston tablets that are sometimes tolerated better and the progesterone is almost the same as Utrogestan ( almost body-identical.)

There is also the Mirena, and other combined patches that contain Norethisterone.