Severe progesterone intolerance

[Touty]

Anyone else out there with this? How do you manage to ease symptoms of menopause?

im on a very low dose combined tablet for hrt, still struggling to cope with mental distress, flatness and terrible feelings of doom. Even at the low dose of hrt I’m struggling with progesterone intolerance.

I haven't been able to find a progesterone I can tolerate and like you my hot flushes are insane without estrogen.
I went on a minimum Utrogeston regime with Newson but have developed a thick lining hyperplasia waiting for my 2nd biopsy.
It's so miserable I just seem to be unwell constantly.
I've come off the patches as nhs specialist has insisted but the hots/fatigue are creeping back rapidly!

Im not on anything at present but also have PMDD and have a "do not prescribe" alert for norethisterone on my records due to unmanageable side effects (severe swelling and migraines) from when I took it as a period blocker. Commenting to show solidarity!

Thank you much appreciated

I’ve started taking cyclogest and feel much better

Be interesting to see how you go on it I feel I didnt give Cyclogest long enough maybe

So I thought I would update this. I am still struggling with progesterone intolerance - I am also depressed on the cyclogest (but not as bad as utrogestan), terrible low and flat mood, I sometimes think if this is all I have to look forward to then there is no point in carrying on

If I tried cyclogest rectally would this help? Anyone know?

as a last resort I will try femostan.

I've not tried Cyclogest rectally apparently it can weaken the walls resulting in piles I didnt dare risk that as when I used it vaginally I suddenly got a pile very random after last one was over 20yrs ago in pregnancy but it put me off
I'm back on Utrogeston managing 9 x a month which ik isnt enough 2 protect the lining. This time using it vaginally seem to irritate my bladder so currently up 6/7 times a night for the loo so no sleep very lowering just sick of it but without the estrogen hots/chills are insane for me
I cant see how I can live like this it's just no life at all seen so many specialist but it seems no answers off anyone
I dont even feel great on the estrogen patch this time only having 25mg as more is making symptoms worse
Have you tried Lutigest or Provera? I've not gp wont prescribe them also I've not tried Femoston do you feel like that may be a better alternative for you?

Are you still in Spain? Sometimes it's tricky to advise as meds can vary incl their brand names.

Previous posters suggested the Mirena coil. Any thoughts?

Other ideas- Femoston.

Long cycle HRT- so back to a sequential regime, mimicking a natural cycle - but with a longer estrogen-only part (could be anything from 6 to 12 weeks) then 14 days of progestogen (whichever might work best for you.)

There is a tablet form of the above called Tridestra.

Hi, I’m sorry to hear you are feeling so unwell, I too am at a loss of what to do.

I remember that you mentioned that you had thickened linning on the minimum progesterone regime? How did the biopsy go?

I am afraid to try the minimum dose, I’ve read lots of stories of women having cancer scares with it.

I’ve stopped all hrt for the moment, luckily I didn’t have a problem with the flushes but did get terrible dyness and burning down below without estrogen.

I’ve also stopped my anti depressant as that wasn’t working either.

I’ve tried noresthione - that was crap too.

im going to look into femoston - that’s my next step. Xx

Hi Jingling - yes still in Spain.

I think I will give femoston a go next.

I have thought about the mirena - but afraid, but as a last resort I guess it’s an option.

Tridestra yes we have that here - it’s an idea.

I’ve also stopped my antidepressant as it was doing nothing.

@Touty You mentioned dryness and burning down below.

Do you know you can use vaginal oestrogen, as cream or pessary, without needing any progesterone as it acts locally and very little is absorbed? Using this for a year gives about the same amount of oestrogen exposure as 2 oral HRT tablets so is a safe option for those symptoms

@QueenOfHiraeth thank you, yes I use this too. I should also have mentioned that I also struggle with depression- so I hoped to also manage this with hrt, or maybe I have to try a different anti depressant 🤔

I've been on Femoston 1/10 for about 18 months. Generally a success for me I think. Maybe give it a go...

Did take a while for me to settle on it mind you... Need to give it a month or 2.

Ok so i stopped the cyclogest four days ago and I can’t believe how much better emotionally I feel without it, it’s such a shame as I felt great on the estrogel.

So I am now going to try provera with the estrogel - can someone tell me what dose of provera I can take? Ideally I’d like the lowest possible dose because of progesterone intolerance . I’m 2 years post menopause. @JinglingSpringbells can you advise?

I'd like to know what's the lowest dose I have provera to try but I've been too scared to take one! Not slept for days as usual on my utro & bladder so irritated 😤

I react badly to progesterone and went for the Mirena option with Oestrogen gel. It took a few months to settle down, but now I have the odd down day - maybe one a month - whereas previously I was having fairly long depressive hormone related episodes. That was when I was on Femeston.

Mirena was a great option for me - though the insertion wasn't straightforward.

I've tried mirena twice now but cant tolerate that unfortunately. I know lots have done well with it

I’m extremely sensitive to Utrogestan and can barely tolerate 5 days a month, let alone 7. Now I’m 52 and should be taking it daily, but I just can’t bear the thought. I’ve considered a Mirena coil, but that could also have negative side effects and I don’t want that!

Recently however, I read an article by a well respected gynaecologist who announced that a drug called Duavive (Duavee in US) is now back on the market and you don’t need to take a progestin with it! It was taken off the market in 2020 as the blister packs were not doing their job properly. Pfizer sorted it out and it’s now available again.

I'd never heard of it before and neither had my surgery’s pharmacist. I’m very interested and have asked for an appointment. Annoyingly, they want to do a full uterine ultrasound before they prescribe me anything (I’ve recently moved so new surgery) and I suppose this is a good thing but I know it’ll be a wait and I just hate taking Utrogestan.

If anyone has any tips on making it more tolerable, please let me know and in the meantime, sending much thanks for the wonderful support on this site.

Bye for now!

Yes, it is, but I warn you it sent me loopy in the 2 years I took it. I was suicidal, tried to end my life several times, I gained lots of weight, my hair fell out & I was just miserable on it.

I am very sensitive to both synthetic progestins and natural eg utrogestan.
5 days on utrogestan, taken vaginally, and I still felt life was hopeless.

You could look at Tibolone. It isn't strictly HRT, but it stops hot flushes and protects the bones.
I believe it is meant to have something in it that is a precursor to hormones that your body can utilise. I was very happy and level on it for a few years and it was amazing to not have the ups and downs of progesterone.

I did recently change back to combined continuous HRT (same dose every day) and am doing 3 days on, 1 day off. If I go to 4 days I start getting depressed but if I take a day off after 3 days the progesterone doesn't build up enough to cause the issues.

I didn't want to try the Mirena myself because if the progesterone in that did cause an issue I couldn't get it removed quickly. I was told that it can be helpful for women with PMDD though as it switches off their own high prog production and replaces with a low dose local version.

Were you taking it previously in a tablet form combined with estrogen though?
I’ve been taking Novofem for years without any issues, but feel I ‘ought to’ switch to transdermal estrogen if possible though?

That is interesting, not heard of Duavive before and possibly won't be available in the UK, would love to know how you get on with it if you get it prescribed.

I'm getting on better with vaginal Utrogestan but am beginning to suspect it's causing bladder issues. Get up more to wee in the night when I'm using it, and have noticed leakage at the gym, which is new.

People who tried Femoston, how hard was it to get, was it via the GP and were they happy to prescribe? I'm wondering if I should try it. Like others I'm just too scared to try Mirena as you can't get it immediately out. I have never been so low as when I was on Every patches with the artificial progestogen. Walked down to the river from my house in the middle of the night and thought hard about jumping in.