Feeling like HRT isn't all it's cracked up to be

[sauvignonplonk1]

I've been taking HRT (started with 1 pump now increased to 2 pumps of oestrogel and 200mg continuous Utrogestan daily) for just over three months now. I should add that I already have an under active thyroid for which I take thyroxine and also osteoarthritis. I was still having periods although they were erratic, I'm 51.

I asked for HRT as I was having many of the usual peri symptoms including terrible sleep, hot flushes and feeling like all the joy had been sucked out of life. Initially, after some headaches and breast swelling things settled and I want to think that I felt slightly better but I fear this was more me 'wanting' HRT to be a magic panacea!

Currently, I'm feeling disillusioned. Primarily I'm horrified at the weight gain (I have always battled my weight and keep close tabs on what I eat etc.) and despite 1000 calories a day nothing is shifting. Plus my sleep is no better, I wake up feeling like I've been run over by a truck as my body/joints ache so much and my mood is no better. The only positive outcomes are that my hair is not falling out so much plus my urinary health/stress incontinence is much improved.

I have a telephone consultation with the doctor next week to review things but I feel like just coming off HRT altogether. If anyone can offer any advice, I'd be most grateful!

why are you taking 200mgs Utrogestan a day?

The dose is 100mgs if using it all the time (unless you have had terrible bleeding and this is an exceptional dose by your GP.)

Not surprising you feel as you do when you are on that dose.

Can you explain?

I can't offer any advice on your medical symptoms but do go back to your doctor regarding your dosage.

I also recommend you have a read of this book by Davina McCall Menopausing. It's a self-help/ guide to what else you can do so worth a try. It's the kind of stuff you won't hear from a doctor.

If you haven't already consider cutting out alcohol and caffeine as these don't help with the flushes.

I hope you feel better soon.

@JinglingSpringbells @Pr1mr0se Thank you for your replies.

@JinglingSpringbells I queried this with my doctor after reading the notes in the packet but she said that the dosage she prescribed was correct and that current thinking was that many women don't like the faff of 16 days etc. and they get mixed up and or forget thus a continuous regime was just as effective. She did say I could do the 16 day regime if I wanted though but I just stuck with her advice. She has been great with managing my hypothyroidism so I trust her. I was having erratic and very heavy flooding periods. Do you have any further thoughts, I know from reading other threads that you're very knowledgeable on all things menopause!

@Pr1mr0se I do have Davina's book and it was based on this that I asked for HRT in the first place! I am a wine fan but am doing dry January at the moment and hoping it makes a difference to my weight at the very least 🙏🏻

@JinglingSpringbells would you please explain why you aren't surprised I feel the way I do on the current dose of 200mg? I'd be very interested. Even at 100mg daily there's still supposed to be a 3 day break but I'm not even having that!

200mg utrogestan daily is 100% above the recommendation of on continuous progesterone. It should be 100mg daily without break.

If you still have periods it's 200mg Utrogestan daily for days 15-26 of the month.

You could try taking it vaginally to see if that helps. It can cause many side effects like bloating.

Even marvellous docs can get this wrong. You only need increased progesterone if you are on really high levels of oestrogen.

Sounds like the HRT is working well for your downstairs issues and I would heartily recommend staying on it.

Your GP is wrong. The guidance everywhere (NICE, British Menopause Society) for utrogestan is 100mg daily for 25 days of a 28 day cycle or 200mg daily for 11 or 12 days of 28.

Here's a link to the NICE guidelines (see where it says For Utrogestan capsules):
bnf.nice.org.uk/drugs/progesterone/

Print them out and post them to her, or see another GP. Why would she think 200mg every day is the same as 200mg for only 12 days? It is double.

On the weight loss, I have lost a bit by cutting out gluten and also doing intermittent fasting. I do the type where you fast overnight and eat as late as you can stand the next day. It's not for everyone though.

I agree with all of the above. My sleep has improved a little since starting hrt (oestrogen gel and mirena coil) but what really helped my energy levels was testosterone. I think gps are not automatically prescribing this but you should ask.

As everyone else has said, your GP is wrong.

It's scary that drs can't even read the basic prescribing guidance that's on the leaflet! This info is available on so many online sites, and she could check with someone including a pharmacist. There is no excuse for this kind of error.

The dose for a daily regime is 100mgs every day ( although the leaflet does say for 25 days. Most specialists are now agreeing that a 3 day break is not necessary as it's not like that with continuous tablet form or patches.)

The reason you feel rubbish is that for many women the progesterone side of hrt is the one that gives side effects. It kind of 'negates' the benefits of estrogen.

So, reducing the dose to a minimum often helps.

You also do not have to use it daily. GPs push this onto women who are post menopause, but it's not mandatory. It's there as a choice because many women don't like the withdrawal bleeds each month on the 12 day pregime.

However, some women don't feel great using it daily. (I don't.)
I'm about 14 years post meno and did use the cyclical type.

Go back to your GP or maybe see another one.

Thank you all so much for taking the time to respond, it is very appreciated.

Since it is painful to even get a telephone consultation with a doctor these days, I think in the first instance I will immediately take a 16 day break from the Utrogestan and then continue on the recommended regime of 12 on 16 off since I am technically still having periods. Hopefully that should help balance things as, quite honestly, my body feels like it needs to menstruate - if that makes sense?!

@JinglingSpringbells do you think this course of action would be ok?

Sounds like a plan @sauvignonplonk1

Expect a small bleed perhaps when you stop.

You might not get anything as you've been on conti and a large dose!
But just be prepared.

@JinglingSpringbells thank you, I'll keep you posted in due course!

I think - as one person who has thyroid issues to another - you should also double check your thyroid function / dosage and also ask for a full autoimmune screening - including things like lupus / sjorgens and Addisons, all of which tend to turn up to the party in women of menopausal type age (although to be fair Addisons is very rare but still worth looking at re joint pain / fatigue etc) and if you have one autoimmune thing (Ie thyroid) you tend to go on to develop more. Just to be sure it isn’t something else going on really. (They won’t include lupus etc screenings in normal bloods, they’re special ones they have to do).

I also would suggest having your thyroid levels checked and ensure they're optimal. It took ages to get back to normal after I went on meds and I had to press as GP would have been happy with me on 50mcg of thyroxine forever regardless of bloods. Have a look at Thyroid UK if you want more info.

It would do no harm to look at your complaints separately as HRT won’t necessarily cure all.
Take a look at magnesium tablets/spray to help you sleep, along with a good bedtime routine.
‘Look at taking some cod liver oil or similar for joints. Exercise will also help

How are you doing now, @sauvignonplonk1 , are you feeling better?

This post was 18 months ago

@lljkk I ditched the HRT altogether last November and I feel so much better! I haven't had a period since so am keeping my fingers crossed that I get to the year mark!

Thanks for the update Savignon. Good to hear you feel much better. It's nice when a solution turns out to be simple.