HRT

[noelsheehan55]

I am perimenopausal. Had been experiencing terrible anxiety and rage and brain fog. I have been experimenting with dosages of bio identical Progesterone with my doctor. Started off with 200mg for half the month but my withdrawal for the other half of the month was awful. Then 200 and 100 for the other half of the month. This definitely helped but i still had withdrawal including panic and shivering and faintness. Now i am on 100mg for the whole month and this is definitely the best however my symptoms are not completely gone. I still occassionally have panic at night and trouble sleeping and some although much lesser brain fog and most importantly have completely lost my libido. Would anyone out there either recommend double dosing on the occasional bad nights. ie random 200mg doses on those nights. Or is there another hormone ie oestrogen or even testosterone that i should be considering in tandem to give me back my Libido? Thanks

I have only just started hrt, so can't offer much advice sorry but your symptoms sound very similar to mine. My doctor didn't really believe my anxiety and brain fog was due to perimenopause and grudgingly put me on eastrodot patches (x2 a week) with progesterone for just 4 days of the month. Is progesterone particularly good for anxiety? Did you have any blood tests done first? I was thinking of asking about testosterone for the brain fog but I think the doctor will just keep prescribing beta blockers.

Lots of people struggle with Utrogestan. Side effects can be lessened by using it vaginally (same pill, inserted), or having a mirena coil instead.

I thought progesterone was just to mitigate the risks of taking estrogen. Estrogen is the hormone that improves most of the symptoms. Testosterone helps with libido in particular. Not proven for other symptoms.

Why did the GP just prescribe progesterone? Surely you need oestrogen as well?

Yes, I'm surprised you aren't taking both, tbh.

I take vagirux, as required for lubrication Estorel 75 patches changed twice weekly and utrogestan for half a month. I think you need a combination. I was offered testosterone for libido but we are happy not having sex so didn't bother. Perhaps another conversation or see a specialist.

@noelsheehan55 Utrogestan is the progesterone part of hrt. It's not prescribed alone. It's prescribed with estrogen (unless your doctor is practising alternative medicine when some think it helps on its own - but no proof it does.)

Why are you having it on its own?

I've come across another Gp who only have prog at first.

I couldn't tolerate the Utrogestan at first but now really love it and find it does actually help many symptoms. I'm actually peri menopausal but went to continuous after a year and went to x200 (25/28 days)

I'd suggest you ask to try a low dose oestrogen patch or gel next to the progesterone. 25 or 37.5 patches. You may find you need to increase with each review if symptoms still not great.

Usually you'd then do cyclical progesterone but I found I needed continuous with the higher doses. It helped with water retention and sleep. And joints oddly. It can lead to a lot of spotting in the early days which most women dislike but should settle down.

25 days out of 28 can mean that you have a bleed if you need too.

There's also a 21 / 28 day regime too but usually for women who experience heavy bleeding.

thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

Only gave that should say

Not alot will give testosterone mine won't I'm 15 years out from a radical tah bso I had a surgical menopause to increase your labido have you thought of may be making special time with your spouse and yourself may be flirting then increasing the build up it works for me and him, also maybe read romantic raunchy novels just a idea goodluck xx

I'm on x200 because also on 125 patches - all Gp agreed and based on bloods. She's v good. I'm starting to feel more human. It's taken 16 months of adjustments!

You tend to need to give hrt a good 3-4 month trial before adjusting

Oestrogen really does help libido and not all women need testosterone.

I'd ask for some topical oestrogen for your vulva, potentially also pessaries.

And oestrogen patches or gel. You should max

As I said it may take a while to get to the right levels to impact all symptoms. But you have to creep up slowly

Sorry, you should maximise oestrogen before trying testosterone. Partly as you may not need it and because it can be converted into oestrogen.

HI all. Thanks so much for your responses. I did do blood tests first and found my progesterone levels only to be low. I cant really tell you why i'm only on Progesterone just to say that technically I am being treated for PMDD Pre Menstral Disphoria Disorder and not perimenopause (I 46 btw). So I guess my doctor decided that that was what I should be taking. And for the most part it has been hugely helpful in terms of my mood. But it has taken away my libido completely and a little bit of my lust for life in general. I have heard on another forum that apparently testosterone gel can be very useful for treating low libido as you mentioned Serenade. So i think i will look into that.

Actually I missed some of the lower down responses. I think its a good idea to experiment with Oestrogen before trying testosterone. Thanks for that.

It is definitely a balancing act! Good luck

You can't have testosterone until your estrogen levels are correct. I'd need to ceck why but it's something to do with testosterone binding to estrogen.

When you said you did do blood tests, was that your GP doing the tests- or did you buy a test yourself?

It's not correct that if you have low progesterone you need to supplement that. Your dr misunderstands.

Low progesterone is caused by lack of ovulation ( we only produce progesterone after ovulation.)

Read the website of the late Prof John Studd where he discusses PMDD and the treatment sis HRT but primarily estrogen.

Basically, you need HRT and that means estrogen.

You should see another dr or a consultant.

Over 45 you don't need a blood test to diagnose perimenopause. Given your age and symptoms I'm surprised you've only been prescribed progesterone. It's only been by increasing my oestrogen levels that my anxiety has been fixed.

Ok fantastic stuff. It seems almost universally people think I should have been prescribed Oestrogen as well as or even before anything else. This seems odd my doctor who is supposed to be one of the best Gynos in Berlin did not know this. I'll get an appointment with her again straight away and if Im not satisfied with her explanation or I'll change doctors. Thanks everyone.

Hi all menopausing women

Well, what a gruesome thing menopause is!!! But it won’t beat me!!! I’m on combined HRT patches and pills. 75mg of estrogen patches twice a week and 100mg of progesterone daily. I have been using Estradot. However, my pharmacy didn’t have this and I was put on Evorel. This has happened 3 times now and I’ve noticed a definite decline in my symptoms when I’m on Evorel. The patch is huge and makes the area it’s on itchy. It’s also a nightmare to keep in place. I’ve lost a few after getting dressed (jeans) and after showering. The patch is really crinkly and pucks when on the skin. I notice that I have an increase in anxiety, sleeplessness, feeling fed up, emotional, etc etc, but on Estradot, I’m totally fine. I was still having periods before and whilst taking Progesterone so my GP changed the regime. Instead of 1 tablet daily, take 1 tablet daily for two weeks then two weeks off. This sorted out the periods pretty much but OMG, my moods were a rollercoaster. Whilst not taking the pills, before the end of the two weeks off, I was red mist angry and my reaction to things was disproportionate. I mean, who wants to unalive their partner because they didn’t put the cap back on the toothpaste!!! I tried this regime for 3 months but couldn’t cope and felt my old symptoms returning. So I put myself back on taking progesterone daily and alls good in my world again!! My GP has been brilliant and really does take on board my feelings etc and supports the fact that I know my body better than anyone.

I thought I’d post this as so many of my friends on HRT are still finding their way through the HRT minefield. I thought it might be worth sharing my experience if it can help someone going through the same. I’m 57 and been perimenopause since I was 44 and menopause for the last 5 years. Periods are slowing down loads, but they out in an appearance now and then but definitely slowing down. I was going to have the Merina coil fitted, but started the process and got as far as having my cervix measured and the discomfort from that was enough for me to stop the procedure as putting in the coil was more uncomfortable/painful that the measuring. My lady garden went through 14 years of IVF treatment, it didn’t like the coil fitting procedure so that’s me done, I’m just going to keep on popping the pills!! 😝😝