How did you decide which option to go for?

[thenewaveragebear1983]

My GP has finally suggested HRT for my long list of symptoms and has said I can think about what there is available and go back in a week or so where she will prescribe it for me.

there’s so many options! How does anyone decide? I’m 40 and still having periods although they are not very regular, they are still one a month (ish).

I’ve always been terribly hormone sensitive, could never take the pill without it causing mood swings and weight gain, bled for 3 months straight on depo provera, gestational diabetes etc… so naturally I am worried about possible side effects and especially from progesterone. i’ve had a copper coil before but not a mirena.

my initial thoughts are to ask for a 3 month cyclical in tablet form, which means I’d only have progesterone every 13 weeks. But I don’t know enough about it really- does anyone have any experience of this method or any advice about the other options?

I wanted to get rid of periods so went for a Mirena and gel.
Lots of people seem to have problems getting the patch to stay on, and I didn’t want seeing it. And I couldn’t be bothered taking the progesterone some days but not others.

I am in the same boat and still weighing up options. I like the idea of gel pumps or patches so could build up/reduce side easily.

Dose*

@DustyLee123 thanks. My concern with the mirena is that whenever I’ve had progesterone before I’ve had constant bleeding, although that was over 15 years ago now.

@PoppyPansyCampion would you consider the combi patches or would you use separate? I also think the gels sound good- as long as you don’t need too much, a lot of the negatives have been around the gels being sticky if you need a lot.

I believe that the progesterone in a Mirena is a very low dose. And I was told by a gynae consultant that the best way to control uterine bleeding is progesterone in the uterus, so a mirena.

I had read quite a lot about HRT options before I took the plunge as most of my friends were already on it. I just decided to give it a go and see how I felt. I too had previously struggled with various forms of the pill so was concerned that might be an issue.
I use one pump of Oestrogel a day and take utrogestan. I’ve been using it for about 6 months and feel much better. Only side effect I’ve noticed is sore breasts at certain times, but I’ve always experienced this with hormonal changes. For me, I had numerous weird symptoms that I’d been tolerating for a couple of years and I really felt like bits of me were falling apart. Working full time and looking after the family had become totally overwhelming. It was my doctor who actually suggested I give it a try and for now I’m sticking with it. I feel much more positive and most of the weird symptoms have gone.

@DustyLee123 that’s interesting. I would definitely consider it, for contraception as well as convenience, I was just worried about the possibility of reacting badly to it.

@Laboheme78 yes, the catalogue of weird symptoms. My friend and I call it the ‘creeping body rot’, it’s like we’re crumbling away. I am so hopeful that some of them subside for me.

oesteogel and utrogestan. Easy to stop if it disagrees with you too much

I'd advise steering well clear of utrogestan if you are progesterone sensitive..

It made me suicidal (much like the pill in my 20s) and so tired the next day I felt like I'd been drugged (even taking it on an empty stomach at bed time).

The patches are great though and Evorel stay on for me (estraderm are awful though)

@Moredarkchocolateplease this is what I am concerned about. Do you have progesterone via the patch as well?

Evorel patches (my consultant said they have the ‘best glue’)! Dose settled at 100…lots of working things out and creeping up the dose over this year. And utrogestan by mouth. I tried it up the way, but didn’t like the faff, taking it orally can increase symptoms, but two months of persevering and it all settled down.
I’m really glad of it…it’s funny when symptoms disappear. I don’t notice until I make an effort to look back. I had had an awful few years.

good luck op.

@thenewaveragebear1983 no I don't have progesterone patches, I went for the coil in the end.

Fewer suicidal thoughts but more exhaustion. It's working out which one you can cope with most really. Not sure why we can't opt for a hysterectomy instead TBH.

I tried utrogestan orally for two months and vaginally for two months. Vaginal was significantly better but made my vulva sore.

Do you think GPS tend to prescribe one method/option first and then modify? As in, do they usually suggest patches + tablets and then only change if that doesn’t work, or do they genuinely mean to think about what you want to try?
my gp was suggesting the mirena but I think that’s because I was saying how heavy my periods are now. Or is that because it’s just what they always offer first? I’m quite anxious about the progesterone (but I’m quite anxious about everything really tbh)

My GP is amazing and just asked me what id like to try first.

She did suggest mirena as I was flooding and anaemic.

So far the mirena is best for me, but I am exhausted all the time with it.

I decided to go cold turkey. In my mind, it’s a natural part of being a woman and I don’t like the idea of meddling with hormones and never took hormonal contraceptives. So I’m letting Mother Nature do her thing and managing the symptoms holistically with lifestyle change – diet, exercise and a cold, hard look at my life to change/remove/reduce the things that cause me stress.

This was after a full health MOT to rule out any more sinister underlying issues that could have been presenting as peri symptoms.

@thenewaveragebear1983 some women who are young like you take the OCP- Qlaira- so you could research that.

HRT is very much a case of seeing what suits you. Each dose and type is on a 3 month trial.

I started on Oestrogel, suggested by my consultant gynaecologist, and Norethisterone as a separate tablet, every 3 months (so long cycle.) I was much older than you and very late peri.

Norethisterone is the progestogen in all patches and a lot of tablets.

When I'd been on hrt for a few years I changed to Utrogestan as it is slightly safer, and I did reduce the length of the cycle from 3 months because I was having heavy bleeds.

What you go for, is up to you. At 40, the risks of HRT are regarded as pretty non-existent as you are just replacing your own low hormones. A 3-month cycle should work and you can try a ready-made product like Tridestra, or create your own longer cycle with any type of estrogen and a progesterone. ( so patch, gel, tablets or the Mirena.)

Oestrogel and mirena for me.

Easy to adjust dosage with the gel - I gradually increased it until symptoms, mainly night sweats stopped.

I started with oral progesterone (Utrogestan) but hated the faff of remembering to take them at the right time, plus the faff of having bleeding. Surely one of the benefits of menopause is not having periods any more?!
Also, utrogestan contain gelatin which I didn’t like as I’m vegetarian.

Had a looong time spotting with the coil but it’s settled down now.

I never knew that the Mirena could make you more tired. Maybe that’s why I’m bloody exhausted the whole time!

@MagpiePi yes I think progesterone in some people can make them very tired.

@JinglingSpringbells thank you, I will look into tridestra and the others you mention

@DatingDinosaur cold Turkey won’t work for me unfortunately, I have lived with these symptoms for 18 months (a list of 20+ which I add to all the time when I read more literature and think “oh, I have that too!”) and my life is passing me by. I’m glad it worked for you but I want to be myself again.