Prostap and Tibolone

[Spirael]

I suffer with progesterone intolerance and PMDD, along with menorrhagia with no diagnosed cause. Over the last few years, I've been heading into perimenopause with all that fun (hot & cold flashes/anxiety/depression/insomnia/aches/etc). I'm in my early 40s.

I've tried all the usual solutions (pill/coil/endo ablation/HRT) with no success. Generally I feel good on oestrogen and terrible on all varieties of progesterone. My testosterone level has been tested to be on the low side and testogel prescribed, but I can't get my prescription filled anywhere so haven't been able to see if it helps.

My consultant wants to try me on prostap for 3 months to put me into a chemical menopause, taking tibolone alongside to stabilise my hormones. The idea being that if it works well, it makes me a good candidate for a full hysterectomy & oophorectomy to solve the issues once and for all.

Has anyone else had this treatment? How did it work? What can I expect? I've heard that the first couple of weeks can be rough as the prostap initially causes a surge of hormones. Is there anything that helped with this?

Just to return to my own thread with an update, in case anyone is in the same boat in the future and finds this thread.

I had the 3 month injection of prostap (rather than 3 lots of 1 month), and it was administered into my buttock. The nurse gave me the choice of where I wanted to be injected, and I figured I'd rather have a sore bottom than a sore stomach! My butt/leg was a bit achy for a day or two, but no worse than how my arm feels after a flu vaccine.

I started taking the tibolone straight away, and I've not noticed any symptoms of peri-menopause/menopause over the last few weeks. No hot flushes, etc. If anything, I felt calmer and more stable than normal, as well as more focused and energised at work.

Just over two weeks after the prostap injection, I had what I presume was a period. It was a bit heavier than normal with some cramps, but nothing catastrophic that ibuprofen couldn't handle. On the lead up, I did have slightly sore breasts and some mild sleep disturbance - but nothing near the horrific insomnia I usually have at that point in my cycle.

From reading around, a bleed at this point sounds to be normal, and a result of the surge and drop-off of hormones. However if I do have another bleed next month, that implies that the prostap isn't working.

Finally, my weight has crept up a tiny bit, but nothing I can't potentially blame on a change of meal routine over summer holidays. Something to keep an eye on however!

Hi,
I wondered how you were getting on.
I have started this treatment today.

I wanted to add something as I know there isn’t much out there about this. I suffer with pmdd and I started 3 monthly prostap and daily tibolone before Christmas, it’s now February.

The first few weeks were incredibly tough emotionally, I’ve never been so depressed, I could barely function, just crying all the time and feeling totally miserable. I wasn’t washing, I lost all hope for the future. I wished I wasn’t here any more. I had panic attacks. I had to take two weeks off work to recover.

a few weeks further on though, I feel amazing. Stable, peaceful, no pmdd, no crying, I’m the same person day in day out. No menopause symptoms. It’s awesome

my one concern is the next injection. Will I get a drop/surge in hormones again? I can’t afford to take any more time off work, I got a written warning for those two weeks off.

thanks for reading.

I’m glad I came across this thread as I’m just about to start this treatment combination. I’m a little bit concerned about tibolone though as the last time my testosterone levels were checked they were slightly high. It’s very reassuring to see that it has been helpful for PPs.

My consultant says she’s reluctant to prescribe it for more than six months so, if it helps, I’ll have to go ahead with an oophorectomy.

@PartyFants re the hormones dropping off - I’ve read that the monthly injection is better for this reason, but these were anecdotal reports. I’m so glad it’s helping, and it’s good to know the first couple of weeks may be very tough.

Have they said how long you’ll be allowed the injections?

I had this for exactly same reasons. I felt great after the first injection - much more energy. After the second round I felt exhausted and suicidal. Came off it. Left it for a year and have now started hrt gel and had Mirena coil fitted. Just got my period - just as heavy and painful as before. I don’t know what the answer is!

@Happyharry2003 that must have been really frustrating. Were you taking tibolone with both injections?