A little bit of background so as not to drip feed, sorry it’s long! I started HRT nearly three years ago for perimenopausal symptoms, mainly anxiety, fatigue, joint pain and insomnia at that point. The GP put me on Oestrogel and sequential Utrogestan as I was still having periods. The anxiety, joint pain and insomnia improved but I can’t say I felt fantastic, especially when taking the Utrogestan. It was a relief to get to the end of the Utrogestan phase each month. I then found that I’d often start bleeding before the end of the Utrogestan phase so I went back to the GP last summer. She organised for an ultrasound to check my uterus lining (all fine) and put me on a continuous progesterone regime as I was then 53. By the end of the first month I felt terrible - tired, headachy, anxious, nauseous, not sleeping - all the side effects I’d had with cyclical Utrogestan but worse. The GP suggested trying other forms of progesterone but I decided to see how I felt without HRT.
I was fine for a couple of months, but gradually my joints started to get achier and then I started to get hot flushes, which I’d never had before. When the hot flushes started interfering with sleep I went back to the GP. This time I saw a student who knew absolutely nothing about the menopause (and didn’t believe it was as much of a problem as women made out!). At my suggestion, she prescribed Evorel Conti patches, which is what the previous GP had suggested we try next. Unfortunately they made me feel just as bad as the Utrogestan.
At this point I paid to see a private menopause specialist. Her first suggestion was taking Utrogestan vaginally, which if anything made me feel worse than taking it orally. She then suggested a Mirena coil as the progesterone in it is a much lower dose. I’m quite nervous about it, but have contacted my GP surgery and have an appointment for ‘coil counselling’ in the middle of August (it will then be another few weeks wait to get one fitted if I decide to go ahead). In the meantime we decided that I would try Femseven Conti patches, the reasoning being that if I am ok with the levenorgestrel in them I’ll be ok with the coil. Again, I had to stop using them because I couldn’t function with the headache/nausea/dizziness. (I haven’t continued with any of these for the recommended three months, but they made me so dizzy and spaced-out that I didn’t feel safe driving). I’ve just heard back from the specialist and her latest suggestions are a) try cutting a Femseven patch in half to see I can tolerate a lower dose and build up gradually; b) go ahead with the coil and hope I’m ok with it or c) try Tibolone. I’ve read up a bit on Tibolone and it does sound promising for progesterone-intolerant women, but from what I can tell it doesn’t help with joints or heart health in the way oestrogen does. One of my main reasons for wanting to continue with HRT is to protect my joints as my mother suffers from terrible arthritis.
If any one has any advice or experience of a similar situation I’d be really grateful. Obviously we all react differently, so what worked for you might not work for me, but it’s useful to have as much info as possible.