Please help me with HRT

[Hrtfrazzled]

I'd really appreciate some advice from those with experience. I'm 39 and was diagnosed with premature ovarian failure earlier this year and advised to start HRT.

I started estradot patches and utrogestan 100mg tablets x2, 14 days a month. I noticed a great improvement after 3-4 months. However the utrogestan was causing bladder issues (urgency and frequent urination) and I was finding the patches a faff. After 6 months I went back for a check up and new prescription. I switched to gel and was told I could try 1x utrogestan 14 days a month (still having a monthly bleed so was maybe getting too much progesterone).

This was 2 months ago. So many symptoms have returned. Low mood, irritability, heavy painful periods too close together. And worst of all insomnia and awful nighttime anxiety. I'm so annoyed I changed 2 things at once as now I don't know where I have gone wrong. Do I need to go back to plan A and put up with the bladder stuff? Could it be the gel? Same dose but maybe I'm absorbing more or less?

Thank you if you have read this far. I'm so upset to be dealing with all of this so unexpectedly early in life and knowing I'll be on it so long.

A lot of women get bladder issues with menopause but there are treatments. There are different tablets to help with bladder issuse. I'm on estradot patches and utrogestan as I find that's what suits me. HRT is as you know not a one size fits all. I've had bladder issues, frequency and urgency, my GP referred me to a women's health physio. These sessions did give some improvement. I was referred to urology. I had one appointment where my bladder was scanned and then scanned again after drinking to check leakage and muscle tone. I had a pessary with a know on it inserted which helps support the bladder wall. That was three months ago and the improvement is immense. I don't get up an night, I can go out and not have to check where the toilets are, I'm not wearing incontinence pads and I don't have to pack spare clothes in case I have an accident. My life has improved beyond belief. I did try tablets but they didn't agree with me

I wouldn’t wait until 6 months are up to go back to the GP. Go back now.
I'm further along than you are and have been lucky to find that what worked for me was right first time. But everyone is different and it sometimes takes some tweaking. I sleep so much better now with the utrogestan, the nighttime insomnia and anxiety ere a nightmare and I hadn’t realised they were a menopause symptom! I also used to get up 2 or 3 times a night but that’s now down to 1 and occasionally none!
Go back and get it adjusted

Have you tried changing your diet to support the production of hormones?
Female hormones are made out of dietary fat, the fats that we eat, so women need to consume more fat in order to produce and regulate hormones.
If you are eating a typical western diet it is probably to low in natural fats.
If you want to look into it, reading Alison Brights book about fat, or watch her on youtube. She takes it pretty far, but you can not really argue that we need sufficient fat in our diets.
Best of luck with it.

@Nutsabouttopic thank you I'll keep that in mind but I feel it is more a side effect of the utrogestan than a menopause symptom as it is only an issue when I'm taking it.

@Beautifulsunflowers thank you, I think you are right. I thought maybe I needed to give it more time as the patches took a while to take effect too but I've gone so far backwards since changing. I'm sleeping ok in the utrogestan phase but awful when I'm not taking it and I felt so panicky last night.

@Sajacas honestly my diet is pretty crap at the moment. Tiredness pushes me towards carbs and coffee which isn't great. Thanks for the recommendation.

Last night was particularly bad and I'm feeling low today. I feel like physical anxiety wakes me and then my brain looks for things to worry about to justify the feeling. Appreciate the advice.

Not sure it's any help OP but I've had absorption issues with oestrogen since switching to transdermal method

Been through 3 types of patch and on the second gel which finally is getting me back to a normal level of oestrogen

I keep having to stop taking the utrogestan as I get so bloated, spotty and depressed

There were times last year when (tests later showed) I had almost no oestrogen, and was taking 200 mg utrogestan... it was really quite dark

Not taking U any at the moment and within 3 days of stopping, once again a cloud was lifting

Good luck to you

Respectfully, POF is a lot more complex than just changing dietary fats and needs knowledgeable, professional management to ensure future cardiac and bone health.

OP - have you also tapped into The Daisy Network? There's a great support forum there. And yes, go see your GP again ASAP..No need to put up with feeling rubbish.

@Hrtfrazzled https://www.daisynetwork.org/

What about the mirena @Hrtfrazzled for your progesterone needs and then find the oestrogen that works best. Oestrogen pessaries are meant to be good for bladder symptoms.

@Saltysnack God yes the bloating is terrible too! I've always had that with pms though so I suppose just accepted it. It's the constant need to pee that I find unmanageable. You are supposed to take it on an empty stomach though which I don't always stick to so maybe I need to improve at that. Hope you get sorted soon. It's horrible feeling so out of sorts.

@SebastianFlytesTrousers I took the dietary advice as being alongside HRT... I definitely won't be stopping HRT. Truth be told I'm terrified at how this will affect me longterm. I feel like I am old all of a sudden. Thank you so much for the link. I hadn't heard of the network.

@Hillsmakeyoustrong thanks for the suggestion, GP has made it too, but I'm not keen on the mirena. I didn't know pessaries were an option. I'll look into that.

Thanks everyone. I feel so clueless and am grateful for all the new options to look into.

@Hrtfrazzled I didn't want the mirena but having done both utrogestan and mirena, the mirena had far less side effects, probably because it only works locally. I hated utrogestan and had to abandon it after just a few days.