Is there HRT without progesterone or an alternative?

[Asabat]

Is it possible to have some kind of HRT without taking progesterone? After various permutations over four years, I am currently on a pretty average Everol 50 and 200mg of utrogestan for 12 days of the month.

I really cannot tolerate it, while not quite suicidal, for days on end I just want to sleep or disappear I am so unhappy and weary. I have PMDD which has associations with progesterone intolerance and also have never been able to take the pill without slipping into depression - in my 20s they gave me beta blockers to help, but things improved when I stopped taking the pill, so I never took them.

The only suggestions I have been given from consultant is to try Slind for 6 months or taking 100mg of Utrogestan constantly. I don't really understand why that would be better - but I am guessing from my reading that the constant dose might help with the peaks and troughs of progesterone that seem to cause the PMDD and depressive mood symptoms? Oh and the other suggestion is the mirena coil, but again constant progesterone doens't seem like a good bet for me.

I can't really go on like this and am thinking that I probablly need to just give it all up and just try and live with the symptoms I have till I actually get to menopause - I will still feel awful, just a slightly different awful.

I I saw this other day and thought this might be helpful. Louise Newson on progesterone intolerance:

https://www.youtube.com/live/8l_OeSFBczE?si=V60rkTotB1ZnOfP4

I feel okay, well good even, and so so much better than on the Utrogestan - no side effects apart possibly from a bit more irritability. However, I have been spotting for over a week now (this was after about 30 days on it), which is a bit boring and makes me slightly concerned as I have had a thickened womb lining previously.

@AnotherNaCha apart from the bleed (which is a real pain, I'm sorry), how are you feeling?

I found that difficult to watch - so much information and so many variables. I always feel a bit hectored by her and her emphasis on body identical hormones, especially now the "artifical" (aren't they all?) ones are actually working for me.

Also my experience with the Newson Clinic wasn't great, they pushed my oestrogen dose right up to 100mg and wanted me to take testosterone on top. I actually ended up feeling worse.

I much prefer Dr Jen Gunter, who I find more pragmatic about what is and isn't possible with HRT:
https://vajenda.substack.com/p/stop-using-body-identical-and-bioidentical

Thanks for the update. Sounds positive - apart from the bleeding.

I was OK but am now a crying, irritable mess. Am also on oestrogen patches so have pulled that off to see if it might be that. Suspect I am way to sensitive for HRT as feel better without it

@AnotherNaCha it may not be for you.

But it also may be a question of trial and error. And trial and error every 6 months as your body changes? (see I am all calm and reasonable now I have a better set up atm!). I definitely wanted to give it all up before the Slynd, I hate having to think about it all the time.

I am actually a bit more weepy, but not in a bad way, so I will take that as it's better than being so depressed I couldn't get out of bed. Sorry you are suffering. It's just shit isn't it?

@Asabat I feel much better on Slynd too. I had no bleeding for 3 months, but once it started it hasn’t really stopped (it’s light, but fairly constant).

I was referred for USS via the 2 week cancer pathway which showed borderline uterine thickening (5mm). I think my next step will be to try cyclogest (I am on high dose estradiol for symptom control so likely also need higher progesterone). I have a meno specialist apt in a couple of weeks. I’d like to stay on Slynd - for contraception - as I’m not postmeno yet.

I like the Newson clinic, they have been the only Drs willing to listen to my own personal experience. I’ve been fobbed off for years regarding the huge impact that hormones have had on my life. I’m very sure I’ve had PMDD since my teens, but this was never listened to.

But then again, I was always fobbed off regarding a food allergy that I was reporting escalating symptoms of…until I ended up in A&E resus with anaphylaxis!

I like the fact that Slynd gives women another option to try. I was feeling rather despondent about HRT until I gave it a go.
Hopefully the bleeding settles for you 🤞🏼

The BMS uses 'body-identical' as it's factually correct.
Bio-identical was a marketing term, as they acknowledge.

https://thebms.org.uk/wp-content/uploads/2024/04/01-BMS-ConsensusStatement-Bioidentical-HRT-MARCH2024-A.pdf

There are some differences anyway with how HRT and menopause are managed in the UK and the US.

Have you tried many different progesterone?