Alternatives for oestrogen HRT

[thaneofglamour]

I have been battling years of reactions to any way of taking HRT. I need HRT because without it I have night sweats and constant nosebleeds. I am also being investigated for endometriosis.

Consultants are very keen to put a coil in (me less so!) to resolve some of the latter issues. I am fine with oral progesterone,however.

My understanding is that if I had a Mirena I would still need oestrogen HRT and my problem whatever I do is this : I am allergic to very single way of taking it. I have tried:

Evorel Sequi and Conti - rash
Estraderm MX - rash and falls off
Estradot - rash (albeit smaller!) and never available anyway
Gel - rash
Spray - rash
tablet form - terrible period pains and not a preferred method for most doctors.

Am I missing another way of taking oestrogen? I really don't want to just give up on HRT but it's not been a magic bullet and I am fed up of being itchy and scaly.

Cream that you apply vaginally?

Only helps the vagina etc- not absorbed into the body.

Do you have a problem with other products causing a rash- ie body lotion, soap, shower gel etc?

Have you ever thought about seeing a dermatologist (would have to be privately as there are waiting lists years long for non-urgent issues.)

There is a thing called the 'skin microbiome' and it sounds as if yours is off kilter because you're reacting to the very low level of alcohol in the products- patches and gel.

The skin issue could be down to over-enthusiastic cleansing with chemicals (harsh soaps and shower gels) or it could possibly be related to your diet and your gut microbiome. Do you get eczema for example ?

Where have you applied the gel? You can do it almost anywhere but inner thighs or upper arms are suggested. Some drs say you can also apply to your buttocks (where patches go.)

I had a horrible rash when I tried the spray when the gel stopped working. It was really bad, my gp thought the alcohol was probably the irritant. No solution but you have my sympathies

The gel was by far the worst. I don't have eczema. The dermatologist wasn't too interested and just told me to take allergy tablets.

I have always been allergic to plasters . I suspect the HRT ones have extra stickiness but they do claim to be hypoallergenic. They aren't!

Not sure about gel and spray but guess it is the alcohol.

My skin is fine with most gels, shampoos and lotions. Perfumes can irritate but none of those in the gel.

It is really frustrating!

The dermatologist wasn't too interested and just told me to take allergy tablets.

? NHS referral?
Did you pay for this privately? I hope not if that was their total help!

Have you persevered with gel, trying just a tiny bit at first? Like 1/4 pump?

Yes it was NHS. For a 'systemic' rash. The thing is, if I stop taking the stuff the rash goes, so no dermatologist is very interested when there's a solution as far as they see it.

The rash with the gel was full on,obvious contact dermatitis. Very nasty. Not allowed to continue with it.

What happens with tablets? It's unusual to get period pain from estrogen only. Have you tried estrogen only tablets and progesterone tablets separately?

https://www.menopausematters.co.uk/treatafter.php

There is no reason to avoid tablets if you're under 60 and have no clotting issues. I'm sure the BMS has a report on this where they say tablets are still fine for some women.

I had terrible ovary pain on the tablets and irregular bleeding. I also have breast cancer in the family. I didn't know about oestrogen only tablets, though, so might investigate this.

I have a Mirena and no oestrogen. It’s fine. I had to stop taking the oestrogen on advice from the breast clinic after I’d had the mirena put in.

Why did they advise that? Did you have breast disease?

@thaneofglamour Have you ever seen a consultant about this?
There is also an estrogen implant. My understanding is it's not ideal as it can be tricky to remove and the dose can't be changed once it's inserted.
Anyone told you about it?

You can have Mirena without the estoogem though which help at least somt

There is no added risk with BC from tablets compared to transdermal estrogen.
The risk with BC appears linked to progesterone and the type.

If you were on tablets, was the pain during the 2nd half of a cycle when you were using progesterone? Are you sure it was the estrogen causing the side effects?

Have you actually seen a consultant menopause gynae?

There are other options no one appears to have mentioned. There is a new-ish drug that works just on flushes that is not estrogen.

There are also other drugs (some SSRIs) that are prescribed for flushes in women who can't use estrogen.

I have seen a consultant. Two in fact. Neither seem very interested in discussing anything except Mirena. The latest one is all about looking for endo so we haven't really discussed HRT.

The tablets were the first thing I tried. Pain came around mid cycle and then ramped up so what you say makes sense. We have a good menopause nurse at my surgery who you can see once in a blue moon so I'll try to make an appointment. Everything was complicated by an undiagnosed gall stone but that's gone .

I don't have hot flushes. I have night sweats and nosebleeds. No one knows what causes those!

Hot flushes and night sweats come under the term 'vasomotor symptoms' and are both the same thing but with slightly different effects.

If you can afford it, you should try to choose a private menopause specialist who talks about what you want rather than banging on about the Mirena.

Update... meno nurse wasn't keen on prescribing tablets and suggested upping progesterone to try to stop bleeding , and trying the Lenzetto Spray. And, yup, I'm allergic to it.

I could just take allergy tablets every day but I don't especially want to.