Should I increase from one to two pumps of estrogel?

[Castaspella]

Prescribed two but have been taking one as I had headaches the first few days. I’m now into my second month and wondering if I should increase or stick with it? My mood is much better but I do feel like my tummy is very (and suddenly) fat. So confused about getting the balance right and worried about having too much. I feel completely clueless despite reading loads on Newson health etch advice much appreciated

My doctor told me when your nipples are sore then you are using too much .

That’s interesting to know! No sore nips here…yet!

Have your symptoms improved? It’s a bit trial and error but if your symptoms are under control with one pump, then there’s probably no need to increase to two. I also had headaches (and neck ache) when I started but that went away after a couple of months.

Thanks, they have improved. I think I was wondering if increasing might help with the belly fat feeling (which I’m assuming is bloating). I wondered if maybe I wasn’t taking enough oestrogen to balance out the progesterone I’m on (200mg uteogeatan)

@Castaspella Presumably you're using 12 days a month of Utrogestan? You don't have to do 2 weeks on / 2 weeks off - you can do 12 days per month.

You might find the belly fat (possibly water retention) disappears once you have the withdrawal bleed and the 'fatness' is just over the 12 days on progesterone.

I'd not over-think it. If your symptoms are controlled with 1 pump pf gel, stick with that for 3 months (this is medical guidance) then reassess.

I’m doing 2 weeks on 2 weeks off, never heard about 12 days per month. Only learned yesterday I could take it vaginally if I wanted to. It’s such a minefield!

The 2 weeks on/off was started by Dr Newson when she wrote GP guidance on prescribing HRT a few years ago.

In that guidance she says that women will 'find it easier' to do 2 weeks on/off - (ie a memory thing) so it's not a clinical decision and it's not what the leaflet says.

The leaflet in your pack of Utrogestan says 12 days per 28 days. However, many consultants (like mine) say that using it 12 days on a month (30 days ) is fine. So you choose the same DATE each month ( for example, the 1st.)

The 14 day dose per month (as described as an option the leaflet in the pack) is an option for women who find they have heavier bleeding and need another 2 days per month to keep the lining thinner.

I've used Utrogestan for over 10 years through a consultant (privately.) I've never ever done 2 weeks on/off.

I hope this makes it clearer and you feel more confident using it.

It's only a minefield because GPs follow the guide they were given (to help them!) but most do not have enough training on HRT to offer variations.

The vaginal use is off-licence (in the UK not but in Europe) so in theory your GP can't offer that, but some are happy to do so.

That’s super helpful as always @JinglingSpringbells- thank you!