What else can I take?

[Thistle72]

Hi,
I’m 52 and have been without a period for at least a year. I have been on HRT, I took the gel and tablets but had a reaction to Progesterone- my tongue swelled up and very painful. I then had the patch but after 6 months I developed horrendous acid reflux and crippling anxiety I took the patch off and the symptoms literally went within 24 hours and I’ve not had any since. It’s now been 4 months and I’m suffering with rage most towards my husband but it’s affecting my marriage. I don’t want to feel this way. Is there other forms of HRT anyone can suggest or something else to lessen my bitch side

Can you not try simple oestrogen gel without progesterone? I know everyone’s different. I would even speak to your GP about having your testosterone checked. I was crabby when mine was low. I use testosterone cream a couple of times a week and it’s help the sleep, brain fog and mood more than anything. (Side effect free)

@Francestein You have to use progesterone with HRT if you have a womb. There's no way round that.

@Thistle72 There are loads of different types of HRT.

You could think about the Mirena coil and an estrogen patch or gel.

Or there is a tablet called Femoston which many women get on with.

Or you could try a different brand and dose of patch (you don't say what dose it was or the type.)

Are you 100% sure the Utrogestan caused your tongue to swell? Could it have been something else and a coincidence?

You cannot use oestrogen on its own without progesterone if you still have a uterus .Progesterone prevents thickening of the endometrium .Thickening of the endometrium can lead to uterine cancer so same should always be monitored while on HRT.It is one of reasons I had to come off all HRT ,that and a profound increase in migraine with aura .I have not found anything to replace it but understand the rage .Menopause is just awful.

Did you have to stop because of hyperplasia? Usually this can be sorted by the right ratio of estrogen:progesterone? Mirena coil?

I have found a combination of nutrition geeks magnesium, ashwagandha, and evening primrose oil take the edge off my rages, but also hormones…

What was the name of the tablets and patch you had? There are different types of progestogens and lower doses that would be worth looking into.

I came off oestrogen first and only took progesterone on the advice of my gynaecologist .My migrane attacks lessened for a while (visual disturbance , headache and just general malaise after every attack) but then became so frequent that there was no point in continuing .The thickness of the endometrium did not lessen either on progesterone only .It is being monitored continuously as my mother had endometrial cancer .I am just not a candidate for HRT .I also developed an irregular heartbeat which has also disappeared since I stopped .I am 60 now so over the worst of it but it realise now I should never have taken HRT.

Has your gynaecologist never offered the Mirena coil?

This is treatment recommended by the RCOG for hyperplasia - or large doses of Norethisterone for many months - (and presumably you fall into that category if you're being monitored all the time.)

Thank you for your replies, sorry I’m at work.
@Francestein I still have my womb so would need Progesterone.
@JinglingSpringbells it was definitely the progesterone, the reaction didn’t cause anaphylaxis but it was after the first dose. I carried on for 48 hrs but didn’t increase further in size but became very sore and tingly. I don’t want to go back on it. I was on the Evorel patch lowest dose, I wanted to pack my job in my anxiety was that bad. I work in the NHS and need to be able to keep my shit together but it went once I took the patch off. The mirena coil I’ve had before but for contraception but I hated getting it put in it was worse than childbirth. I couldn’t go through that again.
@Om83 I was on Urgestran is it and my patch was Everol Conti lowest dose.
I will look at your other suggestions and make an appointment with my GP. I don’t always trust them though. Not sure if I need to go private……. It’s such a minefield.

You do have other options.

First, you can use Utrogestan vaginally. Insert it last thing at night, or anytime as log as it stays put to dissolve.

This would probably reduce or eliminate any side effects.

It's off-licence but many women do it this way (me) and my consultant recommends it.

You could try any one of the many tablet forms. There is no reason not to, at your age, because they are only contraindicated for older women. One of the most body-identical is Femoston.

You could also, (most likely have to be private) use HRT on a long cycle using any form of progesterone less often than monthly- eg alternate months.
This is in the report by the BMS on Endometrial Protection with HRT.
It comes with the caveat that you may need scans every now and then.

I think that if you can afford it, you see a private consultant gynaecologist who is trained in and up to speed on HRT (not all are- you need to read their bios.)

All the best!

@JinglingSpringbells thank you so much. You are very knowledgeable about it all thanks for sharing. ❤️