Hrt plateau and dip

[JJkate]

Hi all, I have been on estrogen daily and 12 days utrogestan for two years now. I have a bad reaction to the utrogestan and tried vaginally which didn't help. I went from two to three pumps of estrogen which helped for a while.

Since January I found the utrogestan symptoms awful again and so considered switching to patches as apparently the progesterone in them is different. I was told the highest patch I could have was equivalent to two pumps of estrogen so would be a drop so I titrated down my estrogen gel for about a week or so to prepare and by 2.5 pumps symptoms all awful again including insomnia so decided to just go back to 3 pumps and forget switching to patches.

That was May, I have felt flat as a pancake and sad every day since. I was looking up guidelines and apparently you have to take three utrogestan tablets to 4 pumps of gel now. I don't know if I could face more utrogestan and so seem stuck and so so so depressed. I really don't want to take the coil. Can anyone relate? Is there anything I can do? Any advice much appreciated.

There are lots of options.
It seems now that the default HRT is gel and Utrogestan.
It doesn't suit everyone.

There is info on the British Menopause Society website in their guides, which says that many women are perfectly ok on pill form unless they have clotting risks.

All tablets and all combined patches contain synthetic progestogen which, long term are linked to a higher risk of breast cancer. However it is still a very small risk and a lot depends on how long you want to use HRT (5, 10, 15 years etc.)

There is also the Mirena coil which you can use with gel or an estrogen only patch.

There is also the possibility now o getting dydrogesterone as a tablet to use with gel. This is already in the tablet Femoston and is a safe almost as Utrogestan.

Have a look at this and see what you might want.https://www.menopausematters.co.uk/perimeno.php

The progestogen in pills and patches is often Norethisterone.