Terrible side effects from HRT

[pinktoucan2518]

Hello,
I need some urgent advice. I’ve been using estrogel and utrogestan (100g) for the past 4 months to help with severe insomnia and hot flushes. Everything was going great, but after 6 weeks of taking it, I started feeling really groggy and drugged on a daily basis. Getting through work each day was a massive struggle and I was in bed by 8.30pm most nights.
I went back to the doctor 5 days ago who advised I came off this brand slowly. She told me to stop the utrogestan but continue to use the oestrogel for a few weeks to ‘clean my system out’. As a result of stopping the utrogestan, I’ve had the worst bleeding, clots and cramping ever. I’ve been in menopause for over a year and haven’t had a period for almost 15 months and now I get this. I’m very worried and scared. I feel the doctor hasn’t given me the correct advice as I know taking utrogestan protects your womb lining and now that I’ve stopped taking it, it’s caused me the most awful bleeding. I paid privately to see a doctor but don’t feel I’ve had the best advice. I live abroad, so the healthcare system is very different here. Thanks for your time if you’ve made it this far! Any advice or support would be much appreciated, thank you!

Hi OP sorry you've had a tough time. Can you go back to see a GP that won't cost money? It sounds like you may have progesterone intolerance. I've had bad side effects from hrt too and have been researching my options. I think it doesn't suit some people and for others you can try different versions, so the patches may suit you better for example. Have you had a look on menopause matters forum? They are quite good. Please let us know how you get on.

Thank you for your kind response, JJKate. Unfortunately none of the doctors are free here, so it’s a matter of paying and hoping you get a good one! I’ve been given some Livial HRT to try in the next few weeks when things calm down, so hopefully that will be better. Unfortunately they don’t offer patches here either! What HRT are you on currently? Sorry to hear you’ve had issues too. I’ve joined menopause matters too, so hoping I’ll get some answers from them too. Thanks a lot!

I had the drugged / groggy side effects - was 100% the progesterone as I was on a 12 days cycle so easy to see when it kicked in and stopped.

The Utrogestan comes in a pessary form which completely banished all my side effects.

Ask if you can try that instead?

@pinktoucan2518 It's tricky offering advice if you are in another country - are you the poster who was in Ireland?

It's unusual to be told to continue with estrogen and stop progesterone. Normally it would be the other way round with a sequential type- finish estrogen but use 1 course (2 weeks) of Utrogestan to 'clear ' the womb lining.

And as you're on both hormones daily, you'd stop both at the same time OR carry on with Utrogestan for a few days to ensure the lining was thin. (You might still bleed a little after stopping it.)

You shouldn't be using estrogen only with no end date and it certainly won't clear your system- quite the opposite. Your womb lining will grow.

Have you not been told to stop the estrogen?
Livial aka Tibolone is very different and has its place but it's not the usual first choice when swapping with HRT.

Have you discussed why this has been suggested rather than eg the Mirena coil or other forms of progesterone?

Hi, ah that's tough having to pay. I've been on estrogel and utrogestan tablets for two and half years. I tried switching to vaginal progesterone but that was worse though some like above say it's better for them. Everyone is different. I'm going to try patches as the progesterone in them is different and some people tolerate it better. If that doesn't work I think I'll come off as I used to feel awful when on the progesterone 12 days but now feel awful every day, like it's built up in my system or something. I never was able to take the pill and have bad reactions to most medication, I have been researching and think it may be something to do with having or not having certain enzymes which means some people can't break medicines down. I have been struggling thinking well feeling bad for 12 days is worthfeeling good for the rest but now it's every day it's not worth it. Good luck and let us know how you do.

You could also consider the mirena coil. Becuase it is positioned in the uterus the progesterone dose is much smaller than for patches or pill and supposedly has less of a systemic effect.

Thanks for your reply FusionChefGeoff. I tried taking the progesterone vaginally and it was great initially but then the groggy/drugged feelings returned. I think I have an intolerance to the utrogestan, even though it’s only 100mg. I’ve decided to come off the oestrogel now as it’s prolonging the bleeding. I don’t know what my doctor was thinking by telling me to come off the utrogestan but keep using the estrogel. I don’t think that’s a safe option!

Thanks for your reply JinglingSpringbells.
I agree with everything you’ve said. I have no idea why the doctor told me to keep using utrogestan on its own (which I’ve read is a big no no). I do feel better coming off the utrogestan as it was making me feel so sluggish and groggy, but the bleeding is off the scale. I live in Hong Kong, so the healthcare is very different here. It’s times like these when I was back in the UK! I need to read up on the Tibolone too. Not keen on trying the Mirana coil so will read up on other options other than the Tibolone. Thanks for your time though!

Thanks Clockface222. I’m not keen on the mirena coil, but I’ll keep on exploring my options as there seems to be quite a lot!

Might be worth having an online consultation with the Newson Clinic? Particularly if you are having to pay anyway, and it’s all they do. At least would provide you with a second opinion. Good luck.

I'm confused. Do you mean she told you to keep using Utrogestan or estrogen?

She told me to stop the utrogestan but continue to use the oestrogel for a few weeks to ‘clean my system out’

I have no idea why the doctor told me to keep using utrogestan on its own (which I’ve read is a big no no). I do feel better coming off the utrogestan as it was making me feel so sluggish and groggy, but the bleeding is off the scale.

Your first posts said estrogen but here you've said Utrogestan.

I’ve been using two types of HRT, the Ustrogel (oestrogen) and Ustrogestan (progesterone) together. Both names are so similar and confusing! I’ve read you can’t use the Ustrogel on its own as it causes massive bleeding so I have no idea what my doctor was suggesting other than coming off the progesterone as it was making me feel so sluggish and groggy.

Thanks a lot for your suggestion, Cursula. I’ll definitely look in to doing this!

Utrogestan
Oestrogel

Go back and ask your dr is the best.

I tried taking the utrogestan vaginally as well and felt great for a while before the groggy and drugged feelings returned. Sorry you’ve had issues with your HRT too. Hope the patches are better. My sister had a terrible time on progesterone and switched to the mirena coil which she said was a game changer. She feels like everything has stabilised now. Perhaps you could try that if you don’t get on with the patches? Good luck with it all! It feels like such a minefield trying to get it right with HRT!

Oh god, yes 😄 Totally got the spelling of Oestrogel incorrect! I’ve come off the Oestrogel now as the bleeding was so bad and immediately feel better from doing so. Think I will give my body a break for a bit before exploring other options (perhaps alternative), to HRT.