New to HRT and think progesterone sensitive. What to do?

[Reginaphalangeeeee]

Hi all.
New to HRT aged 46. I still have regular periods and began Oestrogel (2 pumps a day) with local vaginal cream too and cyclical vaginal 200mg progrsteronefron day 12. Well I am 3 days into the prograterone and after feeling euphoric with the estrogen (cured my brain fog and joint pain and generally lifted my low mood), the progesterone hit hard. Pelvic cramp initially& bloat/constipation. Now feeling quiet low mood/sad/can't be bothered and also have sore boobswith return of joint pain. I have put on 2 kg and sure retaining water.

Do I just see it through and hope For the best?
I really don't want the Merina coil but understand that is the solution for some.
I think another option is to take it continuous, but would Injust stay miserable and forget happiness as the norm?

If I hadnt have felt so bloddy great with the estrogen gel for the first 2 weeks, I would be saying right now that the progesterone symptoms are as bad as PMT and maybe it's not worth it?

Will it settle and get better?

@RobinEllacotStrike Do you know that recently ( 2 weeks ago) the NHS agreed to a new drug for flushes to be available on the NHS? It's been available for two years or so privately.

www.nice.org.uk/news/articles/500-000-eligible-to-benefit-from-new-non-hormonal-treatment-for-hot-flushes-caused-by-menopause

Also, there are women who can use long cycle HRT- like you were - on the condition they have a uterine scan every 6 months or so. It's in the BMS menopause guidance.

You'd probably need (private?) specialist input for these if your GP isn't up to speed but it might be worth it.

Hi @JinglingSpringbells I did not know that - thank you.

I will ask my GP about trying this new drug, and I will ask the specialist about the scan option when I see them in October.

💐

@Reginaphalangeeeee everything crossed for you

I am progesterone intolerant, and I take livial tibolone which is a different sort of HRT. I get on well with it.

https://hub.menopause.org.au/Play?pId=cd672260-9748-43f2-81a6-905057c0c2ea

https://pmc.ncbi.nlm.nih.gov/articles/PMC2671819/

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/tibolone/about-tibolone/

I am sensitive to progesterone but only when I use it vaginally, orally its just fine. If you haven't tried it orally perhaps try that?

I’m on my second cycle of progesterone and not seeing any benefits from HRT whatsoever - oestrogel doing nothing on one pump and if I have any more gel it makes me feel completely wiped out. Not seeing the point of this, I went on HRT to help manage my extreme irritability and it’s made it worse :( mirena not an option for me (am nearly 46)

@mildlysweaty oestrogen gives you energy, progesterone takes it away in my experience.

Have you tried using more gel on days when you are on the progesterone?

Thank you @Moveyourbleedingarse❤️ can’t remember when I tried two pumps but it was honestly dreadful, I felt so weird on it in a drained way. Since starting HRT I’ve had the worst PMS and cramps in my life and seem to have lost the ability to proofread my work emails - as someone who’s always been a stickler for spelling and grammar this horrifies me!

Oh interesting - I started the patches, stuck it out for three months but found basically two weeks of pms on the progesterone was outweighing the oestrogen boost…didn’t realise it was so common.

Like you, I felt absolutely euphoric when I started oestrogen in Jan. I then had my cycle of progesterone and felt dreadful - fluey, stuffy-headed.
I was so worried when the second cycle came around but I was absolutely fine. No unpleasant side effects at all.
Had my three month check up last night and the doc has switched me to one progesterone tablet each night, to try to get sleep back on track.
All in all (and touching lots of wood here!!) I feel soooo much better.
Definitely worth sticking to it for another month or so, I would say.

Progesterone affected my orgasms, either didn’t happen or took forever!

Get some testosterone. My libido went through the roof.

Did things settle down OP?

Good question @PuppyKeep. Yes The response to progesterone lessened each month (taken 3 months now). I still don’t like progesterone effect, but I guess it reflects that second part of the cycle where energy and mood is lower.

Libido still not improved and know GP would say, increase HRT. I want to bypass that and do straight to testosterone.

A lot of people seem to find the progesterone phase much harder than the estrogen phase, especially when first starting HRT. I'd give it a little time if you can, but definitely speak to your prescriber if the low mood continues sometimes adjusting the dose, timing, or method of progesterone can make a big difference.

It makes me wonder how many people just skip taking the progesterone due to the bad effects and just use the oestrogen. I’m sure this may be quite common and people not realising the risk of endometrial cancer by not taking it.

I didn't do this.
But I was very tempted to.

Any experience on if testosterone lessens the progesterone effect?

I just had my "HRT specialist" NHS appointment - what a bloody joke.

telephone call & the guy gave the impression he just wanted to get off the phone from the start. He hadn't read any of my notes & had no idea why my GP referred me.

Fezolinetant (the new drug Jingle mentioned) isn't availble via my NHS Trust. Nor is 6 monthly scanning.

Slynd - not available & he ridiculed me for "googling information".

He is going to try me on Tibolone but only after I pushed - his whole stance was to stay on the non HRT antidepressants that aren't very effective.

This is the "specialist" but my GP was more helpful. He kept banging on about taking "over the counter supplements" without explaining what these were - I asked and he wouldn't answer my question - bizarre. What a Chocolate teapot of an HRT Gynecologist.

I just feel like not even the so called NHS specialists give a fuck.

@Reginaphalangeeeee apparently Tibolone can improve libido.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/tibolone/

I was fine on a combined patch (synthetic progesterone), fine on Kiofem (oral oestrogen and synthetic progesterone) but when I switched to oestrogen plus continuous Utrogestan ( the bioidentical, gold standard progesterone) I felt dreadful - very very anxious after 3 months, oral and vaginal. I switched for good reason, to minimise breast cancer risk, but nothing could justify me staying on it.

Now on oestrogen plus synthetic prog. and will try a Mirena in October.

Utrogestan does not suit everyone

Slynd is available. There are women on this forum using it.

So is the other drug.

https://thebms.org.uk/2026/03/nice-supports-nhs-prescribing-of-fezolinetant/

Maybe you can question is again with your GP because both sources say these drugs are available. Maybe there is a difference between regions- I've no idea- but you could pursue it.

I never adjusted to it. I hadn't wanted to have the Mirena either but not only was I feeling like life was not worth living half of every month but also I was a bit crap at remembering to take it on the right days (possibly unconsciously because I really felt suicidal at points). So on the advice of my GP I pretended I needed the Mirena for contraception and got it quickly. I feel so much better now, like the Oestrogel can do its work unhampered. Also DH is weirdly a lot less annoying too.

I felt awful on the progesterone days (200mg per night)....poorly/as if I had flu. Lasted for those two weeks and beyond.
I spoke to the GP (via the BUPA Menopause Plan) and she suggested taking 100mg each night. That's been great for me. I have absolutely no side effects at all.

But why did you have to lie about needing it for contraception?

My GP suggested the Mirena for HRT and then fitted it.

I agree with your post though. The only thing I don't like is the stabbing sensation from the Mirena sometimes. But two years in and I'm used to it, I'm certainly not going to change it as I'd have to STOP HRT without it!

I was all over the place with my HRT and so up and down but switched to BioID and it’s been life changing. They blood test you and your dosage is made specifically for you so not a one size fits all. It’s private so not free but if you can afford it, it’s incredible. I’ve gone from low mood, low energy and bad sleep to feeling like I used to pre menopause. The blood test and consultation wasn’t expensive at all so maybe worth having that so you can see what your levels are and why it’s affecting you so badly. It might be an easy fix.
https://bioidhealth.com/

These types are HRT (called 'compounded HRT) are not licensed and not endorsed/ approved by UK doctors, including the British Menopause Society. There are good reasons why and there are risks using them.
It might be worth you looking up the information from the BMS for your own information.