Anyone else on higher dose than 100 patch and 1 progesterone tablet daily?

[Ellah500]

I started out using gel and cyclical progesterone. The gel amount kept increasing due to persistent symptoms and the progesterone break wasn’t doing me any favours. I told the doctor I was going to take daily progesterone 1 tablet and also discussed the gel was only working for the first half the day leaving me suffering in the evenings, even on higher doses.
I transferred to the patch 50 and have had to steadily increase to 100. I’m finding I’m only benefiting on the first day, day and a half and then symptoms are returning. The most distressing of these symptoms is very low mood, feeling detached, unmotivated depressed and a loss of any excitement in life. I’m honestly really struggling with that part.
I already take 100mg Sartraline an don’t want to increase the dose.
so I’m wondering is there anyone who is taking a higher dose patch and more than 1 progesterone tablet or changing their 100 patch every two days? If so, can a gp prescribe this? Lastly, does anyone benefit from testosterone cream and is this available on the NHS?
thank you for taking the time to read this 😊

Hi op
Ive been taking 75mg oestrogen and 100 mg progesterone for 2 or 3 weeks. But, I think the progesterone lowered my mood and increased my anxiety!!
so now, Im
back on my Evorel Conti patches and have upped my sertraline to 100.
Could it be the progesterone that’s making you feel low?
it doesn’t agree with everyone. Obviously there’s synthetic progesterone in the patches but not as much

I am on 100mg patch and 100 utrogestan daily, I'm in perimenopause still.

My GP did say I could use a second patch along with the 100mg one as some women need higher estrogen doses. I'm a little hesitant about it though.

If I were to do this I would increase the utrogestan, but I don't find using utrogestan a problem. I'm considering upping it to 200mg daily as it is, after some discussion with someone else on here recently who mentioned it's BMS guidance now.

I've never used gel, but I thought some women split the dose and used half in the morning and half in the evening, could you try this? You could use one blob in the morning and one at lunchtime?

I've never found I felt different in the mornings to the evenings with the patches, I'm not sure how that would work as they have a different distribution pattern to gel. They are more of a slow ramp up and on over 3/4 days, so they are at their highest in the middle two days. I believe the gel is 24 hours, so might make more sense if you felt worse in the afternoon maybe ? I'm not too sure.

Perhaps trying a time out or something in the middle of the day or doing something different to usual for an hour would help ? Exercise?

I do recognise the detached feelings you mention as being a menopause symptom.

Never tried testosterone, but it is available on the NHS. People seem to find it hard to get their GP to prescribe it, mine is open to it.

I agree with the PP that you might want to consider changing the type of progesterone for something else- like the Mirena coil or patches with Norethisterone, or a tablet form of HRT, Femoston.

Micronised progesterone is known to have side effects like low mood for many women.

I read somewhere recently that ADs can inhibit the action of HRT.
Is there any way you might consider reducing that dose (ADs) and seeing how you are?

I hope you won't mind me suggesting things other than HRT because it's not a silver bullet on its own.

Also, are you exercising? I know it's common knowledge but exercise does release endorphins and can be as good as ADs for mild depression. The charity MIND has a lot about this and other self-help on their website.

It's worth thinking outside the 'HRT box' and looking at the other ways to improve your mood. There is also a lot of new research on how food/ gut health affects mood.

Increasing your oestrogen further is unlikely to have a significant effect on mood. And you should really be on 200mg micronised progesterone daily at those doses.

You could try the Mirena to see if that suits you better - some women just don’t feel good on oral progesterone.

Alternatively try a different delivery system - changing patches earlier won’t help as they deliver at a sustained rate over time eg 100 mcg in 24 hours and aren’t “running out quicker”. They are designed to be worn for up to 4 days.

Low mood over winter can also be related to low vitamin D so do have a look at your diet, as well as increasing fresh air and activity levels. These can all benefit mood.

I hadn’t thought about the progesterone element to be honest. It could be worth seeing what happens there. Thanks

When I used the gel I found the effects wore off by evening but the patches didn’t thankfully.
I’m hoping my gp will agree to two patches and see how that is.
im on my feet most the day with my job which is pretty physical. The one exercise I do enjoy is walking but I’m limited with distance due to a nasty ankle injury in 2023 and now a fused ankle. And feeling so down I tend to hibernate too much which isn’t great I know

Thank you for the advice, anything is welcome

I’d be very surprised if your GP prescribes two 100mcg patches - that is unsafe prescribing potentially, even more so on only 100mg progesterone.

Mood in menopause is difficult to manage, as it often is so linked to many other lifestyle factors. If you have no other symptoms such as night sweats, just increasing oestrogen is unlikely to be helpful.

Try and get out a bit more, and overhaul your diet if you need to.

Sorry, it was me who mentioned a second patch.

My GP suggested trying a 25mg patch to add to my 100mg, not a second 100 !

Should have clarified...

You can split the gel and in fact the British Menopause Society suggests this for women on high doses ( 4 pumps). I've done it for years with 2 pumps.
1 in the morning, one at bedtime.