HRT - everything worse

[wheretolivecannotdecide]

Hi all

looking for advice, similar experiences and hopefully positive outcomes. I started HRT a couple of weeks ago. I have the Evorel 50 patch & didn’t notice any side effects, however, I’ve now had 5 days of progesterone at night and everything feels worse. My mood is rock bottom, I have headaches and exhaustion is next level. I’m starting to feel despairing and that I’ll never enjoy life again. Does it get worse before it gets better?! Did anyone get used to the progesterone? I really didn’t want a coil as I’m worried about not being able to get it removed easily if it doesn’t agree with me as it’s so hard to get appointments where I am.

Agh. No answers. I have been on gel & progesterone 3 months and blown up like a balloon. Put on over half a stone and still gaining. Think will have to call a day. Skin also flared. Has taken edge off my anxiety. So bit mixed. But the weight gain and feeling of being bloated is grim.

Yes I know what you mean, I’m starving but trying not to eat but my activity levels are virtually nil so I’m expecting a big gain too. I’d aleady been gaining fairly rapidly before starting HRT 😓 all feels totally hopeless if I’m honest

Oral progesterone? A significant proportion of people don't get on with that because it is metabolised completely differently than other administration routes.

I’m on oestragel every day and progesterone 14 days on / off. Might have put a tiny bit of weight on but I think that’s more that I’ve started eating crisps quite often. My symptoms were anxiety, poor sleep and sex not enjoyable and difficult. All of these symptoms have improved.

I could have written this myself a few years ago on the same HRT. The progesterone part left me feeling awful. I was exhausted beyond belief and could barely keep my eyes open during the afternoons. My mood was so low that it was actually quite scary how low I felt.

I tried to see it out and did 4 months on them but every month was the same and I had to come off them.

Have tried a few other forms of HRT and the progesterone part just left me feeling so ill.

Apparently I am progesterone intolerant.

I am on evorel 50 and find patch change days are awful. Migraines, stomach issues etc. I'm also on slynd which seems to cause bloat and stomach issues too and I had a very bad time on the 4 sugar pill days. I spend the whole time feeling like I'm going to be sick,.dizzy and urgently need to go to the loo. But my anxiety and sleep have improved.

I'm going for a review soon, I think I need some way of evening out the evorel dips and I'm not sure about the slynd. It must be that which is helping my anxiety but I'm not sure it's worth the stomach problems.

@ProfessorBinturongyes oral. I haven’t been offered any thing else but maybe I will if I go back

@ErlingHaalandsManBun yes, that’s how I feel. So low it’s scary. Which other progesterone types did you try?

Just administer it vaginally. Reduces side effects in lots of women and is just as effective.

@Janiie I will ask the GP if they will prescribe this

@Janiie have just looked up nhs guidance online for my local area and it says they won’t prescribe these in my area. They’re not licensed for womb protection in hrt apparently 😞

They are used vaginally by many women, not licensed for this exact use but many meds aren't. I presume you are on utrogestan?

You don't need a different prescription you can use the same oral capsules just insert as high up in your vagina as poss. They are absorbed directly to the uterus without the side effects oral use can cause.

Google Menopause Matters there's a forum there where if you search vaginal utrogestan there'll be more info.

It's off label but many women do take oral Utrogestan vaginally as it more directly protects the uterus and significantly reduces the side effects.

https://share.google/aimode/YULpZShdt4CaOIA4T

No, but the GP won't know. It's the same tablets. You can get pessary utrogestan but you can use the oral ones vaginally.

I swapped to mirena.

What you describe is classic progesterone intolerance.. Also increasing the oestrogen will help.

Wow thanks everyone I will research using them vaginally, I had no idea I could use the oral ones this way 🙈
the box I have doesn’t say utrogestan. It just says micronised progesterone

That's the same thing.

I was on the Evorel sequi patches and found they weren’t helping my symptoms after a year. I went back to my GP to change HRT. I can’t take progesterone orally because they’re not sure how it works alongside weightloss injections. I refused the recommended Mirena having had bad experience with that in the past, so I’ve ended up with spray oestrogen and utrogestan vaginal pessaries. GP said they’re not licensed for use as HRT, because there’s not a lot of evidence from trials. Instead I’ve got to monitor it for a couple of months to see how it goes. I bought some plastic applicator tools online to make sure it gets to where it’s meant to go iyswim!

I’ve started using the micronised progesterone vaginally, so I can stay on the oestrogen patches. It was awful for me orally. Really low mood and sooo tired.
if this doesn’t work out I’m stopping HRT as I’ve tried synthetic progesterone and they give me low mood too!

@Lizzbeari used progesterone vaginally for the first time and couldn’t believe the difference yesterday, I felt so much better. I’ll see how I am this week for the true test as I lead a pretty exhausting life! I need to be on top form.

I’m on oral sequential progesterone. In the two weeks I’m take it I Bloat, feel doom ridden, feel exhausted and have an extra period. I’ve been on it 6 months. I’ve tried telling my GP this (via the automated system at our surgery which is the only way we can actually contact a dr), and she said my dose was too low and I should double it?! I really don’t want to do that as I don’t want to increase the other symptoms. She didn’t say anything about them!
I believe there are other kids of progesterone you can take (synthesised?) which might be better. I just need to get through to my GP to actually discuss it. (Or else I’m wondering about going private to a specialist provider as GP seems a bit useless on this).

That’s good to hear. I’m still unsure but going to give it a bit longer. Let me know how you get on!

This is why I prefer the Mirena coil, continuous low dose progesterone

I didn’t get on with synthetic progesterones but am still awaiting a menopause clinic appointment so sticking with the vaginal capsule at the minute.

@PersephoneParlormaid I really don’t want the coil. I didn’t get on with the mini pill and the thought of not being able to get an appointment for months to remove it if I hate it puts me off. I won’t discount it entirely, but much prefer the progesterone vaginally for 2 weeks if it continues working

For info only @wheretolivecannotdecide you can get the coil fitted privately by a private GP or a consultant. Obviously this comes at a cost, but many menopause GPs offer it. The costs I've seen online is that coil is around £90 and there is an appt charge too.

I was offered one by my consultant (privately) and didn't want it but they did say try it for 3 months and it could be removed after that- which is very different I assume to the NHS where you may need to wait longer.

There are also many other options (I feel like starting a new thread on just this!)

• The new option of Nalvee - dydrogesterone can be used alongside estrogen. It's been available in the tablet HRT Femoston for years but is now a separate tablet.

• The mini pill (3 a day)

• Norethisterone as a tablet alongside estrogen (it's in most patches but also comes as a tablet.)

• Longer cycle HRT where progesterone is used less often, such as every 2 months (or 6 weeks rather than 4.)

• Reducing progesterone to 10 days (rather than the usual 12-14.)

Some of these are available more from a specialist and may require monitoring, like a uterine scan now and then, but they are options and worth knowing about.