Has anyone tried Slinda alongside HRT for perimenopause symptoms?

[Frankbutchersfangs]

Hi all

has anyone else tried slinda to manage symptoms of perimenopause?

im 47 and have been on HRT for over two years - two pumps and 200 mg of progesterone, then 100 mg progesterone daily and 3 pumps of oestrogel. However still having heart palpitation insomnia mid cycle and pre period. Saw a private menopause specialist and she has put me on slinda, which is progesterone only birth control as she thinks quietening the erratic effects of my ovaries would help. I’m scared though. Has anyone else tried this?

I'm wondering why you're using combined continuous HRT when you're still having periods and are only 47. The guidance is either no natural periods for 12 months or over age 54. If you're still having periods, what's the idea behind using continuous HRT? It won't control your own cycle.

Would you not be better going back to sequential where you use progesterone for only 12 days a month?

Or, if you're really intolerant to it, you can take it less than that on a longer cycle, with medical supervision (usually privately.)

Slynd is the POP and it's maybe a bit 'overkill' to use this progestin as well as Utrogestan.

What are the qualifications of the dr you saw?
Many aren't really 'specialists' and are GPs with some very minimal training in HRT. Apologies of course if she's not one of those.

She is an actual specialist. (This is her bio: GP for 10 years and
diplomas with the Royal College of Obstetrics and Gynaecology, and the Faculty of Sexual and Reproductive Health. I am experienced in fitting coils and contraceptive implants, and hold the British Menopause Society Advanced Certificate.
I am particularly interested in hormonal migraine, premature ovarian insufficiency, PMS/PMDD, Testosterone replacement, and the management of menopausal symptoms after breast cancer.)

The GP put me on continuous progesterone because my periods are now 49 days apart. When I was on cyclical progesterone it was not helping with sleep and because of the lengths of my cycle GP wondered if daily would help. She also prescribed Sertraline 50 mg which has helped a little alongside the HRT, but still have hormonal insomnia mid cycle and pre period and the specialist said it would maybe help if they suppressed my cycles.

I’m not using progesterone as well as POP just POP

The GP put me on continuous progesterone because my periods are now 49 days apart. When I was on cyclical progesterone it was not helping with sleep and because of the lengths of my cycle GP wondered if daily would help. She also prescribed Sertraline 50 mg which has helped a little alongside the HRT, but still have hormonal insomnia mid cycle and pre period and the specialist said it would maybe help if they suppressed my cycles.

There is so much difference in how doctors use HRT.
I appreciate your private GP has HRT training but they are offering you something very different to mine (consultant gynaecologist with decades of fertility experience as well as menopause) when I was at the stage you are now ( I was early 50s - as a comparison.)

When I was at the stage you are now, with periods once every 3 or 4 months, I was put onto a long cycle of 10 weeks estrogen only and 12 days progesterone. This is still acceptable for women in peri but sometimes they like to do a scan now and then to monitor the womb lining.

It's also a complete no-no (goes against NICE guidance) to offer SSRIs as well, for sleep etc . There is some evidence they stop HRT working so effectively.

You also need to question is Slynd at the daily dose for contraception gives enough endometrial protection. I was offered the POP as an option when I wanted to change from Norethisterone) but was told it needed to be used as 3 tablets daily for HRT. Maybe Slynd is stronger but you should ask. (I assumed you were using it with progesterone from your first post.)

Sleep was my biggest issue and in my mid 50s I went up to 3 pumps of gel.
It might suit you better to use 4 pumps- you're very young and often younger women need more- and to experiment with cyclical progesterone.

If you were to try a longer estrogen only cycle, you can isolate which part of HRT is helping and which is maybe not.

You could also consider the Mirena coil or a different type of progesterone such as Norethisterone or dydrogesterone (tablets.)

SSRIs shouldn’t be used instead of HRT - in my case - very low mood and poor sleep all month, they’ve been a fantastic addition to the HRT and i wouldn’t be without them.

also her qualifications are as follows:

Qualifications
Member of the Royal College of General Practitioners 2014
Advanced Certificate in Menopause Care from British Menopause Society (BMS)
Diploma from Faculty of Sexual Health and Reproductive Health (FSRH)
Diploma from the Royal College of Obstetrics and Gynaecology

I am not sure how much more qualified one needs to be

I just tried it a few weeks ago…never again! It really affected my mood and I was so angry. However, I don’t seem to agree with any sort of progesterone at all, so that was my last attempt.

I use Slynd instead of utrogestan.
I'm really struggled with utrogestan for years.

Its been ok. It doesn't make me depressed like utrogestan but I do feel anxious plus its completely killed me previously very low labido

I asked about Slynd as my Mirena will expire this time next year - my GP said it’s not licenced for HRT here (Scotland) which is a shame as I previously got on well with PoP pre peri.

I am not sure how much more qualified one needs to be

It wouldn't matter that she's a GP but it's not from what you say as you're scared to use it- why is that?

That's not to say she isn't good but she's gone against NICE guidance by using SSRIs before changing your dose and type of HRT or any previous per-meno long term depression.

Some young women in peri are offered the oral contraceptive pill with a more body-identical estrogen- like Zoely and Qlaira- vut they don't add extra estrogen.