I’ve been wondering about this for a while. With the theory being that oestrogen stimulates endometriosis and progesterone suppresses it, why have I only ever been put on synthetic forms of progesterone? I’ve been on the contraceptive pill, depot provera, Mirena coil and Prostap injections. All of them had side effects and whilst some helped with pain they weren’t a long term fix. Now I’m unfortunately experiencing the mine field of peri menopause (& had a flare up of bowel endo symptoms and pelvic pain due to being incorrectly given oestrogen only HRT) and I’ve very recently started on a daily capsule of prescribed body identical progesterone called Utrogestan. This can be taken orally or used as a vaginal pessary, is much safer and has minimal side effects compared to synthetic forms of HRT. Does anyone know why this doesn’t seem to be offered to endo sufferers? Or am I being completely dumb in thinking this would be a good treatment option to try? I haven’t been on it long but I’m intrigued to find out if my pelvic pain eases.
I’m very suspicious that due to pharmaceutical companies influencing and controlling our health care, (they fund a lot of stuff for g.ps etc as the NHS can’t finance it all) our medical professionals prescribe synthetic drugs rather than body identical substances. Basically because the pharmaceutical companies wouldn’t make any money from it and the medical professionals get incentives and perks from the pharmaceutical companies to prescribe their drugs. Sorry for the long post! Any views on this?
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Sorry, I think you’ve got it backwards. Synthetic progesterone is really cheap. It costs one tenth of what Utrogestan costs. And it can be made generically so companies are not making anything on the patent. Also drug reps don’t really fund anything meaningful for GP s these days, it’s more a long the lines of catering for a lunch whereas 30 or 50 years ago they could and did do more.
Interesting....thanks for that. I thought they funded the training and therefore would have some influence. I wonder why progesterone isn’t prescribed instead of Progestins. Guess there must be a medical reason. Thanks
Hi Nikkky, as wanwood said things have changed dramatically over the years (and rightly so) to avoid any potential influence - drug reps can give training and provide a meal when they visit a surgery to do so ( ie bring in sandwiches) but in small settings like this they aren't allowed to so much as even give away a pen (literally) - v strict rules.
BUT to the point - I also can't work out why it's not used for endo; my best medically-educated guess is that the dose it comes in (an HRT dose) is too low to suppress the menstrual cycle and thus help with endo. I'm online tonight purely to try to figure this out as I have severe adverse psychological reaction(s) to synthetic progesterones so am hoping it might be an option instead. If you find out anymore pls do let us know
Look up the work of Dr Jerrilyn Prior in Canada who uses natural progesterone for adenomyosis and also Lara Briden, a naturopath from New Zealand. I’m going to start using this as have some left from an HRT prescription and if needs be get the doctors to prescribe me HRT but only take utrogestan for now.
Mirena is too painful and I have awful bladder and kidney symptoms which flare up in the 2nd half of my cycle when I think the swelling is causing my bladder to shrink. Has anyone else had this? Sadly endo surgery didn’t help but it wasn’t on my bladder, just around the nerves to the uterus (and bladder).
I'm sooo glad you brought this up. Utrogestan jas been amazing for me (I'm same age as you)!!
To cut a very long story short (we all have them); I was gutted when my excision surgery eventually failed. I had it back in June last year with 5 blissful months of feeling like a normal person again..
The Bang! It crept back up on me.. I was devasted and requested a referral back to gyneas again via my GP.
This was in November and I've since heard nothing back.
So I kinda took matters into my own hands. I was beginning to have night sweats again, as I used to with my horrendous endo symptoms (I'd heard it was the endometriosis itself which could cause this). But in the back of my mind, wondering if I was perimenopausal. Not had a proper period since 2017 when I jad the first Mirena Coil placed. In other words, no way to tell.
So I decided to take oral progesterone (Uterogestan) as a HRT to see if it would help. Well I wasn't going to take the oestrogen gel which had also been prescribed for me (during Prostap treatments) as knew it would make the pain worse.
Hand on heart.. I've felt amazing. Night sweats have stopped, but the horrendous pain has also stopped. And I mean completely. I'm beginning to wonder if it's too good to be true.
I'd been meaning to post my experience on here for a while now (been taking Uterogestan for 3 months now), but since I was looking up endometriosis and progesterone, came across your post.
Unbelievable. Now am I in natural perimenopause are what?🤷♀️
Nope. Not me.. but then it has enabled me to go the gym more. Oh and I've just had covid so hsve lost weight haha.. but no.. no difference to weight on the whole. It's been like a wonder drug to me!! Xx
Hi Manda,That’s great to hear that Utrogestan has made such a difference for you. I’ve definitely seen an improvement in the pain. It hasn’t gone completely but I rarely need to take pain relief, which is good. I’m on oestrogen HRT too and my symptoms haven’t flared up so the Utrogestan is keeping things in check. When I first started HRT I was wrongly prescribed oestrogen only and my bowel endo symptoms flared up within 2 weeks. It’s interesting isn’t it? If I’d known about body identical progesterone being available I’d have tried it years ago instead of Prostap etc. The dose can be increased if needed too. I’m so glad I’ve started on the oestrogen as well as it’s helped with my debilitating menopause symptoms. That might be something you want to explore as topping up oestrogen levels is good for our future health and you already have the benefit of having Utrogestan in your system. I hope you continue to be pain free x
Nikkky, is the oestrogen only you are on body identical also? Can you share what the name of it is? My GP appointment is on Monday and I want to ask her to prescribe body identical HRT. Will let you know how I get on with it! I'm excited I might have found the answer to all of my issues... it's been the perimenopause! Hormones are so difficult to balance but we'll get there eventually!
Hi. All of the oestrogen HRT is body identical these days. It’s the progesterone that’s the problem as it’s synthetic in all of the combined HRT products (the combined patches and tablets contain synthetic progesterone). That’s why you need a separate oestrogen and progesterone prescribing, so you get a body identical progesterone called Utrogestan rather than the synthetic stuff.
There are 2 brands of oestrogen gel- Oestrogel and Sandrena. Oestrogel comes in a pump action bottle, whereas Sandrena comes in small sachets. It’s down to personal preference really, plus some women find they absorb one gel better than the other. I preferred the sachets of Sandrena.
There are different brands of oestrogen patches- Evorel, Estradot and Estraderm. Again, some women prefer one brand over another or find they absorb better on one particular brand.
Some women find that the first thing they try works really well but some of us have to experiment with different methods and brands. It can be trial and error and takes patience.
Unfortunately there has been a National shortage of HRT for months and that has caused huge problems. It’s been difficult for lots of women to get their usual HRT and they’ve had to switch between methods and brands. Terrible. The supply does seem to be getting better though.
I hope your g.p is recently trained in HRT. If not you might have to tell them what you want. With the oestrogen, it’s just a case of you deciding whether to start on gel or patches. Some women prefer the application of a gel once a day, whilst some prefer to stick a patch on and forget about it for 3 1/2 days before changing it.
Hi Nikkky, got the HRT prescribed by the GP yesterday! She IS the menopause specialist at the health centre and before I even told her which labels I wanted her to prescribe me with, she told me herself! She says she only works with Utrogestan and she gave me Oestrogel. She is not sure either that I am going through the menopause. She said to try it for 3 months and then see. She said my ovary could perfectly well still be working well. She said there is no way to tell and that not having a womb does not mean the ovary stops working shortly after. There are many women with only ovaries and no womb! She said it's wrong for the surgeon to have told me that my only ovary would stop working and I'd go into menopause within 2 years of the hysterectomy. She said that's like putting a date to die for someone who has cancer. She said they can't say for sure, no one can... Anyway, I have had a look at the leaflet that comes with Utrogestan and it puts you off! All these warnings against women on HRT and possible future breast and ovarian cancer, heart disease, blood clots etc and it also says that we will experience a montly withdrawal bleed. What happens if we don't have a womb? Does it bleed into our abdominal cavity??? I really do not wish to bleed once a month 😱 When I asked her how would I know if the endo gets worse, she just said because the pain will come back... what? I know that is why we have to take progesterone along with the oestrogen but I really don't want to feed the endo at all... Did you have second thoughts when you started on HRT?
Hi. I honestly didn’t have any second thoughts on starting HRT because at that point I was completely floored by menopause symptoms, couldn’t function at all and was suicidal. I did do a lot of research though which reassured me that HRT was perfectly safe. Unfortunately the info leaflets that are put in with HRT products are not only years out-of-date but are not even specific to that particular product. They’re not correct in regard to body identical HRT and relate more to synthetic hormones. Body identical HRT is safe, it does not cause cancer, blood clots or heart disease. It has been acknowledged and the info leaflets are supposed to be in the process of being updated but I imagine that will take a long time. In the meantime women read the enclosed leaflet and are too scared to take HRT, it’s terrible. I don’t know how this has been allowed to go on for so long. The flawed HRT study in 2002 has a lot to answer for as that made doctors and women fearful of a HRT. They’ve since admitted they got it wrong and apologised but of course that didn’t get the huge media attention.
You have got menopause symptoms and you’ll most probably be peri-menopausal rather than post-menopausal. When our uterus is removed the blood supply to the ovaries is reduced, affecting their function and we go into menopause within 5 years of the surgery. This can be a gradual decline in hormones, similar to a natural menopause or it can happen suddenly if the ovaries shut down quickly. I had a gradual decline for 2 years after my surgery where I had menopause symptoms but wasn’t really aware of what was happening and was just trying to get on with things. Then the terrible mood swings, palpitations and insomnia started. I had no patience with anything and felt so angry and emotional all the time. I wasn’t sleeping well and would wake very early with a horrible foreboding feeling for no reason. Then almost 4 years to the day after my surgery- WHAM. It was like I’d been hit by a train. I suddenly could not function at all, it was terrifying. It took me 4 months to realise this could be hormonal and that was only because I read an article about surgical menopause and the penny dropped. No medication had worked so I just knew it was a lack of hormones making me ill. After 3 days on HRT I felt a little improvement, which was such a relief.
Definitely give it a try and don’t be scared. The oestrogen won’t flare up your endo because the Utrogestan will counteract the stimulating affect of oestrogen. If you’re still worried about the endo you could always start off with the Utrogestan for a few days before starting the oestrogen to get some progesterone into your system first. You’ll be taking the progesterone continuously every evening, unlike ladies who are peri menopausal with a uterus. They only take it 2 weeks out of 4 so they can have a bleed and shed their womb lining. It’s essential for keeping their womb lining thin and healthy. You don’t need to worry about that. It’ll just control your endo and it can have mild relaxing/calming affect for some women.
HRT honestly hasn’t made by endo worse- infact I have far less pain since starting it. My pain now is more from adhesions.
Best wishes with it and let me know how you get on x
This is very helpful. Please forgive me if I ask the same questions as I do honestly forget what I read and I find myself having to go back on the posts to re-read to see if you have already answered it... It's my memory issues... The leaflet says it was revised in May 2020 though... and what is that about a withdrawal bleed? Only for women with a uterus then? What if women without a womb are still having this bleed but into the abdominal cavity or through the vagina thus like a period again even though we don't have a womb? Have you ever experienced bleeding again?? I'm concerned because I am on blood thinners also which would affect any internal bleeding... I did ask the GP what side effects to watch out for and she said that there wouldn't be any! That was confident! And can I ask what adhesions are? Are they scar tissue from the surgery or new endo growths that are pasting organs and tissue together??? Because I have been told from the last MRI that they can see adhesions to the rectum/bowel and the new endometrioma in the ovary and another smaller one on the ovary. How is the endo growing if the ovary is not really working well anymore?? I remember the gyne a few years back said that not much endo would grow anymore now that the womb is out but here we are with new growths and adhesions... I really wish I was prescribed Utrogestan straight after surgery to prevent these new growths... I don't know why they don't use it to treat endo. Can the endo be reversed/shrink I wonder with Utrogestan? I'll start taking it alone for a week or so as you have given me confidence! and to have a good level of it before I add the oestrogen, that's a great idea Nikkky!! God bless you!!
Oh gosh, yes, the memory problems! I was terrible and was going completely blank mid-sentence, forgetting words, forgetting names, forgetting everything. My memory is loads better since being on HRT.
The leaflets are still out of date. They’re just a generic leaflet for all hormone meds with no distinction between HRT, contraceptives, synthetic hormones. The following info is on the Balance-menopause website and is dated as November 2021:
‘The information inserts with your HRT are out of date and not accurate, the MHRA (Medicines and Healthcare products Regulatory Agency) are working to change and update them in line with the evidence that shows that HRT is safe and effective’.
The withdrawal bleed is just the lining of the uterus shedding so you won’t have that. I haven’t had any bleeding at all on HRT.
I haven’t had my pain investigated since my surgery but I had the return of bowel endo symptoms when I was initially prescribed oestrogen only HRT. Starting the Utrogestan stopped my bowel symptoms so it seems to be controlling things. I still get some sharp twinges and areas that are painful to touch but they don’t bother me that much compared to how it was. I think that could be adhesions as I’ve had them previously.
You will still be producing oestrogen so that could be stimulating any endo that was missed during your surgery. Your natural progesterone will be low and out of balance with oestrogen as progesterone declines by our 30’s. The Utrogestan should hopefully help.
Yes, I too do wonder why we aren’t prescribed body identical progesterone but it just doesn’t seem to be known about among gynaecologists. They seem very behind in many ways. Plus, as I understand it the pharmaceutical companies are only interested in the synthetic progesterones rather than the natural as the natural isn’t a patented drug. It’s all so complicated and not necessarily about what is best for the patient x
Hey Nikkky... I was finally prescribed oestrogel and utrogestan 4 weeks ago but I decided to begin on the utrogestan alone until I got my hormone levels tested. The pain in my remaining ovary that has the new endometrioma ceased completely and I haven't felt it in 4 weeks! I sleep better also. But my brain fog and memory issues continue to get worse and worse. I'm so scared... I got the blood results back today and my oestradiol levels are 1888 pmol/L -OMG, I don't know how this is possible... FSH is 6.8iu/L so my GP called gynecology at the hospital. She could not speak to my endo gynecologist but to someone from her team and she was advised to tell me not to take any hormones (not even the progesterone I have been taking) as I am not menopausal as revealed by the test. And to retest in 3 months. I am in tears. My oestrogen is so high yet I feel menopausal but it might be that my immune system is reacting to the high levels of oestrogen and eliciting the same symptoms as if I was suffering with the menopause and decreasing levels of oestrogen.. What do I do??? I am so confused and feeling so lost...
Hi there, you will be peri-menopausal and not post menopausal. The blood tests would only be reliable if you were post menopausal and are not recommended or reliable for peri-menopausal women. They’re a waste of time but some doctors still insist on doing them.
The same thing happened to me in that my gynae consultant did blood tests, told me I wasn’t menopausal and to stop HRT. I’d only been on HRT for a few weeks. Two months later I suddenly became extremely ill as my oestrogen dropped even lower and I couldn’t function at all. It was terrifying.
Unfortunately most g.p’s, consultants etc do not recognise peri-menopause and are either not trained at all or not up-to-date. They haven’t got a clue when it comes to hormones. The NICE guidance states they should go on symptoms and not blood tests. I didn’t know this and just believed my gynae consultant.
Basically, in peri-menopause your ovaries (or ovary) is gradually reducing its oestrogen production but desperately trying to produce more oestrogen as your body does need it to function properly. This can result in high (but very brief spikes) in your oestrogen level. It is not the level that your oestrogen is at consistently and it will be dropping too low as well. You have got the low Oestrogen symptoms such as brain fog and definitely need oestrogen HRT. Don’t let them scare you about high oestrogen levels as it’s complete nonsense when you clearly have menopause symptoms.
It’s great that the progesterone helped. I was similar and realised I should have been prescribed body identical progesterone years ago instead of the synthetic stuff. A lot of doctors are not even aware of the body identical progesterone. They are so behind when it comes to women’s health.
It’s so difficult to challenge them but all I can suggest is that you contact your g.p and tell them (don’t ask) that you want to start HRT as you have menopause symptoms. Tell them what HRT you want prescribing and if they are dismissive say that these symptoms are affecting your quality of life and you want a 3-month trial of HRT. They can’t refuse it. You can also use the symptom questionnaire and HRT prescribing guide on the balance-menopause website as you might need some factual info to back you up. I feel for you as it’s so hard to navigate when the health professionals are clueless and constantly contradict each other.
It’s a battle but it’s a battle worth fighting. Don’t stop taking the Utrogestan. You’ll honestly feel such a difference when you get some oestrogen into your body as well x
Hi Nikkky, what about my FSH? It is only 6.8iu/L which reflects that are not menopausal, right? Doesn't it have to be over 30? Isn't this what shows if I am menopausal or not?
Hi, the blood test for FSH is also unreliable. Taking into account your menopause symptoms and your FSH result it shows that you are in peri-menopause and not post-menopause. If you were post-menopause your FSH would be consistently high but in peri-menopause your FSH can be low one day and high the next. If I explain it like this: menopause is just the particular day that our periods stop (it lasts one day), so we are either pre-menopausal, peri-menopausal or post-menopausal. If you’d had both ovaries removed you would have been post-menopausal straight after your surgery, but as you’re left with one ovary you can go into the peri-menopause stage at any time. Unfortunately, due to the hysterectomy you don’t have periods to use as a guide. If you did they would be very erratic and that would be another symptom to help the doctor to diagnose peri-menopause. Again, it comes down to doctors not being trained, not understanding and quite often not even acknowledging the peri-menopause stage. This is the stage when our ovaries are slowing down oestrogen production and oestrogen levels become very erratic as the ovaries try to carry on working. Oestrogen levels can change hour by hour, that’s why blood tests are not recommended to diagnose peri-menopause. During peri-menopause we get the awful symptoms of low oestrogen but can have symptoms caused by the constant fluctuating too. Oestrogen HRT can be taken during this stage to control the menopause symptoms and as long as you continue with the Utrogestan your endo will be controlled x
Hi Nikkky, you are being really helpful and the one I am trusting these days! I won't stop taking the Utrogestan as the pain has stopped. When my GP said she had spoken to gynecology and endo consultant and he said to stop HRT and to do nothing and retest my hormones in 3 months, my heart sank. I said to her "What about all these brain issues?" she said I don't know. I couldn't believe it. My memory was starting to 'fail' long before the surgery perhaps because of the high oestrogen levels. I was told I was oestrogen dominant and that is why I have endometriosis they said. I understand that the levels must be up and down every day. I wonder if I have depression as well as I feel so low and have no energy to do anything or any motivation to carry on. That is how I feel. Totally worn out, fatigued. Is that menopausal too? I suppose starting the oestrogel would do no harm. I could see if my symptoms improve... My GP did prescribe them a month ago but I only started the Utrogestan in case the oestrogen levels were still too high... so you are not shocked by the level of 1888 pmol/L ?? When I had them tested in February they were only 707pmol/L !! I wish I could be tested when they are super low to give then proof of how wrong they are when relying on blood tests... how frustrating...
Honestly, the symptoms you’ve described are menopause symptoms. The fatigue and depression are amongst the worst of the symptoms. You feel like you are dragging yourself through the day, no interest in anything and no motivation. You don’t feel like seeing anybody and you just withdraw as you don’t have the physical or mental energy anymore. You lose any zest for life and that’s because we need oestrogen (and oestrogen at a decent, stable level) to make brain chemicals such as serotonin and dopamine. I had no idea but no wonder the anti-depressants I was prescribed weren’t working at all. I thought I had treatment resistant depression, which was really worrying. Memory issues are pretty common with menopause too. I was forgetting what I was saying mid-sentence and would go completely blank. Also, I was forgetting words and names as well as forgetting how to do everyday tasks. Oh and I was full of rage and very irritable- like pmt on steroids. My confidence and self-esteem was rock bottom. Other things were palpitations, headaches, itchy skin, itchy vulva, tinnitus, buzzing in my head, blurred vision, breast pain, joint and bone pain, hair falling out, dry/dull hair. The list is endless as it can effect any system or organ. All of the symptoms I’ve mentioned gradually appeared over the 2 years after my hysterectomy and steadily got worse. Then I started waking every morning with a feeling of dread and doom. Apparently that’s quite common and it’s a horrible feeling. When I got to 4 years since my op (almost to the day) I was completely floored with horrendous anxiety, terror, palpitations and an overwhelming feeling that I wanted to die. The suffering was unbearable and I don’t know how I survived it to be honest. Sorry for going on and on but I think it’s so important for women to know what can happen to some of us.
Anyway, no I’m not concerned with your ‘high’ oestrogen level as firstly, it is not too high. Remember that during pregnancy women can have levels of 40,000 and feel perfectly well. With you being Perimenopausal and having the menopause symptoms associated with low oestrogen you are obviously not staying at the 1800-1900 level for very long anyway, otherwise you would be feeling well. Lot’s of women (especially with hormonal depression) require stable oestrogen levels of 1000 or more.
Don’t be scared of starting the oestrogen. If you absorb it okay you’ll be pleasantly surprised! I couldn’t believe the difference it made xx
Also, Nikkky, I am wondering with these super high oestrogen levels, could endo turn into cancer??? Or perhaps high levels in our case (peri menopause) are normal and nothing to worry about? As long as we compensate with Utrogestan... By the way, I am only taking 100mgs before bed. Should I be taking more? How much do you take? and does your GP prescribe the dose you take? Thanksssss
Hi Nikkky! It's been a long time... I have been accumulating experience with regards to HRT. And I really don't know what's going on with me anymore... my oestrogen levels must still be predominantly high because every time I start using Oestrogel, the symptoms seem to get worse... As you may remember, I was taking just the Utrogestan for 4 months and the endo seemed to get better and seemed dormant but when I add the Oestrogel, I start getting pain from the ovary that had developed a new endometrioma... So I keep restarting the Oestrogel when I feel that my symptoms feel like the menopause and then after the 3rd day, I stop it again because my symptoms seem to be worse than before I applied the Oestrogel... I don't know what to do anymore I still feel low and anxious with negative depressed thoughts, keep not being to sleep much, waking up lots of times, flooded with dizziness and almost vertigo. Constipation and IBS is so bad still and getting worse it feels... I get palpitations that go up to my head and then I feel like I might faint and I feel hot then cold again after a few minutes... it's so weird... but these symptoms seem worse when on Oestrogel. I restarted it last Monday morning after those freaky symptoms began again on Sunday and within 30mins I was feeling great but yesterday I was getting dizzy again and feeling sick after lunch... I don't know if what I needed was to apply another dose of Oestrogel or discontinue it altogether... So today I haven't applied it again... I don't know what I need at this point... I've never been able to apply Oestrogel more than 3 days at a time because of all the symptoms getting worse after day 3... how weird... do you think I need to find a menopause private clinic? one of Dr Newton ones? I don't get anywhere with the GP who is specialised in the menopause and my endo specialist doesn't seem too knowledgeable on the subject of the menopause either...
Hey Nikkky, long time no hear. How are you these days???? I've just switched from Oestrogel to Estraderm MX75 because after 3 months of using the gel, I was not noticing the effects of it much anymore so I thought patches might be a steadier source of oestrogen than the gel and the gel was causing dizziness (I think but I'm not sure it was the gel) What I don't understand is how one pump provides 750 micrograms of oestradiol while the patch provides only 75 in 24 hours. Doesn't make sense... although that might explain why I was feeling dizzy if it was causing a spike of oestrogen rather than a constant flow of oestrogen like the patch might do... I haven't noticed any improvements with my memory, concentration or low mood yet though not even with the gel I still feel like I'm losing my mind and I still feel like I want to quit my job because of how confused I still get with all the info I need to remember and retain. I don't seem to be able to remember anything still. How are you doing with everything you were struggling with??
Hi Manda, are you still only taking Utrogestan and not Oestrogen HRT? Does it not cause any withdrawal bleeding? You still have your womb I'm guessing... I was also wondering why they don't use Utrogestan to treat endo! I had it prescribed yesterday but reading the leaflet it's made me scared! I thought it prevented all the conditions that it warns about! Doesn't make sense...
Hi Nikkky, I guess I am scared that if I have super high oestrogen levels, adding more would multiply the endometriosis... I asked the endo revisited group on Facebook and the admin members there told me that really high oestrogen levels can also give the same menopausal symptoms! And one of them actually had a hypersensitivity to oestrogen and would have the same symptoms I am having during her periods and then years later when given oestrogen HRT because it was the oestrogen she was 'allergic' to and her immune system was reacting to it as it tried to 'attack' it and get 'rid' of it. So I am so confused... What you say makes so much sense but I am also concerned because endo and our endocrine system also produce oestrogen. Have you ever heard of zoladex? I have also been suggested to take that to try and shut down my only ovary whilst taking a low dose of HRT to counteract the menopause symptoms to natural menopause... I was given by my GP oestrogel and utrogestan a month ago. She gave me 3 months worth. I have now used a month's supply of utrogestan. You really think I should start on the oestrogel?? Is it okay to go against medical advice given by that consultant my GP has spoken to from the endo clinic? I'm scared...
It’s very difficult as you’ll hear lots of different stories and opinions, which gets so confusing. I know some people say that high oestrogen can cause the same symptoms as low oestrogen but that’s not true. They’ve obviously not experienced the symptoms of low oestrogen because they can be horrendous and debilitating. Unfortunately a lot of women are told they’ve got high oestrogen because health professionals don’t have the knowledge to interpret their hormone blood test results. They don’t actually know what is low and what is high and don’t know about fluctuations. Your oestrogen might have been at that higher level because you were ovulating at that time but it’s still st a brief spike.
There’s also the theory at the moment that oestrogen can cause a histamine response but whether that’s true......who knows. It all comes back to this fear of oestrogen that has been instilled in everyone since that failed study in 2002. It led to doctors completely ignoring menopause.
I’ve been on Prostap before (similar to zoladex) and I wouldn’t recommend it. It puts you into chemical menopause but you’re already peri-menopausal anyway, so it’ll take away any natural oestogen you’re making. Then you’ll be replacing it with HRT. It doesn’t make any sense. They’re still treating endo by removing our oestogen instead of prescribing body identical progesterone to balance the hormones.
The utrogestan has worked in terms of your endo pain so that’s promising. If you start on 2 pumps of oestrogen gel you can see how you feel. I didn’t absorb the gel but if you do you should notice even some subtle improvements to brain fog etc within a couple of weeks. You might need to gradually increase though as some women need 8-10 pumps of gel a day. Remember, you can always stop the gel if you want to.
Oh yes, I do go against medical advice. I wouldn’t be alive if I didn’t x
I hadn't seen this comment! I happened to scroll down and then I saw it I think I am going to start the oestrogel. I'm also trying to find out what the other blood tests revealed as I had another menopause profile test done a week after the one that revealed the 1888 oestradiol levels... it'd be interesting to see... I will call the gyne secretary tomorrow to see if she can tell me over the phone... it's funny, I go against medical advice quite often too!!! I always feel like I have to ask the right questions and really research and prepare my approach every time I go see a doctor. Ridiculous!
I’m the same- it’s like preparing for battle every time a have an appointment! I don’t have any faith in doctors when it comes to women’s health, even the female doctors. I’ve been fobbed off and wrongly advised so many times over the years. Some of them seem to be fine that you’ve done your research as it helps them, while others hate it and immediately feel the need to patronise and belittle.
Endo doesn’t turn into cancer, so please don’t be worrying about that. Oestrogen doesn’t cause cancer either. It’s the synthetic progesterone in some HRT that has been linked to cancer that’s why we are safer on the body-identical Utrogestan. I take 100mg a night as prescribed but I know some women do take a higher dose. I would stick on the 100mg and just see how you get on with the oestrogen gel. I actually feel like the oestrogen has helped too as a I don’t feel that inflamed feeling inside my pelvis. Oestrogen has anti-inflammatory effects so you might find you benefit from that.
You have been like an angel sent from above, honestly. Your reassurance is God sent! Okay, I'll start the Oestrogel tomorrow morning! It might even help my IBS symptoms then as the doctor says that the endo inflammation might be what's causing the IBS. I've been suffering with IBS since my first pregnancy back in 2000! I always noticed that it would get worse before and after my periods... is that when oestrogen is at its lowest?? I wonder... All the symptoms you have described I have them I also wake up with feelings of doom and gloom and all life feels unbearable and things that I never had an issue with I suddenly feel like I can't cope with them. So yes, anxiety and anger and zero patience. Little things irritate me. I often have issues with everyone in the family now like my tolerance for mistakes and flaws is zero and it is not me as I've always been quite good with loving others when they don't seem too lovable! I don't know... It feels like am sinking into depression and depression is not in my vocabulary. Feelings like I rather die as well as I don't feel I'm coping with anything and feelings that my family would be better off without my constant nagging and negativity and low moods I am finding prayer difficult too and it's always been my life line! And I can't seem to get myself to accomplishing much lately. Getting up in the morning is hard. I feel useless at work because of my inability to focus and remember names and faces or new information and feeling confused. My hearing got worse 6 months after the hysterectomy with onset of Meniere's which was vertigo and dizziness and since then my hearing in my bad ear has deteriorated. I wonder if that too was a drop in oestrogen... My joints and bones are always hurting and stiff. My whole body is heavy and stiff and I have lost so much 'youthfulness' I thought I was just getting old. I am only 48! And the memory issues and fog and inability to concentrate etc I was fearing it was early onset dementia. I was so scared... And synthetic oestrogen will improve all of these?? May God hear you because I am putting my faith and hope in HRT! I am so excited that this could be the solution to my health issues... and I am so tired and depressed always talking about 'my health issues' I was always so fit and healthy. I was blaming it on the hysterectomy, that I never should have had it. In fact, I mistrusted it so much that I kept delaying it. No wonder. I feel so much worse than before the surgery. It's been downhill ever since, not a solution at all. Have you ever tried nutrition? Because I have spent so much money on nutritionists and functional doctors and supplements and nothing has made any difference. I was even vegan and now vegetarian but I feel weak and bloated and with horrid IBS. No matter what I eat, I get so windy and bloated... I did mention to you that the nutritionist recommended a test to see if I have mould and it cost me £300 for it to reveal that I do have mould as she was told by the Dutch test people that high oestrogen levels are often caused by a mould infection. But I can't have had a mould infection for this long, surely. And the supplements she prescribed to get rid of this mould were making me feel so much worse... So I have been believing all this time that my issues were oestrogen dominance... since 2018 when I started seeing this nutritionist. She gave me a sugar balancing diet to follow and supplements to cleanse a parasite infection in the gut but I have never felt any difference It's never ending... I think she has given up on me! And now I always have to be careful with carbs and sugars because I have it in my head that I am insulin resistant and that every time I may eat some sugar or carb, my sugar levels and insulin production go sky high which causes oestrogen to also go sky high... She told me to take tablespoons of flaxseeds as they help level excess oestrogen and to eat other phytoestrogens because they regulate excess oestrogen levels. And to eat more protein and less carbs. I keep thinking that I have to do the keto diet and that I will never be able to eat carbs without feeling like I am poisoning my body Have you ever read about all this?? Or come across these recommendations?
Yes, I have come across all of those things. I’ve tried all sorts too because we get so desperate for a solution that we’ll try anything. Nothing helped with my symptoms at all. Diet and exercise are important but they don’t replace our hormones. There’s a lot of stuff about balancing our hormones but you can’t balance what you’re not making in the first place!
All oestrogen HRT is body-identical these days (it’s made from yams and is a copy of what we produce). It’s amazing really.
I wouldn’t be surprised if your ‘Ibs’ improves or resolves. I was told I had Ibs for years and spent years seeing different gastro consultants. None of the meds or diets helped at all. I had an upset stomach and pain every day for many years. About 5 years after my endo diagnosis a scan showed adenomyosis and I had a mirena coil fitted. My bowel symptoms disappeared the day after and that confirmed to me that it was the endo or adenomyosis causing my bowel symptoms. The symptoms would return and then disappear when I had a new coil fitted. After my hysterectomy I didn’t have a return of my usual endo/adeno bowel problems but for the first time ever I suffered with constipation. That caused bloating and cramping. I now understand that it was caused by my lack of oestrogen. x
That’s great. My bowel symptoms (diarrhoea numerous times a day and always feeling like my insides were inflamed) stopped immediately after my hysterectomy op. I’d had those symptoms for nearly 20 years and lived on Imodium medication. In the months after my op I started suffering with constipation for the first time in my life. I didn’t think much of it as it was actually a relief not to have diarrhoea every day (too much information-I know!). I know now that the constipation was caused by my oestrogen dropping off as oestrogen speeds up digestion. It’s getting better since starting HRT but progesterone slows digestion (opposite effect to oestrogen) and as my oestrogen isn’t optimised yet I still have sluggish digestion.
HRT can take time to get right as it depends on how well we absorb the oestrogen and whether we need higher doses but hopefully you’ll see some improvements soon. It can make you feel a bit headachy and nauseous for the first few days as your body is responding just like it does to any hormonal changes. You can get sore boobs too! Nothing to worry about. Fingers crossed x
OMG, poor you, 20 years???? Gosh, that's not acceptable. Doctors can be so unhelpful... And don't worry, it is not too much info! It would be if you were talking to my husband but not to me at all !!! My IBS stopped completely after my hysterectomy but returned after 6 months which is why I requested another scan to check things out and they found the new endometrioma in the remaining ovary then which explained the IBS returning. I should have realised that the IBS was definitely hormonal then. Yet I still went to a functional doctor and did all those expensive private stool tests and hormone Dutch test. Stupid me. I feel so guilty about that now as it's all the endo... what a waste of money and energy that was... My IBS is flatulance and burping lots after I eat... my knees have been hurting a lot too. That might be low oestrogen I suppose also... I do get constipated a lot also. But it's on and off... I think I already feel better! Although I had a mild flu at the weekend and I am feeling much better now. Might be that 😂 I pray that you soon get the balance right with the oestrogen and progesterone so you can fully recover and feel like your old self again. Although it sounds like you must be feeling so much better now if you were suffering for 20 years 😱 And you are looking to get testosterone also and transdermal patches, was it? How is that journey going?
It’s not stupid at all, we get so desperate to know what is wrong with us and how we can fix it that we end up trying anything. There’s always somebody quite happy to take the money off us! I’ve wasted so much money on private appointments, scans and supplements over the years.
I hope you’re one of the fortunate women who feel much better within a few days of starting HRT.
I’m on oral oestrogen (tablets) as I found I didn’t absorb the oestrogen gel or patches but the gel and patches are the best option. I’m on testosterone gel and seem to be absorbing a bit as my level has risen from virtually zero. It’s recommended to get your oestrogen levels up first and if you’ve still got low energy and low mood testosterone might be needed x
I think the zoladex to shut down my remaining ovary would be in an attempt to lower the high oestrogen levels to then give me lower artificial ones but yes, makes little sense and that would make a bit more sense if my oestrogen levels were consistently very high, I guess. But you say that they fluctuate and my ovary makes more in an attempt at balancing them... Also, I think the nutritionist was trying to get at the root cause of the high oestrogen production which is why I was tested to see if my body was producing such high levels or if it was a case of my body not excreting them as it should but recirculating existing levels. And then the mould test made so much sense also as we had lived with a mouldy washing machine for years and the mould was getting transferred to our clean clothes and then possibly being absorbed through my skin and the lab team said that high oestrogen is often due to mould in our systems which is why I believed it... but if I've had endo for many years, then I don't think I was exposed to mould back then... don't know! I just need to get to the bottom of it that is why I was naive and spent tons of money trying to 'fix it' as you say... Part of me still wonders if it might be the mould causing the endo... no one knows what causes endo that is why I wanted to believe it and thought we had cracked it! But the supplements were flaring up my IBS although my nutritionist said that it was the mould getting cleansed and flushed out which also makes sense. I didn't stick to it long enough
Where do you live? It'd be cool to meet up for a coffee if you were local !!
Hope your constipation and sluggish digestion improves soon... I can believe that it takes time... it has taken years for the endo to cause damage so it will take years to repair it
My boobs are often tender already but it might be because of ovulation as it is only a few days a month. I do have very hard and dry nipples though which is yucky... my turn to give you too much info!!
Also, you are very right when you say that we can't balance our hormones if we don't product them in the first place. However, the nutritionist gave me the hormone balancing plan when I still had a womb and both ovaries before the hysterectomy but it didn't make any difference other than lowering the inflammation which at least was something. But it didn't reverse the endometrioma's growth... It lowered my CA125 to normal levels though so I wish I had carried on doing that rather than have the hysterectomy. I really regret that surgery. It's brought on many other problems not to mention the embolism post surgery I could have avoided all of that and the endo worsening... I never had pain from endo before the surgery. Didn't even know I had endo or even knew what it was. I suppose it was good that it was discovered but I also wish I didn't know I had it to be honest! Now there is bowel adhesions and new endometriomas and new hormone imbalances and horrid menopause brain issues and so on plus my hearing getting so much worse... not good! I was right to try and avoid it... I thought it would solve everything and give me back my health. How wrong was I... I was so naive... Endo was never ever mentioned to me as a possible cause of my many issues starting with IBS and the heavy and painful periods as a young girl...
Oral oestrogen has the risk of blood clots, doesn't it? That's great that you can have it orally... I could not have that form because of the pulmonary embolism history although I am on blood thinners because of it
Sorry, I thought I’d replied! Yes, oral oestrogen carries the risk of blood clots but it’s very small in comparison to the clot risk with the contraceptive pill. To be honest I’m happy to take the small risk as the alternative would be no HRT and that’s just not an option for me.
Hi Nikkky, just to update you... what a nightmare... GP who is a menopause specialist called me today to tell me to come off Utrogestan immediately because according to my recent blood test results, I am not menopausal due to the very high oestrogen levels and low FSH. Of course I challenged her and reminded her that my endo discomfort stopped since started Utrogestan but she said it is not licensed to treat endo as it is an HRT med. And therefore not appropriate in my case. So she's giving me Desogestrel, a POP. To stop ovulation and counteract the high oestrogen levels. I don't understand why this treatment wasn't offered it to me way back to treat the ovarian cyst or after my hysterectomy to prevent the new endometrioma growth and endo regrowth... I am nervous to go on that mini pill. I have never been on the pill before and I've just read that it works by thickening the mucus produced by the cervix or by thinning the lining of the womb yet I have no cervix or womb anymore! I'm concerned about it messing up my hormones more or if it improve my ever worsening brain issues and fatigue and all the other 'menopause' symptoms... what a fun journey this is proving to be... full of question marks and challenges...
oh and she spoke to my endo specialist on the phone that is why they have both reached this decision to trade Utrogestan for Desogestrel... I'm confused...
Hi, I’m not surprised that you’ve had that experience as it’s pretty common to be told you’re not menopausal when you are peri-menopausal. Blood tests can confirm if you’re post-menopause but are useless for diagnosing peri-menopause as your FSH and oestradiol levels will be all over the place. It’s terrible the lack of menopause education amongst health professionals. They’re not good with menopause in general but are even worse when it comes to peri-menopause. HRT can be started in peri-menopause-it tops up your hormones so you avoid the dips that cause the menopause symptoms. A lot of health professionals aren’t aware of this as they’re not trained and up-to-date on it.
I was treated in a similar way to you. I didn’t know it was peri-menopause causing my symptoms after my op, but I went to my g.p as I knew something was happening with my hormones. At the time I had what felt like permanent PMT-I was so low, irritable, angry and impatient with myself, everyone and everything. She didn’t even mention menopause and just prescribed the mini pill. I decided not to take it because I didn’t want to be on synthetic hormones yet again and it wasn’t like I needed contraception anymore. My left-sided pelvic pain was getting worse so I then made a private appointment with the NHS gynae consultant who had done my hysterectomy. In the meantime I started to wonder if my symptoms were menopause related and researched menopause and HRT. I then rang my g.p and told her I had menopause symptoms and wanted to start HRT. I was given oestrogen only HRT and within a couple of weeks my mood and energy levels improved greatly but my bowel endo symptoms returned. I went for my gynae appointment and she dismissed that my pain and bowel symptoms were endo and immediately started down the inflammatory bowel disease route. I’d already been investigated and ruled out every bowel condition years ago but I went along with her-no choice! She also told me to stop HRT and have hormone blood tests. I did what she said and like you my FSH came back normal and my Oestrogen was 880. She told me I definitely wasn’t in menopause and not to start HRT again. I wasn’t aware of peri-menopause as everything online just mentioned menopause, rather than the different stages of our hormonal decline. I didn’t know I was actually peri-menopausal and about the unreliability of blood tests during peri. I believed the gynae consultant and didn’t start back on HRT. It was two months later that I was suddenly, completely floored and couldn’t function. I didn’t know it was menopause as I felt like I was dying. I would never have believed menopause could make you feel so ill. It was mental and physical torture. Not one g.p realised it was menopause related and I suffered horrendously for 4-5 months before realising myself that it might be menopause. By chance I was reading an article by Diane Danzebrink where she described her surgical menopause and the penny dropped with me.
I’m so sorry for the long, long post but don’t do what I did and trust that the doctors are correct. You could try challenging them by saying that you are clearly peri-menopausal and you know that hormone blood tests are unreliable and not recommended due to hormonal fluctuations. You have troublesome symptoms so would like to start HRT. They can’t refuse it. If you check out the NICE menopause guidelines that they have to follow that might help to back you up. Don’t give up with it as replacing your oestrogen and progesterone will be life changing x
Thanks Nikkky. I don't know why GP won't test me. I think if we tested my hormones every week for 4 weeks, we might get an accurate picture of what the situation is. But she said they don't have to test after age 45 but also said that my case is so rare that she doesn't quite know what to do with me and so she is prescribing the mini pill... but that is just going to mess up my hormones even more, won't it? Shouldn't the surgeon have prescribed that right after my surgery in order to prevent the new endometrioma and recurrance of endo? I have seen this in the NICE guidelines, that they are advised to prescribe it for that reason. Also, I am having awful constipation and my abdomen feels even more bloated. When I do go, I push and push and then my hemorroid bleeds because of it (too much info, sorry!). Do you know if Utrogestan can cause constipation and sluggish digestion and flatulence? I started taking Fybogel and thank God I finally went this afternoon but last night I was in so much discomfort and this morning that I thought the endo might have been causing bowel obstruction, God forbid. I have received an appointment for an ultrasound scan in a week but I don't know what they'll be able to see from it as it is not an MRI. Gyne possibly wants it to see if endometriomas are staying same size. Can they see if endo is affecting the bowel? Probably not
I tried the Oestrogel a couple of weeks ago and it was giving me pressure in my head like a heavy head and I began to feel twinges in the ovary again when it had already stopped after I started taking Utrogestan alone 6 weeks ago. So I got scared that perhaps I do have too much oestradiol in the blood already and my body could not cope with it or that maybe the GP is right and I am not perimenopausal... I really want the HRT to work and take away my symptoms but what if it's true that these symptoms are not menopausal but a result of astronomic levels of oestrogen in my body? What if it's not the ovary that's producing it but my adrenal glands and the endo cells?? And then maybe it is circulating in my blood and not being discarded and causing all this damage? I hear that unopposed high oestrogen (I know you said that oestrogen dominance does not exist) can also give the same symptoms as the menopause... I don't know what to do. Ideally if my hormones were tested once a week for 4 weeks, that would shed some light, wouldn't it? I don't know why they won't test more... I could go privately...
Hi. The NICE guidelines are such that blood tests aren’t required after the age of 45. That’s because it’s presumed that all women are peri-menopausal from the age of 45 (although for some it’s much earlier than that) and they’re unreliable due to constant hormonal fluctuations. That’s why they have to go on menopause symptoms. Even if you had your hormones tested every week it wouldn’t necessarily provide any answers as hormones can change from one hour to the next.
The mini pill will only provide you with synthetic progesterone and that comes with risks and side effects. The Utrogestan is better as it’s a copy of what your body should be making. You won’t be getting the oestrogen you need either from just taking a progesterone. The problem is that most g.p’s and gynae’s are more familiar with prescribing contraceptives than HRT so that’s what they prescribe.
The surgeon should have prescribed a progesterone and possibly oestrogen HRT but they don’t seem to bother. Again, a lack of training in endo, menopause and hormones. Some tend to think they’ve removed all of the endo and it won’t return but they can easily miss it.
Progesterone can cause constipation as it slows digestion but so can low oestrogen, as oestrogen speeds up digestion. It’s probably a combination of this that’s giving you constipation. I’m the same as my oestrogen levels aren’t high enough yet but I need to take the Utrogestan to control the endo. All I know with ultrasound scans is that when I had one years ago they didn’t spot my ovarian cyst, endo or adenomyosis. They didn’t even spot that my bowel was stuck to and stuck under my uterus, causing a bowel restriction that was very painful. I’m sure it’s helpful for some women.
When first starting the oestrogen HRT it can cause headache, nausea and boob tenderness for a week or so. It’s the initial reaction to the change in hormones but is not dangerous and will pass.
Oestrogen dominance is really a progesterone deficiency, so if you’re taking Utrogestan you’re replacing the progesterone your body isn’t making. Therefore you haven’t got unopposed oestrogen. High oestrogen can cause nausea and boob pain but it doesn’t cause all of the other symptoms that low oestrogen in menopause causes such as night sweats, bone pain, dry skin, bladder issues, depression, memory problems, fatigue, overwhelm etc, etc. The list of possible menopause symptoms is endless! In hindsight I know that my brain just wasn’t firing on all cylinders and I struggled to think straight, problem solve and make decisions. The only way to reassure yourself that you need oestrogen replacement is to try it and make sure you take the Utrogestan as well. You can take the mini pill as the progesterone part of your HRT but most women just take that if they still need contraception.
When you start to see an improvement in your symptoms it will give you the confidence and reassurance that you’re doing the right thing x
Okay, I suppose I won't lose anything by trying it... GP prescribed 3 months but I have now used 6 weeks of the Utrogestan. I stopped it a couple of days ago as I had been told but I will restart it along with the Oestrogel and stick with it for longer than 2 days as you say it takes a week to adjust... I wonder if GP will carry on prescribing it though now that she has been told by my endo specialist to stop it and that it is not licensed to treat endo... they both agree that I don't need HRT yet
Yes, finding a doctor who will prescribe HRT can be difficult so you might need to speak to a different g.p and be quite assertive. If you start to see improvements on HRT you can use that fact to support your case. Good luck with it.
I read a great book called “how I ended my endometriosis naturally” and in that she suggested bio identical progesterone cream and swears by it. I’ve just started using my cream so will see how it goes. My surgeon had never heard of it and suggested I take the synthetic version via Mirena coil (he was adamant that I wouldn’t experience side effects, which is bad as that can never be guaranteed & a lot of women do). With endo, we are Esteogen dominant which means we need high progesterone so the cream / oral versions sound great to me. Along with foods that help the production of progesterone and cutting down / out wheat as studies have shown that this GMO crop impacts endo sufferers massively. I agree with the pharma industry making millions via synthetic products. I just don’t see how in 2022 the are doctors who haven’t looked into alternate roots and are familiar with natural products that have been proven to help massively.
Hi there. Yes, it’s terrible that they are not educated in hormones and just dish out synthetic versions. A lot of them just carry on doing what they’ve done for years and don’t question anything. There’s a real lack of interest and research in women’s health. Of course, they don’t suffer the consequences.
Remember that your NHS g.p can prescribe body-identical progesterone capsules called Utrogestan. This is better than bio-identical as bio-identical isn’t regulated. I did try a progesterone cream but it didn’t do anything for me. It might be that I didn’t absorb it through my skin as I’ve found out since that I don’t absorb topical HRT preparations. The Utrogestan has helped though and it’s cheaper than buying the cream. The NHS provide 3 months supply for the cost of one prescription.
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I still feel low and anxious with negative depressed thoughts, keep not being to sleep much, waking up lots of times, flooded with dizziness and almost vertigo. Constipation and IBS is so bad still and getting worse it feels... I get palpitations that go up to my head and then I feel like I might faint and I feel hot then cold again after a few minutes... it's so weird... but these symptoms seem worse when on Oestrogel. I restarted it last Monday morning after those freaky symptoms began again on Sunday and within 30mins I was feeling great but yesterday I was getting dizzy again and feeling sick after lunch... I don't know if what I needed was to apply another dose of Oestrogel or discontinue it altogether... So today I haven't applied it again... I don't know what I need at this point... I've never been able to apply Oestrogel more than 3 days at a time because of all the symptoms getting worse after day 3... how weird... do you think I need to find a menopause private clinic? one of Dr Newton ones? I don't get anywhere with the GP who is specialised in the menopause and my endo specialist doesn't seem too knowledgeable on the subject of the menopause either... 
Anyone tried dienogest ethinylestradiol to treat endometriosis?
Info needed on mini pill pls? Endo removed....48yo near menopause...
HRT AND GnRH
endometriosis and HRT
Cancelled surgery 
