I started taking HRT a while ago and I felt was all over the place, sometimes on top of the world. sometimes awful - it took me a lot longer than it ought to have done to figure out that in the 2 weeks that I take Oestrogen only I'm amazing, and when I take Utrogestan with Oestrogen I can barely function - during this time I don't exercise, I eat junk and loads of carbs, I shout at my family and my anxiety is through the roof.
In the UK we had a while where you couldn't get Utrogestan, and I spent 2 months feeling amazing, I lost weight, I was happy, social, I ate well and I exercised.
I decided to have a look online at the current research into HRT and see whether me having a BMI of under 25 and taking unopposed Oestrogen was likely to have a greater relative risk than taking sequential combined HRT and spending half my life feeling awful and gaining weight.
So here's the kicker - on Google Scholar I found HRT and Endometrial Cancer reviews and papers. There's not much available for Micronized Progesterone specifically, but it categorically didn't reduce the risk of Endometrial Cancer compared to Unopposed Oestrogen (these are longitudinal studies - looking at whether women got Endometrial cancer, rather than clinical trials - but they were published in 2010 Allen et al. and 2014 Fournier et al.).
I've talked to my doctor and told them I won't take Utrogestan anymore, and they recommended i have a coil put in, as this is pretty much the only alternative. Based on the NICE guidelines I MUST take progesterone.
I had a look at the NICE guidelines, and Micronized Progesterone's ability to protect against Endometrial Cancer is just assumed - there is no reference to actual studies showing it works at all.
So I went and had a look at the total relative risk of taking HRT... if you start below the age of 60 regardless of whether you take progesterone or not your relative all mortality risk is around 0.7 - which is a 30% reduction in your chances of dying year on year.
I'd love feedback from other people - do you know of any real studies (Not the ones in 90's that looks at cell histology and uses combined equine estrogen, or when you dig in you realise they only had 50 cell samples for the micronized progesterone cohort) that show that Micronized Progesterone actually does what it's prescribed for?
Also, does anyone have enough clout anywhere that this might put this in a more public forum, I don't really use social media, and that seems to be the only way to contact anyone who might actually get some attention.
I believe that women should have agency to make an informed decision about taking the form of HRT that works for them. Smoking almost doubles your All Mortality Risk, drinking Alcohol every day increases it by about 50%. Being Obese increases it by roughly 25%. If you climb Mount Everest you have a 1 in 100 chance of dying. We are allowed to do all of these things, but taking Oestrogen only HRT which reduces your risk all mortality risk by around 30% is prevented by the NHS because of an increased risk in Endometrial cancer which accounts for around 90 of the 285,000 women who die in the UK each year(0.03%).
