Issues with HRT four weeks on

[Serendipitious]

I’ve been taking 100mg of Utrogestan, 2 pumps of oestrogel and vagirux for a month now. Initially I felt calmer but now I’m feeling worse than before.

I’m getting more genito-urinary symptoms especially the day after using Vagirux. It’s the same as Vagifem. Especially after dropping down to twice a week. I’m feeling incredibly depressed, constipated and demotivated. Like a constant state of PMS. I suspect it’s the Utrogestan. Sleep has become more fragmented probably because the Utrogestan is making me pee more.

What to do? I can’t just take oestrogel. To be honest I hate this whole routine, especially applying the gel and waiting for it to dry. I don’t want the mirena coil or any other IUD either. Totally fed up ☹️

[Buddy195 Administrator]

Do you take one utrogestan tablet daily or take 2 tablets for 2 weeks? I found the latter affected my anxiety levels more than the former. According to information on Louise Newson’s free Balance App, it is also possible to take it vaginally, if supported by your healthcare provider. There are other creams and pessaries available if the one you have been prescribed is causing symptoms. I find the Balance App really useful for comparing HRT medications & having up to date research articles. There is also an ability to post questions.

healthunlocked.com/redirect... 

[Serendipitious in reply to Buddy195]

I was recommended to follow the continuous HRT method. So every single day. I think it’s making me anxious too but the depression and mood swings are the worst. I tried it vaginally for a few days and didn’t feel a difference either. I forgot or rather couldn’t be bothered to take Utrogestan for two days which caused a bleed obviously and some respite with the constipation, rather the opposite effect! I’ll have another look at Balance, thanks.

[debsmitch60]

Hello, I couldn't take utrogestan orally as it was literally knocking me out. I went to Louise Newsons clinic too. I was told that wasn't usual but to use it vaginally, but only every other day. It doesn't affect me like that now. I am still not great either and I also hate waiting for 3 pumps of Estrogel to dry everyday. I think if I felt good I could maybe deal with it. Have you thought about estrogen patches?

[Serendipitious in reply to debsmitch60]

That's good to hear. How long did it take for you to feel better when taking it vaginally? I only tried it for a few days and gave up because on another forum somebody said it didn't help.

[debsmitch60 in reply to Serendipitious]

Well tbh I don't feel great but have other things going on. I would at least trial it for 6 weeks. At Louise Newsons clinic they said if you use it vaginally then you only need to do it every other night. Good luck 🤞

[TiggerMe Ambassador in reply to debsmitch60]

Lenzetto is very quick drying, I wasn't keen on the slime

[PixieElv]

Hello

I was told by my gynie to use the Utrogestan vaginally as it didn’t agree with me orally. Might be worth a try?

I now have the Mirena, which is just brilliant for some many reasons, but understand you don’t want to. I also have the Estradot patches, which I find work better than the gel.

Best wishes

[Serendipitious in reply to PixieElv]

Nice to hear from your PixieElv. I didn't realise you were on HRT again? I thought your issues related to central hypo.

[PixieElv in reply to Serendipitious]

Yes symptoms originally were/are CH, but menopause has kicked in too 😞

I used to he Utrogestan before, when it wasn’t menopause but CH. Mirena and Estradot is now. It does help with feeling less achy and I think I can concentrate better and may have some libido back?

[Serendipitious in reply to PixieElv]

PixieElv,

Glad to hear you're able to concentrate better and less achy. My memory is still bad and my knees are achy and have been for a long time. Plus I don't think I've ever had a libido 😂😪

[PixieElv in reply to Serendipitious]

Have you had bloods done? You may need a change or increase in oestrogen? The patches are supposed to release continuously rather than just in one hit.

😊

[Serendipitious in reply to PixieElv]

PixieElv,

Will I have to get the bloods done privately? Is this after 6 weeks? I've not yet no. Interesting about the patches. Plus it saves having to wait for it to dry every morning. Do you know how the patch compares to the gel in terms of equivalent dose?

[PixieElv in reply to Serendipitious]

Your GP should do your bloods after 6 weeks. Some plead poverty to avoid it though, but we know how to insist on getting what we need 😜

Patches come in 50, 75 or 100mg continuous release over 24hours. You need to change them twice a week.

If you could get your head around the Mirena, that was really the game changer for me.

[TiggerMe Ambassador in reply to PixieElv]

Testosterone is what you need for libido

[TiggerMe Ambassador in reply to PixieElv]

The other clever thing about testosterone is that it acts as a backup, if you are running low on estrogen it gets converted into it! 🤗

[PixieElv in reply to TiggerMe]

that I didn’t know 😳

[TiggerMe Ambassador in reply to PixieElv]

Crazy clever our bodies 🤯

[Serendipitious in reply to TiggerMe]

Testosterone can convert to oestrogen via the aromatase pathway, however does that mean all of it does?

[TiggerMe Ambassador in reply to Serendipitious]

I think it acts as a backup source which can be called upon?

[Will_blue]

Hello

I was prescribed utrogestan & oestrogen patches. I suffered for a few months with breast tenderness & very low mood but I'm now 7 months in & both side effects seem to have lifted. I was assured that things would settle & they seem to - hope the same for you. I take utrogestan at night before bed & I sleep a lot better than I used to. Patches are fine apart from scrubbing off the adhesive residue.

[Serendipitious in reply to Will_blue]

Will_blue,

Good to hear you feel better now. So what that shows is that it can take several months for things to settle. Thanks for letting me know. Although seems hard to carry on for that long with those fog over me and not forgetting the food cravings!

[TaraJR]

I don't know if this is relevant, but are you hypothyroid as well, and taking thyroxine? Going on HRT very often means you need an increase in thyroid meds. Just a thought in case it was a low T4/T3 making you very low and constipated

[Serendipitious in reply to TaraJR]

TaraJR,

Yes I have a lot of issues with my TSH being too low and FT4 normal but FT3 low. To make matters worse by GP has just lowered T4 from 100mcg to 75mcg anyway. I am still taking 100mcg. I've also changed practice because my GP was an unpleasant person to deal with. I just hope the new one will bump up my dose again. I suppose its all results dependent too. Don't know why he had to do that at the same time when I'd just introduced HRT. Well it was the local hospital that prescribed but even so.

[PixieElv in reply to TaraJR]

that is only necessary if you take oral oestrogen. The patches or gel bypass the liver and therefore am increase is normally not needed 😊

[Serendipitious in reply to PixieElv]

I’ve noticed things like constipation are worse. I wonder how that has materialised then.

Doesn’t the presence of oestrogen in the blood stream affect thyroid hormones anyway? By raising TBG preventing cellular uptake? That part I’m not sure about, tbh.

[PixieElv in reply to Serendipitious]

neither am I, but I’ve seen links to papers on here.

[radd]

Serendipitous,

I am sorry you are still struggling with all this.

Look at the whole holistic picture as opposed to compartmentalising. Have you tested thyroid hormones since making med changes? Sex hormone replacement risks only working well if thyroid hormones are also sufficient and working effectively with adequate iron and nutrients.

You were also insufficiently replaced with thyroid hormone for a good while due to worries over a low TSH and even if optimised now, reversal of negative change can take many months. HRT should help your thyroid hormones work better and vice versa.

[Serendipitious in reply to radd]

radd,

I haven't tested since making those changes no. I've only been on HRT for 35 days so far. It's something I need to do. However, I did also read that progesterone is a muscle relaxant which can inhibit peristalsis and hence cause a sluggish bowel. I remember getting quite constipated before my period in the past too.

I've just changed GP practice. I will need to see one of the GPs about medication too. I was explaining to TaraJR that my GP at the same time lowered my T4 from 100 to 75! I'm still taking 100mcg but will also have to convince this GP to reinstate the 100mcg. There again it may depend on the results but I remember feeling awful on 75mcg. Thanks.

[CoeliacMum1]

Do you get oestrogel every time and not oestrodose?

Worth looking to see that hasn’t changed.

I’m just weighing up if there’s even any difference with oestrogel, as one has Orange square 🟧 another Green square 🟩 on the bottle…some are saying it’s manufacturing thing and no difference, some others are reporting some symptoms worsening, most definitely oestrodose has caused concern for many and it’s well reported, you’ll find something about it on balance website.

I thought I might add in that if thyroid has been ok previously. I actually didn’t find it caused any shift with my thyroid but of course we aren’t all the same.

Hope it’s as simple as an inferior product and easily rectified by getting oestrogel written on your prescription, not estradiol! They can give you any brand then.

There was a table to be able to convert different products, although I think it was more patches v gel, when stocks were hard to come by/ low and people were given alternatives, but again Balance website has lots of information.

[Serendipitious in reply to CoeliacMum1]

CoeliacMum1,

I've not even heard of oestrodose. Thanks for making me aware but its definitely oestrogel.

[CoeliacMum1 in reply to Serendipitious]

Well that’s good, is your bottle using now different to last bottle you’ve had eg the coloured squares on bottom front of the bottle, just another consideration.

Obviously still look at your Thyroid and nutritional status eg, Vitamin D, B12, Iron, ferritin and folate, if this hrt isn’t the issue.

I have heard few can have some issues with progesterone, even though it’s a calming hormone, sometimes our levels take time to settle I think 3 months is usually trial period (was for me) my GP said to let things settle and have a check up after that… it may need tweaking.

Hope you get sorted soon 😊

[Serendipitious in reply to CoeliacMum1]

I’ve only just started HRT and I’m on my first bottle of oestrogel. Interesting, just noticed the orange square at the bottom.

Is this the inferior product? It’s by Besins International.

[CoeliacMum1 in reply to Serendipitious]

Not to my knowledge I’m actually better on the orange (I think) I started a green square and noticed slight change but back on orange recently, but there’s been a few stating they’re different, but others saying it is just manufacturing thing with these coloured squares… oestrodose is besins too, and reported to MHRA as definitely some having problems and that’s been deemed the inferior product to many… but not all.

It’s early days for you on hrt, I think your GP will say keep at it a bit longer unless things are at a point you can’t deal with it, but keep a diary of your problems to see if you can pinpoint anything, I’d probably get another appointment/chat booked in with GP, tell them your concerns in meantime, if anything like my surgery it’s a month for just a call, although I’ve not requested an urgent appointment as most of mine are reviewing things.

Don’t disregard your other conditions if any though hormones trigger other problems when out of sync.

[Serendipitious]

My other significant issues are the genito-urinary problems. Sorry if this is TMI but I'm getting a lot of itchiness, discharge and the skin is really delicate and sore and bleeds easily. I also get a back ache when bending over. Will these be resolved in time by the oestrogel? It seems to have gotten worse since starting HRT. When I was taking vagirux daily it got better but since dropping down to 1 tablet twice a week its a lot worse. It's almost like oestrogen is stimulating the epithelial tissue but it's not enough and hence its resulting in those undesirable symptoms.

[CoeliacMum1 in reply to Serendipitious]

If it’s depleting hormones causing utis having hrt can help but also take a read of this.

lizearlewellbeing.com/healt...

lizearlewellbeing.com/healt...

I’m pretty sure optibac have a particular strain of probiotics that help combat utis… I have definitely heard it mentioned on some menopause chat… might be mentioned in the above links. It’s been a long time since I’ve read/listened to them.

Oestrogen causes a build up of lining of uterus and taking progesterone keeps this area healthy and thin. If you get any bleeds mention to your GP regardless of how long you’ve been on hrt, these are probably only settling down problems, but mention them regardless.

I take only one pump as I’m sure I was still am maybe slightly oestrogen dominant, (probably been most of my reproductive life) and found weirdly opposite to many. I’m still on cyclically hrt at 56 (still ovulating) when I have gap from progesterone I feel worse without I can’t sleep well without it.

[Serendipitious in reply to CoeliacMum1]

CoeliacMum1,

Thanks for that. Really helpful. The bleeds aren't menstrual but atrophy related because the skin is so delicate and sore. I'm going to speak to my GP about it next week. My knees are also painful too. I'm also going to give Optibac a go too.

You're lucky to still be cycling.

[CoeliacMum1 in reply to Serendipitious]

Family thing, all late menopause I get hormonal cysts which have caused a few investigations, so I’m keeping my oestrogen low as I can deal with for now.

Many have good reviews on optibac as there’s a specific probiotic in it that helps.

Good luck 😊

[Serendipitious in reply to CoeliacMum1]

I think they suspected I had one too a while back. It quickly disappeared itself whatever it was.

I always suspected I had unopposed oestrogen or high oestrogen all my life. Probably not enough progesterone but now I really know the meaning of too little oestrogen!

All the best to you too x