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Opinions on HRT

Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

Dear ladies.

I was wondering what everyone's opinions are on HRT?

What are your views? How you feel about taking it? Do you take it? Would never take it, if not what are your reasons?

Biggest fears? Do you feel you understand HRT and why it is recommended?

As I am a nurse practitioner I understand the physiological changes that happen in the body. I prescribe HRT and advise women on the risks and benefits of HRT.

I'm interested in people's views.

Best Wishes

Diane Porterfield Bourne.


Link to my recent video where I discuss HRT:


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Comments

  • WombleWomble Posts: 4

    I feel dreadful. I've been on progesterone tablets combined with oestrogen gel for about six months and feel like they are having no effect at all and now I can't get to my doctors for an appointment! The worst but is the constant muscle ache and now I have started bleeding after two years without a period .. 😔

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @Womble

    Thank you for your message.

    It sounds like your GP has you on the right HRT, are you taking Utrogestan at bedtime or other progesterone tablets?


    If you haven't had a bleed for 2 years, you must see your GP. You can call them and explain.

    If you haven't had a period for a year you are post menopausal and it is not normal to have bleeding unless you have just been started on HRT. You have been on HRT for 6 months and just started bleeding?

    I would just get this checked out.

    Please keep in touch and let me know how it all goes.

    Best Wishes

    Diane Porterfield Bourne.

  • WombleWomble Posts: 4

    Hi Diane, thankyou for your reply. Yes I am on utrogestan. Does it make a difference if you take it at night or in the morning? I know I was told to take it at night but kept forgetting so I take it in the morning.

    I know I should see a doctor about the bleeding, and I am very worried but at the moment it is an impossibility because of the covid 19 situation. You can only have a telephone consultation and I havnt even been able to get one of those. I phoned my gp surgery the other morning and I was 42nd in the queue on hold.. I have also had bad constant muscular pain in my arms since October. I have depression, anxiety symptoms and I'm very irritable constantly. The worry of not being able to even see a doctor is making everything worse.. 😔

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @Womble

    Thank you for getting back to me.

    You should only take Utrogestan at bedtime as it induces sleep. I normally advice women to have on their bedside table and its the thing to take as you get into bed. It must be taken on an empty stomach or 3 hrs after food.

    You do need to speak to your GP about the bleeding. Its getting through thats the problem...

    This needs to be addressed first then your HRT afterwards. Once all this is sorted I can advice you on your HRT and get you feeling better again.

    Please keep in touch.

    Best Wishes

    Diane Porterfield Bourne.

  • NadineNadine Posts: 6

    Hi Diane,

    I've been using Oestrogel 2 pumps a.m and 200mg Utrogestan at night on days 15-26, I was prescribed this by my G.P 6 months ago. As time goes on I'm finding the Utrogestan is making me feel quite depressed which is very unlike me. My question is can I halve the dose to 1x 100mg capsule? I have researched and found that this is quite safe. I also read that inserting a capsule vaginally decreases side effects and also world better because it's targeting the uterus directly rather than going through the body first?

    Thanks very much.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @Nadine

    Hello Nadine. Thank you for writing into Live Better With Menopause.

    Both Oestrogen and Progesterone can really affect mood... but you are on a low dose Oestrogen, have you talked to your GP about increasing this first?

    If you are still having periods you need 200mgs as you have been prescribed. Vaginal Utrogestan can be prescribed but mainly for other side effects. Your GP can talk to you about this. I would advise seeing if you can increase the gel to 3 or 4 pumps a day. If the symptoms remain then it might be the progesterone. Utrogestan is one of the newer better ones but we all react differently.

    Please let us know how you get on.

    Best Wishes

    Diane Porterfield Bourne.

  • NadineNadine Posts: 6

    Thank you for your reply. Would using extra Oestrogel improve my mood? I feel fine when I'm just using that but within a few days of the Utrogestan my low moods really kick in. My GP put me on those doses without doing blood tests and just told me that's the usual dose they prescribe for everyone!!? However I can't understand why the dose of Utrogestan is 200mg when I'm only using 2 pumps of gel; it makes sense to me that I'd only need a high dose of progesterone if I was on a high dose of oestrogen? Thanks I really appreciate your advice..I need to keep my mood positive because I have Autistic twins who are also going through puberty!!🙄

  • JunieJunie Posts: 44 ✭✭

    Hi Nadine

    I use utrogestan vaginally, not orally.

    Everyone is different, so check with your Gp.


    hugs

    Junie

  • NadineNadine Posts: 6

    Thanks Junie🙂 do you find it's less side effects that way? Can I ask what dose you use? I also feel quite bloated since starting the HRT which also gets me down😕xx

  • JunieJunie Posts: 44 ✭✭

    Hi Nadine

    I am on 100 mg.

    it is suppose to be taken orally, but my hrt specialist told me to take it vaginally.

    i trust her as she is a specialist in Hrt. My gp put me in touch with her.

    I always use it at night before bed. No problems with it.

    but please check with your specialist.

    hope you get it sorted to suit you.

    hugs

    Junie

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @Nadine

    Hello Nadine, good to hear back from you.

    Increasing your Oestrogen generally does make you feel happier but the progesterone maybe a factor.

    Please discuss increasing your Oestrogel. The 200mgs of Utrogestan is not related to the dose of Oestrogen you are taking. It is a standard dose prescribed to menstruating women.

    Please do not change this until you have discussed increasing your Oestrogen for at least 2-3 months.

    Utrogestan is an excellent progesterone but we are all different and can be sensitive to it.

    You don't need any blood tests if you are over the age of 45 to diagnose menopause, it is based on your presenting symptoms.

    If you call your GP and talk over the phone they might verbally agree for you to increase. I prescribe HRT every day and this is what I advise and prescribe.

    Good luck and let me know how it goes.

    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @Nadine

    Thank you for writing in.

    Your GP has prescribed you 2 pumps of the gel, taking 200mgs of progesterone is not related to this.

    Utrogestan can be taken vaginally if women are experiencing symptoms with progesterone. But its absolutely vital that you discuss this with your GP. You say that 2 pumps of the gel is helping you, that's great. If that needs altering your GP will guide you.

    Please keep in touch and good luck.

    Best Wishes

    Diane Porterfield Bourne.

  • NadineNadine Posts: 6

    Hi Diane,

    Thankyou for your reply. To be honest I have reduced the Utrogestan this month to one 100mg capsule because I read on other forums that it is safe to do so, however I feel just as bad mentally and just can't snap out of it which is very unlike me. Do you think I'm sensitive to progesterone? Or could using it vaginally stop this side effect? I think my G.P might just prescribe me something else and I'm reluctant to keep trying different ones.

    Thanks again for your help,

    Nadine

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @Nadine

    Good to hear from you.

    Have you discussed how you are feeling with your GP? I am a prescriber myself and would not advice altering medications unless you have been advised by your GP or pharmacist.

    You may well be sensitive to progesterones, many women are... and they can be awkward. But please talk to your GP about your progesterone regimes. Its vital you have the right dose to prevent thickening of endometrial tissues in the womb.

    Utrogestan can be taken vaginally but it's essential your GP advises on this, or refers you to someone who can help.

    Have you considered the Mirena coil? This is an excellent way of getting progesterone too.

    Please talk to your GP and let me know how things go for you.

    Keep well and safe.

    Best Wishes

    Diane Porterfield Bourne.

  • MonicaMMonicaM Posts: 192 mod

    Hello ladies,


    I have an appointment with my doctor on Tuesday and I am hopeful that she will put me on some type of treatment to help with the hot flushes, night sweats and low libido. I will update you guys next week to see how it goes (if I don't forget) LOL.

  • NadineNadine Posts: 6
    edited May 29

    @DianePorterfield-Bourne

    Hi Diane thank you for your reply, I spoke to my GP who asked a specialist for advice and was told I can use Utrogestan vaginally. She seemed to think I should still use 2 capsules but I have read that one is enough because it's going directly to the uterus..what do you think? Or should the side-effects be reduced using it this way? Also I haven't had a bleed for the first time, do you think that's because I only took one capsule nightly this month? I feel pretty bad, really sore breasts, awful PMT and my moods are all over the place which is very unlike me. I took the last capsule 10 days ago so I'm not even sure when I should start using it again. Thanks I really appreciate your advice.

    Nadine

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @Nadine

    Good afternoon Nadine.

    I'm so pleased you discussed this with your GP and they spoke to a menopause specialist.

    With all medications its very important to take them as prescribed to you, please do not alter this until you have discussed with your GP. 2 capsules can be prescribed but there is 200mg capsule you can take instead ( they would have to prescribe it). Sometimes this is easier to use instead of using the 2x100mgs.

    Are you taking 1 or 2 capsules vaginally?

    I do think you need to talk to your GP, as I can't advise about changing regimes of prescribed medications. The menopause specialist advised 200mgs for a reason, so best to stick with this until you have spoken to your GP.

    I hope I have helped.

    Best Wishes

    Diane Porterfield Bourne.

  • cath40cath40 Posts: 2

    Dear Diane

    I have one pump of Oestrogen a day but have only been prescribed 1 x 100mg capsual. The instructions say you should take two. Could you advice as it seems most ladies on this conversation are taking 200mg.

    Many thanks

    Catharine

  • LouETLouET Posts: 3

    Hi Diane,

    I have the mirena and am on 200mg patches. Some symptoms remain unfortunately and blood tests show that I am not absorbing transdermally (have also tried the gel) - at a 15pmg patch my levels were still low at 132. I cant get to see a menopause specialist at the moment and presuming my only option is oral tablets. I had high hopes with hrt and, whilst it works brilliantly for some, unfortunatrly I am not quite there yet

  • karenfrenchykarenfrenchy Posts: 3

    Hi im on day 3 of the estrogen patch and 1 Utrogestan everynight.

    Im a bit scared using hrt but i get a lot of symptoms, so i need help.

    My last 3 periods were last August, January and March.

    I've also to keep taking the mini pill.

    The doctor tried to insert the merina coil but was too painful.

    I will keep you posted how i get on.

    Im 51 years old.

    Karen.

  • Kitch2010Kitch2010 Posts: 1

    Hi

    I am on estrogen at the moment, 2 pumps, after having been on evorel patches. Also take utrogestan 200 mg at night for 14 nights. I am not sure if this is enough after having been on 50 mcg patches. I have severe pains in my arms at times. And can feel low in mood? My GP is not very helpful when it comes to discussing HRT. Any help would be great. And are patches better than the gel.

    Thank you

  • Morning55Morning55 Posts: 13

    I am on patches 2mg 2 x a week for 5 months. I want to switch to the gel for convenience oppose to putting on 2 patches. I have no uterus so I don’t take progesterone plus progesterone never did anything to help me feel better. If the patch was helping me would I not feel better since it’s been 5 months? My doctors said o can try the gel should I switch? MentallY I feel like a crazy lady and it’s a struggle to keep my sanity . Any advice I would appreciate

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @cath40

    Thank you for your message.

    1 pump of Oestrogen is a lower dose, as long as this is relieving your symptoms then that is all you need.

    The progesterone is related to your age and menstrual cycle. It isn't related to how much Oestrogen you take.

    If you are concerned about your prescribed medication please discuss this with your GP.

    I hope I have helped.

    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @LouET

    Good afternoon and thank you for writing in.

    Are you taking 200mg patches of Oestrogen? and your bloods are still reading low Oestrogen.

    What has your GP suggested ? Have they referred you to an NHS menopause clinic?

    It sounds like you may not be absorbing it via the skin, difficult till say until you are assessed by specialists.

    But some people need Oestrogen from different routes, this will be discussed.

    The other thing has your GP checked your testosterone level? Might be worth having a chat.

    Best Wishes

    Diane Porterfield Bourne.

  • LouETLouET Posts: 3

    Thank you Diane, yes thats correct - 200mg oestrogen. I was increased from 150mg to 200mg in March this year on the advice of my local nhs menopause specialist as levels were only 132pmol/L. I was prescribed testosterone at that point but then read I should only use it once the oestrogen is at the optimal level and so, as that hasnt happened yet, I havent applied any. I did wonder if I should try the spray but, as I dont absorb gel or patches sufficiently I dont suppose I will have greater success with another transdermal product.

    With best wishes

    Louise

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @LouET

    Good morning.

    When did you last see or speak to your NHS Menopause specialist? I really think you need another appointment or certainly a phone consultation as you need quite a few parts of your treatment reviewing. They will be the ones to discuss options/routes/repeat bloods etc.

    You are obviously still worried and not feeling yourself, so these or your GP would be the people you need to talk too.

    Hope they can help and support you.

    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @karenfrenchy

    Hello and good morning. Thank you for writing into Live Better With Menopause.

    Many women are afraid of HRT... I actually posted a video on this very subject yesterday on Live Better With Menopause Facebook group. If you can't find it, @Blanka_C will help you find it.

    HRT is a decision you and your health provider make together and they can alleviate your concerns and explain the reasons to take HRT, any risks and the benefits. You have made that decision. It's early days and improvements can be a matter of days or a few weeks. We are all different..Many women all over the world take HRT and it is recommended in NICE guidelines as 1st line treatment for menopause.

    One thing I read was that you are taking the progesterone mini pill and utrogestan (progesterone HRT) too. Can you clarify this with your GP as the mini pill gives you progesterone and acts as contraception where as utrogestan is just progesterone.

    Please keep in touch and let us know how it all goes.

    Best Wishes

    Diane Porterfield Bourne.

  • Diane Porterfield-BourneDiane Porterfield-Bourne Posts: 267 Menopause Nurse Practitioner

    @Kitch2010

    Hello and thank you for your message.

    Receiving Oestrogen in a patch or gel is the safest way of getting the hormone into your bloodstream. The 50 mcg would be equivalent to 2 pumps but it does sound like you are having effects of low Oestrogen. Please follow the product literature on how to apply safely and correctly or speak to your GP and or pharmacist and they will clarify.

    As long as you are applying correctly, it maybe you need more gel or go back onto patches? It is very early days but do look into how your applying it before thinking it isn't working.

    Let me know how you get on.

    Best Wishes

    Diane Porterfield Bourne.

  • karenfrenchykarenfrenchy Posts: 3

    Hi Dianne

    I did discuss with the gp about taking the mini pill with the Utrogestron and she said it was ok.

    I wont be having too must progesterone will i?


    Thanks

    Karen.

  • Blanka_CBlanka_C Posts: 349 Community Admin
    edited June 8

    @karenfrenchy

    Hi Karen,

    Just wanted to share the link to Diane's short video on HRT:

    We've also recently published an article on HRT which you might find useful to read:


    Hope it goes well with your GP.

    Blanka x

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