Struggling with finding right HRT combination

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hrtquestions
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Joined: Wed Jun 01, 2022 3:59 pm

Struggling with finding right HRT combination

Post by hrtquestions »

I am menopausal and have been on HRT for about 5 years. I am struggling to find the right combination of estradiol and progesterone/progestin.
I take estradiol for significant symptoms of joint pain/stiffness, fatigue, mood, insomnia. I cannot sleep without it. I therefore must take progesterone or progestin for my uterus. However, I have not found a form that works for me. I would prefer to take bio-identical, and was taking 100 mg oral Prometrium daily for a while but it caused anxiety. In addition, if I stop taking it, I have a massive clotty bleed, so most importantly it did not stop me from building up a uterine lining. I have tried 200 cyclically, but it gave me heavy bleeding when I stop monthly, plus insomnia (I know, a paradox but it is true). I recently tried Combi-Patch and am bleeding every other day, plus my mood has never been so irritable so I need to try something else. I have not yet tried Crinone, but my provider said that is tricky if I am sexually active, due to my partner being exposed to the progesterone, plus it seems less than ideal to have to use vaginal insertion plus the discharge every day for the rest of my life. I have not yet tried an IUD but also worry about side effects.
So, in general, I need the estrogen but have the side effect of building up the uterine lining pretty quickly, and have not yet found a progesterone form that will stop the lining from building up. If the worst case scenario was going back to daily Prometrium, I would try it, but I am worried about the uterine lining. Any suggestions of what is going on with me and other things I could try would be most appreciated! Thank you very much.

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