Menopause Discussion > All things menopause
Utrogestan used vaginally
Gig:
Thanks :) I THINK I understand and i was managing fine with the 12 week regime but now this new 8 week regime has thrown me- which is a bit daft!
What your first line here said
Gig if you are on a two month cycle you just start the progestins 8 weeks (or two months) after you started taking them the last time.
seems different to this:
Basically if you have an 8 week cycle you take prog for the last 2 of them (or 10 days or whatever you do) and the cycle resets
The first part of your post says take them at 8 weeks, the 2nd says take at 6 weeks ( presume that's what you mean?)
When I was having a 3 month cycle ( which i was for years- have just changed to 2-monthly after Xmas) then i was taking progestins every 10-11th week and would bleed around 14 days later. I know that now I am moving this forward by 4 weeks.
I just wanted to check though that a cycle means the actual bleed- not when we start taking the progestin- which will be 10 days plus 4 after stopping before the bleed starts.
Does this make sense? i can ask my dr but not due to see him for another couple of months for routine check up.
Basically the question is- does an 8 week cycle mean you start the progestin at 8 weeks , or you take it before so you bleed by the 8th week?
Gig:
StellaJane
My friend who sees the same dr was on oestrogel but as she is younger than me was told to have monthly bleeds and she was taking the same as you were - 1mg Noreth. for 10 days each month.
So that seems to make it clear to me that our dr prescribes different strengths depending on the length of the cycle.
Gig:
Thanks.
I don't think the bleed has to be spot-on! When i was on my 3-monthly cycle I was quite cavalier and would go from anywhere between 12- 13 weeks for the bleed.
Then I had some incidents of spotting, and ny gynae got all worried. I think now that this spotting was due to my fiddling with the oestrogel dose- trying to reduce it. However, I had a biopsy and a year later a hysteroscopy. This means he now keeps a very close eye on my bleeding.
When I mentioned how heavy the bleeds were he suggested I had a 2 monthly bleed instead just to be sure that I wasn't going to get endometrial hyperplasia/ cancer.
I haven't noticed any difference in quantity of blood loss etc if i take 7 days or 10 days.
I see your logic in suggesting 2.5 mgs might be enough. My thinking is that if you need 12 mgs for 4 week bleeds, then you need 3 times as much for 3-monthly bleeds ( and therefore 7-10 days of 5mgs was roughly the same: 7 x 5mgs= 35mgs.) Now that i am going only 2 months, I think 7 days might be worth trying.
I have scan now and then ( once every couple of years now, but was every few months for 2 years because I had a benign ovarian cyst) and when scanned my lining was always over 6. About 6.4. They like to to be below 5 post meno but my dr accepts 6.4 on the basis I am on HRT ( even though the scan was just post bleed.)
However, I know he is being careful re. this and we are balancing the risks of breast cancer and progestins, and uterine cancer.
He's trying to keep my intake of progestin to a minimum and so far this has meant taking it less often. Whether I can also reduce the dose is something I need to ask.
I think I need to ask him at my next appt.
Cassie:
I used the 200mg for the first time this past month after my gynae upped my dosage from 7 days of 100mg as he said that it was not enough, was told to use it for 10 days but was naughty and stopped after 8, I know I shouldnt!
Had a normal bleed, nothing major, didnt really notice the difference. Would love to use the Utrogestan for 12 days every 2nd month rather but wonder if I would get breakthrough bleeds again, thats what happened when I didnt use it regularly, have another one at the mo but this is my own fault, ran out of Oestrogel and boy, just a slight dose less and wammo! Hate it, but will start a separate thread for that whole saga!
x
Hurdity:
Hi Gig
Well I did say it might sound garbled!
Those two statements that I made are actually the same! What I was saying is just time it from whatever you use to time it ie when you start the oeostrogen only or start the prog or finish the prog (this doesn't count for odd days fiddling you said you do sometimes!).
It doesn't matter when you start the 8 weeks from if you see what I mean. It is the cycle length that is important and the bleed has nothing to do with it - sometimes these vary with different women and in the same individual (mine dont vary as they always come 3 days after the last prog). As stellajane said it doesn't have to be that precise. I make sure I always start my 12 days Utro on a Sunday night approx 2 months since the last time - adjusted forward or backwards to avoid where the migraine might come. Does that sound clear?
I'm the same as you stellajane 12 days per 2 months. I must say I would imagine that if I was on 100 mcg patch then 200 mg utro every 3 months may not be enough prog. It certainly is supposed to be dose dependent ie you need more prog and/or for longer the more oestrogen you have and for longer - but I think some of the doses are given to cover a wide range of usual oestrogen doses. Remember we are messing with what is licensed.
Also Gig as you are with private doc who is also probably erring on side of caution re a high dose of norethisterone for the 3 month cycle.
By the way also if you have a 3 monthly cycle it is not 3 x as much prog as needed - but more!
I said this before when previously on the forum:
For the sake of argument - say you take prog for 2 weeks:
4 week cycle = 2 weeks oestro only + 2 weeks Oestro + prog
8 week cycle = 2 wks O + 6 weeks O+P (ie 3 x as much unopposed oestrogen)
12 week cycle = 2 wks O + 10 weeks O+P ie 5 x as much unopposed oestrogen).
That's why you need to make sure you have enough P when you lengthen the cycle to shed the (even more) lining that has built up.
However as stellajane says - you should be able to reduce the dose to around half - although you are having just over half the length of time of unopposed O ( ie 6 weeks instead of 10).
Hurdity x
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