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[Dancinggirl]

Hi All
I'm reviewing my options re HRT so I've been scanning some of the posts . I want to know more about Utrogeston as I have never been offered it. I currently use Gel+ Mirena Coil - so a no bleed regime (i'm 57 and had premature menopause in 30s). I love the idea that it helps with sleep - I spend so many nights lying awake worrying about all the stresses in my life - but am worried it might upset my stomach because it is taken on an empty stomach. Do you feel dizzy in the morning as well?
I read there is a pessary option?
Can anyone tell me how they get on with the 25day x100mg regime with oestrogel?
Is anyone using the pessaries with gel?
I have also heard you can use the gel continuously but take a higher dose of Utrogeston to induce a bleed 4 times a year to protect the uterus.
Any info greatly appreciated.

[Cassie]

The gel is fab as you can adjust the pumps as you get symptoms. I am on and a half plunges a day but may have to up to 2, been getting a bit flushy in bed @ night. Using 200mg Utrogestan, vaginally for 10 days, the 100mg is also great, depends on whether you want a bleed or whether you want to have a non bleed regime.

[jo61]

cassie does the 200 mg give a bleed or the 100mg

[meno lesley]

I use gel plus utrogestan 25 days out of 28 and i am 55. This is my 5th stab at hrt and is the best, the only problem i find with utrogestan that it gives me some muscle pain. I do not get a bleed.

Lesley x

[Dancinggirl]

Thanks to all those who have responded. It sounds as though i should try Utrogeston as an alternative to a Mirena.
Do any of you get an upset stomach with the pills?
How easy are the pessaries to use? Are they messy? Do they come in the 100mg dose?
It's so great to share experiences like this - I wish I had discovered this site before.
Keep giving me feedback - I want to know more
Dancinggirl x

[Cassie]

You can get a bleed with the 100mg and the 200mg depending on how you use them, ie for how many days per month. They suit me better used from the bottom up, less side effects that way, I pop one in at night and when you go for your morning wee, then whats left comes out and not much fall out after that, they dont stain ones undies or anything. And yes 100mg or 200mg both can be used either orally or vaginally.

[Dancinggirl]

What about sex with the pessaries.
If I was using 100mg almost every night I assume my husband would need to use a condom or he'd be getting a hit of progesterone?
I'm liking the idea of a better nights sleep.
I get up at least 2 times a night to wee - have done since I had my children - so annoying.

[Hurdity]

Hi dancing girl

I've used Utrogestan for a couple of years - I use 200 mg vaginally and still have a cycle. I was having a two month cycle but I had some thickening (of the womb lining) so I am going down to a 6 week cycle.

The standard prescription as you will see from the menu on left is for 200 mg orally for 12 days per 28 days for cyclical use and 100 mg 25 days out of 28 for continuous use (in practise many women in fact take it continuously.

It's a question of whether you are happy taking utrogestan continuously - which I don't want.

The standard prescription is varied by many specialists because some women suffer from progesterone intolerance (including bio-identical prog in our own bodies - utro is bio-identical) - so lower doses are sometimes offered although it is recommended that there is greater diligence re any untoward bleeding and regular scans to check for endometrial thickening.

Also many specialists recommend vaginal use if there are side effects with oral use. However I can't imagine many women wanting to do this continously - at least if you have an active sex life!

I don't find it messy - the same capsules are used for oral or vaginal use. I just told my GP I was using it vaginally although it is not prescribed for use this way. Some women are able to use a lower dose vaginally than orally as the progesterone is delivered straight to the uterus. eg I was using 200 mg vaginally for a two month cycle.

There is another type of bio-identical progesterone which comes in waxy pessaries - called Cyclogest but  not so often prescribed escept by specialists and some GPs as it is not licensed for use as HRT. I used this for several years and they can be used as suppositories.

Utrogestan makes me need to pee more in the night though!

Hurdity x

PS typed the above before your latest post - re sex - I think it would be more that the prog would be diluted and likely to leak out after sex so you wouldn't guarantee to get enough - this is OK if you are cyclical as there are other ways  - but not on prog continuously!

[Dancinggirl]

Thank you everyone - so interesting. Going for my annual check soon and feel better informed.
I am not entirely happy having the Merina - have had chronic fatigue many times over the last four years and have often wondered if it is due to the progesterone in the coil. Also vaginal flora very often off colour - itchy and burning.  I worry I am getting infections. Had stomach cramps lately and some break through bleeding so wondering if it's coming to the end of it's life a bit early. I think the thought of something stuck inside you is not ideal either.
This is why I'm considering my options.
I'm wondering if the regime Hurdity uses may work for me as I am well over the menopause.
A 6/8 week cycle with Utrogestan 200mg used vaginally might be worth a try and if not happy  perhaps try continuous and then if all else fails go back to Merina.
I'm worried about getting period pain as before when I was on cyclical regime in my 40s.
Does that sound like a plan?

[Cassie]

Hurdity so are you now taking Utro 200mg for 12 days every 6 weeks, is that it?
Re sex, I only take it for 10 days of the month and my hubby is on serious rations anyway,  due to my low testos and libido lol, so it doesnt phase me and he is very patient bless him, I always tell him, if he comes near me @ that time, he will grow a fanny which brings a smile to his face, I dunno about using it continuously you would then prob have to use it orally if you didnt want to contaminate your husband And DG, just to add that the progesterone in the Mirena is synthetic which can have nasty side effects, whereas the Utrogestan is a bio identical micronised progeseterone not a progestegin, which may make a difference to your side effects.

[Dancinggirl]

Hi Hurdity
No, not on Utrogestan yet, still have mirena. After reading all the stuff on the forum today (I liked the sound of your personal regime) I think utro maybe a good option for me so will probably give it a go.
Many thanks to everyone for their input - so helpful. Hope my experiences will help others.
I'll keep everyone posted about my progress.

[Dancinggirl]

Sorry Cassie
Misunderstood your post - half of it was a question to Hurdity and the second half was feedback for me re: the Mirena. My understanding of what Hurdity does is that she uses patches all the time for oestrogen and utro for 12 days every 6 weeks. I'm hoping Hurdity's regime may work for me ( though I use gel) although I'm worried about the withdrawal bleed as I always had quite a bit of period pain with my withdrawal bleeds back when I was peri and had cyclical HRT.
I have tried conti tablets - various kinds - but they didn't suit me.
It's so interesting to hear how everyone copes with the HRT problems. I hope in time there will be greater flexibility with tailored regimes as the benefits, not just for quality of life but many health issues, are now proving to be very positive.

[Hurdity]

Hi there
Cassie - yes that's right. 200 mg vaginally - just started for the first time with reduced length cycle. Will do 10 days. I will vary the cycle slightly depending on what I'm doing because I can't have alcohol when on prog as get migraines, and also to time the bleed....

Thought I'd have a go at reducing the cycle length so that I could keep up with the 50 mcg rather than have the reduced dose ( yet to have this agreed by docs when I go in a couple of weeks - but using up all my old 50's!!)

Re sex  - I know what you mean!!!!! Not going into details on here but ditto re having low testo (I presume) so low libido, and patient husband.....!!!

DG - re period pains - mine are only very mild compared to the ones I used to get because the bleeds are small. It will depend to some extent on your oestrogen dose and the cycle length and whether you have anything  else going on eg fibroids. The more oestrogen the greater the bleed and therefore more likely bad period pains.

You could try a 6 week cycle with utrogestan and see how you get on. Should be OK if you are only on 2 pumps of gel?

Hurdity x

[Cassie]

I wonder if I could get away with 8 days of 200mg, every 4 weeks, Doc said 10 but I get such insominia of late whilst on it, am seeing him soon, I guess it depends on the thickness of the lining again.

Thx Hurdity, hope that all goes well on your new regime. x

[Dancinggirl]

Hi Cassie and Hurdity
Thank you again for such great feedback.
Please keep reporting back as to how you are both getting on with these regimes.
I have my check up appointment tomorrow so will discuss it all with nurse.
When you think that between 25% - 50% of women have problems with the menopause and research is now showing so many health and quality of life benefits and the benefits are outweighing any risks in many cases, you'd think the drug companies and doctors would be bringing out a more tailored approach as they have with the contraceptive pill. Would there be a reduction in other drug use e.g. antidepressants, sleeping pills? Would it reduce the cost for treatment of heart disease, Alzheimers etc. on the NHS?
Some comprehensive training for practise nurses would go a long way to help the situation.