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[foreign body]

Hi Stella Jane, I am post-menopausal.I also thought about lengthening the Utrogestan phase to see if it makes any difference. What holds me back is my sensitivity to progesterone. I absolutely hate it. It messes up my life big time. Insomnia, worse hot flushes, moodiness, serious constipation, slow digestion, i feel bloated and sluggish...but i guess i should give it a try next month and see if it causes a bleed. Another option is increasing the amount of estrogen, maybe my body needs more now. My uterine lining is within the safe limit.

[Darcy]

Hello - i am very new here and hoping this discussion is still ongoing.  I am currently on Utrogestan 100mg (taking V route) for 10/14 days in cycle and 1.5 to 2 pumps of estrogel every day.

My last bleed was in january for about 4 days (thats nearly 4 months ago).  have been sticking to the cycle and even tried utrogestan orally 4 weeks ago (that was horrible as it affected me badly) but no bleed as yet. 

Now i am getting worried - i stopped my last Utrogestan 13 days ago and have had some light spotting since then but nothing major and for the last few days have been getting cramps.  I feel like i am going to have a period but nothing happens, on a Keto diet but not losing any weight at all = it seems like my body is holding onto the water / fat.  I also feel bloated a lot.  I have lots of energy though and mentally feel quite normal.

Anyone have any advice for me - i have actually just booked a private ultrasound scan and CA125 blood test for monday!.

thanks for your help  DD

[dazned]

Hi 

Not everyone gets a withdrawal bleed whilst on hrt,I didn't always.
Utrogeston isn't as powerful as synthetic progesterones,say northisterone for example, I wouldn't worry . If there was any excess lining I'm sure it would have shed. You are also on a relatively low amount of oestrogen this maybe why. As you already have a scan booked you will soon know about the thickness. It's more usual to be concerned about unscheduled/unexpected bleeding.

[Hurdity]

Hi Darcy

  from me too.

I agree with dazned - looks like the utrogestan is doing its job in keeping your lining thin. Vaginal utrogestan is more effective at the same dose than when taken orally as it gets to the uterus where it is needed.  Perhaps you could tell us how old you are and where in menopause you were when you started this regime - what was your cycle doing before starting etc? If you had been using a Mirena for example your lining would very thin already so nothing will have built up during gaps between periods for example. Some women get very heavy bleeding when they start HRT for this reason - after several months of anovulatory cycles without bleeding.

Do let us know about the scan anyway and the results of your tests.

Hurdity x

[Darcy]

Hello thanks for the welcomes - its really nice to find people going through the same thing - everyone i know doesn't seem to have any problems going through menopause.  Hurdity I am 51 years old, been taking natpro natural progesterone cream since i was 42 which helped to curb my PMT.  I started to notice menopause symptoms early 2015 - with mainly brain fog / tiredness / not wanting to do anything / then feeling hot at night / Weak bladder / missing periods etc - i started reading loads of books on the subject (Suzanne Somers was one!) and in May i decided to try Testogel (bought on ebay!!!)  I had a tiny bit and it made so much difference right away i was almost back to myself.  After a few months i realised Testogel wasnt the answer - so i found out about Estrogel and got my doctor to prescribe it around December 2015  I turned 50 Nov 2015.  Been on Estrogel and Utrogestan since then - usually having periods as normal (lighter than they used to be before the HRT).  Have been feeling great on it but always find the utrogestan makes me feel a bit rubbish after a few days then i seem to get used to it - One other thing i had / have a prolapsed bladder which i had since the birth of my second child 15 years ago - it got really bad before i started the Estrogel - its fine now but if i reduce the dose even for a day it comes back.  Wasnt on birth control pills or mirena coil for at least 20 years - always had a 28 day cycle.  Will keep you updated - re: tests - also going to have a DUTCH (dried urine) hormone test to see what my levels and metabolites are like.  Thanks for your help DD x

[amy1235]

Hi- I'm new on here and have been desperately reading all and any posts that might offer me some insight into what I should do to feel better. I'm 55 , most probably post meno , and had been on cyclo-progenova for some 5 years  ( 2 mg) I wanted to go bio-identical and try to reduce the estrogen as I was worried about the risks.....so I recently changed to estradot 75 with utrogestan 200 for 12-14 days of a monthly cycle. The first month went ok, had a few vivid dreams on the progesterone part and felt terribly premenstrual before having a bleed which was lighter than it had been on the previous HRT. I then decided I would try a longer cycle like I've read some of you on here are on- so I went for 28
days on the estrogen and then started the progesterone ( two 100 mg pills vaginally) I thought, for 12 days. After the first seven days I suffered the most horrendous migraines and a really disabling " spinning " kind of dizziness which for one whole day just left me bed- ridden and with a pounding headache ( I've had this kind of episode three times in the last year and wondered if it was something to do with the progesterone part of the cycle) . I felt so unwell I just stopped the progesterone and its taken two days for me to feel normal- ish again. I don't feel I can cope with this another month and I don't really want a bleed every month either........I would be so appreciative if any of you can offer me some advice as I feel so unhappy about feeling this unwell.

[Darcy]

Well i got my Scan today and it was fine - only a small fibroid 26mm in the womb, thickness of the lining 3.9mm. 

However i found out a few days earlier about DIM which reduces the 16H and 4H levels of Estrogen Metabolites and increases the 2Hydroxy (the good one!).  I have been taking it 3 days and feel so much better already - I did have a metabolites test done in Jan and my 16Hydroxyestrone was 14.6 in the red!  I am hoping this will take it right down for my next test. 

I have decided to go 3 months with just estrogel then use the utrogestan for 14 days to see if that might agree with me better.

Thanks for your help DD

[Hurdity]

Hi Darcy

Glad your scan was OK. However re the DIM I have no idea what you are talking about and the metabolites!!! Are you in UK - this doesn;t sound like anything that's done here or that is ever measured? Haven't come across it before. Please can you explain and pref with link to something if you can, so I can read and digest slowly!

Hope the long cycle works for you and do let us know how you get on. Has anything been suggested about your fibroid as that isn't exactly tiny? The longer oestrogen cycle may make it grow ( I did have a tiny one 8 mm that didn't grow with oestrogen).

Hurdity x

[Hurdity]

Hi- I'm new on here and have been desperately reading all and any posts that might offer me some insight into what I should do to feel better. I'm 55 , most probably post meno , and had been on cyclo-progenova for some 5 years  ( 2 mg) I wanted to go bio-identical and try to reduce the estrogen as I was worried about the risks.....so I recently changed to estradot 75 with utrogestan 200 for 12-14 days of a monthly cycle. The first month went ok, had a few vivid dreams on the progesterone part and felt terribly premenstrual before having a bleed which was lighter than it had been on the previous HRT. I then decided I would try a longer cycle like I've read some of you on here are on- so I went for 28
days on the estrogen and then started the progesterone ( two 100 mg pills vaginally) I thought, for 12 days. After the first seven days I suffered the most horrendous migraines and a really disabling " spinning " kind of dizziness which for one whole day just left me bed- ridden and with a pounding headache ( I've had this kind of episode three times in the last year and wondered if it was something to do with the progesterone part of the cycle) . I felt so unwell I just stopped the progesterone and its taken two days for me to feel normal- ish again. I don't feel I can cope with this another month and I don't really want a bleed every month either........I would be so appreciative if any of you can offer me some advice as I feel so unhappy about feeling this unwell.

Hi amy1235

So sorry your post got missed - sometimes this can happen which is why it's best for newbies to start a new thread in the new members section and then you can be properly welcomed.

Anyway - your experience is not unusual - some progesterone sensitive women do react in this way unfortunately. I used to get migraines during the prog withdrawal phase (ie after stopping the progesterone) but also sometimes while taking it (and especially if I had alcohol). I don't seem to get them much now - at least not from the prog anyway. How horrible for you to have such an extreme reaction that you had to stay in bed.

Did you go and see the doc just to see if there is any other explanation?

What I do to limit the systemic absorption from vaginal utrogestan is:

For the week leading up to starting the cycle I use 1 vagifem per night rather than twice a week - to plump up the tissues (this is my own pet theory that this will help limit systemic absorption of progesterone as it does for oestrogen - not sure if there is any info on this anywhere!).

I work out how much I need to take - in my case it's from 6 weeks to 2 months approx cycle - so I always take 12 x 200 mg to ensure the lining will be shed.

Then I ease myself into it gently - so the first and last two days I just take 1 x 100 mg. OK this gives 2 extra days to the cycle but it means there is not quite such a hit and also coming off it is not so extreme either.

This may not work for you - but for me it minimises the worst of it.

It is very important to take the progesterone - to protect the womb lining, so is it possible for you to ask for referral to a menopause specialist so that you can perhaps reduce the number of days you take it? This should be done under medical supervision since there is greater risk of endometrial hyperplasia and potentially cancer with lower progesterone doses but provided you are monitored and OK'ed by a gynae this may well improve things. In cases such as yours it appears the gynaes prefer to keep the same length cycle ( ie 28 days) but reduce the time and dose on prog - since the higher doses and longer time of taking it needed for a longer cycle would be too unpleasant and often debilitating.

Also it might be possible to (very) gradually reduce your oestrogen dose eg to 62.5 (cut a bit off) just so that you can take a teeny bit less progesterone - and maybe even eventually to 50 mcg if you feel OK on this - perhaps better this than having to take so much prog?

Some women find the synthetic progestogen Provera is better tolerated so maybe try this one?

Sorry I can't help any more and I do hope you manage to see this - good luck and let us know what you decide.

Hurdity x

[amy1235]

Hi there Hurdity

Thank you so much for your response. I figured I would have to try and slowly cut down on the estrogen to reduce the progesterone part of the cycle ......I will try your idea of 100mg for the first and last two days perhaps and see how I feel. I've asked my GP to change my patch to 50 mg but I've still got some 75 mg patches which I'll snip small strips off first. Dr Studd mentions using utrogestan (200mg?) for the first seven days of the cycle for progesterone sensitive women but there's no mention of what doseage of estrogen this is matched upto...does anyone know anything about this? Also you mention using vagifem- is this as well as patches? Thank you so much for this forum.

[Cassie]

I think Dr Studd prescribes 100mg for 7 days for sensitive ladies.

[Noheroicsplease]

Hi all,

Although I've posted elsewhere, and people like the lovely Hurdity have been helpful, I'm interested to know generally how people have got on with utrogestan? (This is a massive thread and although I've been through it, I keep getting diverted from this question!)

Thinking of changing from the mirena. Reasons? A lot of bleeding (which, actually, has stopped in last week), a flatness? A such tiredness. Wondered if the tired morning side effect with utrogestan was very prevalent with lots of women?

Thanks all.

[Hurdity]

Hi there Hurdity

Thank you so much for your response. I figured I would have to try and slowly cut down on the estrogen to reduce the progesterone part of the cycle ......I will try your idea of 100mg for the first and last two days perhaps and see how I feel. I've asked my GP to change my patch to 50 mg but I've still got some 75 mg patches which I'll snip small strips off first. Dr Studd mentions using utrogestan (200mg?) for the first seven days of the cycle for progesterone sensitive women but there's no mention of what doseage of estrogen this is matched upto...does anyone know anything about this? Also you mention using vagifem- is this as well as patches? Thank you so much for this forum.

Hi again amy1235

As Cassie says Studd's prescription for severely progesterone intolerant women is 7 days x 100 mg which is way lower than the prescribed dose of 200 mg x 12 days. I suggest you would not be wise to follow this minimal prog regime without medical supervision due to increased risk of endometrial hyperplasia on this dose, although vaginal delivery gets more the the uterus where it is needed (did I say that before?). And yes you are right in that this is a blanket one size fits all Utro dose for all oestrogen doses. Since Studd often prescribes high doses of oestrogen, it could be a risk in some women.

Also if you are using the utro vaginally and doing it monthly then you could probably get away with halving that for the 12 days - but again you would need to check after several cycles how your lining responds, and get your doc on board so that you might be able to have scans on NHS ( unlikely unless your prog intolerance is severe and well established ie on your records maybe?).

Hurdity x

[Mary G]

amy1235, sorry to hear about the problems you are having with Utrogestan but I'm not surprised, I would not function at all on that high dose.  My advice would be to reduce the dose and go on from there.  You might find you manage well by just halving it.

I am severely intolerant to progesterone and can only take a very low dose under supervision because I can't even manage 7 days now.  Taking it for a long period of time is completely out of the question for me because it stays in my system for a long time after the final dose. 

The standard Utrogestan (and synthetic progesterone) dose is debated on here a lot and my personal view is that the NHS guidelines need to be reviewed because too many women are taking too much and suffering horrendous side effects unnecessarily.  I think they work on a worst case scenario and then add to it.

Quite a few of us are Professor Studd patients and his standard prescription for women who don't tolerate progesterone well is 100mg (preferably vaginally because it works better at clearance and thinning) for 7 days per month.  I have never come across anyone who has followed his prescription and ended up with serious problems (does anyone else?) and he does not make regular scans a condition of using this regime.  That said, it is sensible to have regular scans because it is not just womb lining that needs checking. 

You may find this interesting: 

https://www.menopausematters.co.uk/forum/index.php/topic,35762.0.html

My advice to anyone reading this who has problems with Utrogestan or any other form of progesterone is the reduce the dose and have regular scans - it is better than giving up on HRT altogether.  That way, you can gauge how much progesterone you need, it is pointless to take too much progesterone for years on end and it is worth bearing in mind that all the risks associated with HRT are in the progesterone component.  So don't guess how much you need, find out.  One size does not fit all and of course you might be unlucky and need more progesterone.  You might have to pay for a private scan but it will be money well spent.

If anyone is in that much doubt about Professor Studd's regime, they should write to him with their concerns and ask him to explain his regime in more detail.

Those who tolerate progesterone well can disregard this post. 

[Dr. Heather Currie]

Just to confirm, while Professor Studd is very experienced and extremely knowledgeable, his regimens are not always in line with current recommendations, particularly around use of progesterone.
As always with providing menopause advice, this should be individualised and flexibility should be applied, as long as there is a clear understanding of national and international recommendations. Some women are intolerant of progestogen and progesterone and so it is appropriate to adjust the regimens, as long as it has been fully explained and discussed.
Best wishes
Heather