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[Katia]

The specialist has recommened this combination for me and my GP has said he doesn't prescribe it.  Has anyone else had this happen? 

[Hurdity]

You have a right to be prescribed the HRT combination that you wish - after all these are licensed products available on NHS. Surely if your specialist has prescribed them then your GP should oblige? I would press him further on this. Which particular product does he not prescribe? Is this code for - he has not prescribed them because he hasn't heard of them and doesn't know enough about menopause and HRT preparations? If so shame on him for not admitting this. He would do well to consult his compendium - or this website for licensed preparations. Is there a cost implication - is the GP practice instructed first to try to prescribe the cheapest option? This still should allow for patient choice if you do not want this option.

Utrogestan (micronised progesterone) is the only biologically identical ( to our own hormone) progesterone available on NHS to be used as part of HRT - so if you wish only to use biologically identical products then he has no reason to refuse. Re the oestrogen - is it gel he is unfamiliar with? You can argue that transdermal oestrogen has been shown to be associated with less risk  for a variety of health conditions than taking tablet oestrogen, and avoids the liver - and certainly when I started HRT my GP respected that I wanted to be "nil-by-mouth" from the start. Having established you wish to use transdermal HRT - then you need to argue that you prefer to try gel to patches - I'm sure you can think of a reason - not least that your specialist has recommended it.

Please go back to this doc or a different one in the practice, having done your homework and rehearsed your arguments and be prepared to stand your ground!

Good luck and let us know how you get on

Hurdity x

[Katia]

I'm about to start this when I come back from my hols. The oestrogel says use as directions so I'm unsure how much to use. I'm guessing 3 pumps to match 2mg in Qlaira. The Utrogestan says take days 1-25.

[Sera]

Hi, following all the shared experience and welcome advice and visits to the GP, I am on my second month of utrogeston day 15-26 100mg ( x2 ) and 1mg Sandrena Gel daily. I am really struggling with fatiuge, sleepiness on urtogeston phase and finding it difficult to function. I would like to try taking it vaginally to see if side effetcs are less, I have read quite a lot of the threads, and would just like to confirm that its ok to use Utrogestan 100mg prescribed for oral use, vaginally ? I am peri meno. On the plus side the pmt type anxiety is less on Utro than was on Femseven sequi 50 mg patches. Thanks and advice very welcome... sorry for any typos but so tired.

[Maryjane]

Hi yes you can use it vaginally , mayake your bladder go 😳 But you won't no till you try.

I can only tolerate 100mg of utrogestin over 10 days.

[Hurdity]

I have never taken Utrogestan orally for this reason - it makes me tired enough when used vaginally but I imagine it would be far worse if taken orally! The licensed dose is 200 mg for 12 days but there is some research which shows that 100 mg for a similar length of time is sufficient in some women if used vaginally - however you would need to check this with your doc to ensure it is doing its job in protecting the endometrium.  As you are on a fairly low dose of oestrogen gel then it may well do the job.

Where are you in menopause and what have your cycles been doing?

Hurdity x

[Sera]

Thanks, I am gonna try and see how I get on fingers crossed

[Katia]

Hi,

I've just started this combination and just want a little advice.  I've had some side effects that are the same as I had with Qlaira, which went away with Femodene. My GP prescribed Utrogestan 100mg 25 days out of 28 and oestrogel use as required.  I struggled to get him to prescribe it, so I'm hoping it will work and I'm not back with my tail between my legs.  I went with two pumps as that seemed average and I was starting from Femodene pill. My face started to burn the same as it did with Qlaira and I got a slight rash. I also felt dizzy and spaced out like I'm drunk. These symptoms went away after about 12 or 13 hours and I feel normal again. Does everyone take Utrogestan at night?  I've taken it in the morning which may be the problem. I also think I will split the Utrogestan one pump am and one pm.  I also started bleeding on the first day I started this combo. I bled with Qlaira, but it stopped as soon as I went into Femodene. Would it just be the change or hormones?  Or could it be this combo doesn't agree with me?  It also making me a bit spotty.   Is it likely to settle down?

[Katia]

Thank you Stella Jane.  I'm not sure I should be on continuous HRT, but I didn't mention it to my GP as I thought it may be better to keep it even like the Femodene birth control pill.  I didn't take the Utrogestan this morning and will try taking it tonight.  I will see how it goes.  So far, it's been nothing but side effect that started two hours after taking this combo.  I'm not sure on the redness Stellajane.  I've was thinking it's a reaction, but now I'm wondering if it's related to the hormone the balance not being quite right.   I didn't have anything like this with Femodene or Cilest, but I did with Qlaira and Yasmin. The spotting for me in the past has seemed to coincide with the burning face. I have a ball of phlegm in my throat and diarrhoea too.  Both of these came when I started the HRT and I'm sure they're connected, but can't be 100%.  I'm wondering if using it vaginally would be better.  Is it the same ones and do they disolve ok?

[Katia]

Stellajane the specialist is private.  My GP grumbled about the gel the specialist recommended and said he didn't know anything about it and only prescribes a couple of HRT's.  Eventually he gave me 1 bottle.   I'm thinking the specialist seems to recommend this combo to everyone.  The other option he gave me was the mirena, which is levenorgestral that I haven't loved in the past and isn't good for hair.  I've also read that it doesn't stay systemic like they say it does.  At this point I think I might be back to the GP with my tail between my legs begging to go back on Femodene.  I'm getting a bit old for it though.

[Katia]

Sorry ladies, another side effect 🙄  About an hour after I've applied the gel my arms and hands are freezing.  Right to the bones.  It's like all the fat has gone in my fingers. I've also gone so dry down below. I'm not sure if that's because of the bleeding. Has anyone had all these symptoms and do they settle?  I'd no problems like this with the femodene pill

[Cassie]

Hi I have been on gel and Utrogestan for years, its great. I would apply the gel to your legs alternating, legs, I always do this and it dries very quickly, I rub it in when I am in bed at night and then I use one utrogestan pill vaginally, its much better for me using it this way and I use it for 12 days per mth so that I get a cyclically bleed, you could perhaps explore using it like this if you find continuously does not work for you. Everyone is different but I love the gel and have never had any side effects at all it works really well, give it some time to settle as well.

[Katia]

Thank you Cassie. The Utrogestan wasn't as bad taking it at night, but I didn't sleep well and then couldn't get up, so I'm a bit tired and snappy. I started bleeding like a period as soon as I started this combo and everything seemed to dry up.    I'm going to give it a little time and hope everything sorts itself out.  I think at the moment I'm comparing it to Femodene.

[Hurdity]

The same capsule can be used vaginally (off licence for HRT) or orally - you just poke it up at night. However not many women want to do this on a continuous basis. Also you have been told to take it 254 days out of 28 so even though this is intended for post-menopausal women, the 3 days break (from the utro) will allow a bleed if one is to happen. In your case if you are peri-menopausal then this is very likely. The only thing is that 100 mg for 25 days may not be sufficient to prevent breakthrough bleeding at other points during the month, and especially when taken orally as much is lost in digestion. The metabolic by-products of utrogestan tend to cause more side effects when taken orally because of having to go through the liver.

Estrogel ( the oestrogen)  can potentially transfer to partner so no skin to skin contact should occur for one hour after application, according to the instructions - so this might affect when you apply it and where on your body.

Hurdity x

[Katia]

Hurdity thank you. You've so much knowledge. I'm day 3 now and it's just like I have a period. I'm not sure if I'm peri or post as I've taken the pill.  I've just turned 50. Maybe I should email the specialist to see what he thinks.  In an ideal world I could take the Utrogestan earlier to stop being tired in the morning as I work and need to eat in the evening 😊

Do you know if the gel takes a while to get going?  Within a day of switching it seemed like everything shrivelled, dried and deflated. Even my lips and I've more dental plaque and phlegm.

Is it normal that the area the gel goes on and my hands turn icy cold to the bone about an hour after applying the gel?  My fingers go like skin and bone. It goes after a couple of hours but it's so unpleasant.