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[Tc]

Hiya. Utrogestan.question please.
When taking 14 days at 200mg.
Do ladies using the "pill" vaginally insert 2x100 pills?
Or is there a 200mg version and if so is it different to the 200mg "pessary" which I would assume is only for vaginal use?

Thank you.

[Saffy]

The 200mg 'pessary' is licensed for fertility treatment not HRT for some reason but AFAIK the 100mg capsules are identical - same shell and same ingredients and can be used orally or vaginally. There is no 200mg HRT version.

BTW - the licensed dose of 200mg is for 12 days cyclically not 14 days (which may be a blessed relief  ). xx

[Hurdity]

The 200 mg version used to be licensed for HRT and for some weird reason is now no longer - since it's all in the packaging and leaflet (the 200 mg capsules were exactly the same) I see no reason for the change and it makes it awkward for us vag prog users to insert those damn tiny balls!!!

Both 100 mg and 200 mg are made for oral or vaginal use - it's only in UK that there is separate packaging for fertility with those very wasteful applicators ( I gather) - like Vagifem (wasteful applicators....).

If you look at the product info on the French database of medicines you can see the instructions are given for oral or vaginal use and for HRT or fertility.

It causes endless confusion here in UK including sometimes amongst medical professionals!

Hurdity x

[Sooze]

So an update from me.  I managed 6 weeks of Utrogestan orally every night, and the first month was really good, but I could tell that I wasn't quite myself as the last 2 weeks went on.  Rather than switch to every night vaginally, which I'd already tried, I've gone to alternate nights and all seems a lot more balanced.

Just 1 question, with now changing my dosage would that be the same as starting a new regime? And therefore should I expect the possibility of spotting for 6 months since the change (it's been almost 4 weeks so far and not had any). 

[Tc]

Snooze sorry I cant Answer  your question. But thanks hurdity and saffy. I don't know where I got 14 days from. !!

[Hurdity]

Sooze - it's not a precise thing. Not everyone gets spotting or bleeding on conti HRT. Also 6 months is not the exact cut-off - some will carry on spotting or bleeding for longer and some will never stop! The main thing is if you don't get any spotting or bleeding at all, and after several months without bleeding you then get a bleed - you should get checked out - as it could mean your lining is building up and the prog/oestrogen ration not right for you. ie play it by ear and if it seems wrong and the bleeding is unusual or unexpected - far better to check it out.

Hopefully all will be well and this continues to work well for you

Hurdity x

[Sooze]

Hurdity,
That makes complete sense!
Thanks,
S

[KatieLiz]

After taking Femoston 2mg/10mg for just over 5 years (occasionally during this time dropping back to 1mg/10mg) I decided to start using a conti regime.  I was going to start using Femoston Conti but my GP offered me the Estrogel gel 2 pumps daily and Utrogestan tabs 100mg 1-25/28.

I finished my Femoston pack and had the usual bleed but immediately started using the gel and tabs.  I was very surprised how lovely and relaxed I was feeling taking the Utrogestan. 

However 2 weeks in, I had the most horrendous headache, stayed in bed the whole day and then discovered I was having another period which lasted about 8 days.

I have carried on using the gel and tabs but stopped the Utrogestan on day 25 and now it's day 28 and I'm having another bleed.

I do want to try this regime for 3 months but just a bit concerned as to why I'm bleeding so much when this is supposed to be the no bleed option! 

I know there are a few ladies going back to the sequi option because of unscheduled bleeding but there must be a balance somewhere that stops the bleeding?  I wondered whether I should just use 1 pump of estrogel but I believe 2 pumps is still less than the 2mg in Femoston?

Any thoughts? 

Katie

Well I'm now on my second month of this regime and 2 weeks into the second month I'm having yet another full period!  Started on Saturday and now day 6 and still bleeding.
I sent an e-consultation to my surgery asking for advice and got a reply to contact the surgery which i did.  They mentioned a phone consultation but the earliest gp availability is in 6 days time or end of the month for the gp who provided my prescription!
Hence I'm now back here for advice.  Do I reduce or increase my estrogen to prevent  the bleeding?  I can't change the 100mcg Utrogestin but can adjust the estrogel but not sure whether to go to 1 pump or 3? Currently using 2 pumps but having full periods every two weeks!  This is supposed to be no bleed!  Really want to try conti as I'll be 59 later this year but it's costing me more in tampons now!
Advice welcome!

[Dotty]

Hi just carry on It can take 6 months to settle x

[Tc]

I'm worried cos I've got the opposite issue. No bleed at all after 3 months sequi so . Changed to continous and was told to take every night without the 3 day break. After 5 months i still  had no bleed  but the utro  built up in my system out of proportion to eastrogen so. 10 days ago I stopped the utrogestan cold Turkey and still no bleed. I dont understand it or know what this means. Does it  mean I'm still not getting enough eastrogen. I'm on 175 estradot!!  Why have I not bled upon stopping it. It's not that I want to bleed per se but it doesnt seem usual or right. I'm at my wits end with it.

[Tc]

Birdy. I dont get how they accumulate. Dont they just react to the amount the patch releases. Will they keep climbing over time on it then? And would a bleed be an indication of that. Sorry if I'm being a bit thick. Just when I think I've got it sorted in my head I get confused again 
Other ladies are having a bleed on a lot lower dose. Do you think it's because of ovary removal. Although post meno ovaries make very little eastrogen dont they? So it shouldnt realy make a difference.
I just keep thinking "what the heck is wrong with me". I'm actually scared by the fact I've gone so high patch wise to no effect.
I'm realy struggeling with this bird
Xx

[Saffy]

I would have thought it was the result of extremely low oestrogen levels too, although strangely I have always had a bleed, even when my oestrogen levels were at their lowest (ie. less than 100 pmol/L). In fact my bleeds are pretty much the same whether on 25 patches or 2x100 patches  .

I've given up trying to figure this all out, makes no sense to me  . In terms of uterine problems I wouldn't worry too much about the lack of bleed 'though TC, it's usually only random and erratic bleeds that are an issue. Given your low iron and B12 levels do you think this could also be the result of a nutritional issue or even simply not eating in sufficient quantities to maintain decent levels? Certainly we know that with both anorexia and malnutrition women's periods stop, perhaps this is the case even when supplementing hormones? Just guessing, of course and I may be well out of the ball park  . xx

[Dotty]

Hi TC if you are post meno and on continuous hrt then you don't bleed. There is nothing to worry about. X

[KatieLiz]

Hi Dotty - yes I am going to carry on with this regime but I think I'm going to just use 1 pump of estrogel and see how it goes.
When I was on sequi femoston I was on 2mg/10mg but my breasts were increasing and getting tender and I wonder if the estrogen was too high.  Also  I may be absorbing the gel too well now on 2 pumps and perhaps this is the cause of bleeding every two weeks?
When I started HRT 7 years ago I didn't have hot flushes but increasing pmt symptoms.
I am now beginning to wonder if my estrogen has always been ok but my progesterone levels way too low? 
I feel great taking the Utrogestan - I have a great nights sleep and wake up very relaxed - this feels like the missing piece for me that I wasn't getting using Femoston!  Just need to get the excessive  bleeding under control now!

[Elmsey]

I'm worried cos I've got the opposite issue. No bleed at all after 3 months sequi so . Changed to continous and was told to take every night without the 3 day break. After 5 months i still  had no bleed  but the utro  built up in my system out of proportion to eastrogen so. 10 days ago I stopped the utrogestan cold Turkey and still no bleed. I dont understand it or know what this means. Does it  mean I'm still not getting enough eastrogen. I'm on 175 estradot!!  Why have I not bled upon stopping it. It's not that I want to bleed per se but it doesnt seem usual or right. I'm at my wits end with it.

Utrogeston stops the build up of the lining so there should not be a bleed.  I think if you have a bleed it means  maybe too  much estrogen relative to progesterone so sounds as if your no bleed is right - I would have thought that if you had been taking it continuously for 5 months you should have little or no liining.  Also,may  take a while for the progesterone build up to clear?

What made you think that you had a build up?