Hi juliekim
from me too!
Glad to hear you have been prescribed body-identical hormones and do hope they work for you. I was like you - trying herbal and other remedies when I started getting flushes etc but only HRT worked to relieve symptoms - and of course the oestrogen is beneficial for long term health as well.
Your question re utrogestan is not straightforward to answer!
Firstly - the amount of progesterone needed to oppose oestrogen (when used as HRT) is dose dependent - ie the more oestrogen you have, the more progesterone you will need to prevent the lwomb lining thickening too much (from the oestrogen), or to shed it monthly.
Secondly the licensed dose of Utrogestan is for oral use (as you say - 200 mg for 12 days per month) but must be sufficient for a wide range of oestrogen doses - which are however not specified.
However you are on a low dose of estrogel so, because of this "one size fits all" progesterone dose it is doubtful you would need as much as someone who has two pumps. I think some women use the same dose of utrogestan (ie 300 mg) for 4 pumps of gel too. Having said that you may well find that you want to increase your estrogel as you get further into menopause and your own oestrogen levels drop.
As you have read, many women like to use utrogestan vaginally - especially those who are progesterone intolerant, because the side effects are minimised. It is not licensed for vaginal use in UK although many private and some NHS practitioners are happy to prescribe it under supervision.
In France the dose for vaginal use is given as the same as for oral ( I have a translation of the French instructions) although limited trials have shown that more usable progesterone is obtained through vaginal use ( because it gets straight to the womb) than through oral use (where it has to go through the liver so more is lost asnd excreted before getting to the womb).
Many of us on here therefore are making our own decisions on the amount to use vaginally - but this is only to be done with caution as you cannot know how your own body will react.
Regarding the amount of time to take it each month or the length of the cycle - again several of us have used our knowledge from what we've read, as well as what others have reported from their private consultations - to reduce the amount of time we take the progesterone per month, or lengthen the cycle - especially if used vaginally.
You have to be aware that Prof Studd's recommendations (of 7 days progesterone
per month) are the minimum needed, but only under supervision - and really only for those women who are severely progesterone intolerant and for whom the bad side effects of the progesterone would make it impossible for them to stay on it for longer. He recommends for such women a lower tolerance of vaginal bleeding before scanning - in other words there is definitely a greater risk of endometrial hyperplasia (thickening of womb lining - whoich can lead to womb cancer) on these lower/shorter progesterone regimes. This has been shown from trials.
I would not advise using Utrogestan for 7 days every 3 months, and nor would Prof Studd. This would not be enough for most women. I suggest using it orally as prescribed for the first few months and see what sort of bleed you get and how you tolerate the Utrogestan. Alternatively you could try using it (ie the 200 mg) vaginally for say 9 days and see how you get on.
There are women on here using all sorts of different regimes - but many of us are doing it by trial and error, but trying to err on the safe side too.
I hope this is helpful in explaining some of the issues re varying the regime of utrogestan from the standard and will encourage you to find what is best for you.
Hoever just a final word of caution - any deviation from the licensed dose could cause problems and it is well to be vigilant, and if necessary ask for a referral to a menopause clinic so that you can be prescribed a differetn dose officially.
Hurdity x
