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[Linsey44]

Hi ladies

I am changing my HRT as I didnt feel that some days Tibolone worked at all and I wanted something more consistent as I am in surgical meno and havent slept since my op in April.  I emailed Dr Currie for her opinion and asked my gp to prescribe this. 

Initially I will use 2pumps should I do them both at once or one morning and one at night? 
Also I am going on holiday soon, does swimming, sunscreen and potentially sweating in the heat affect how much hormone will be absorbed?

I also got 100mg Utrogestan which I plan to take at night should this be around an hour before bed in case it makes me sleepy?

Thanks for any help you can give.
Linsey

[Hurdity]

Hi Linsey44 - sorry I can't help with the gel, and I am sure an experienced user will be long soon.

Re the Utrogestan - yes it's normally better to take at night in case of adverse side effects although they may be mild with 100 mg. I use it vaginally but I have a feeling it is better to take it with food if taken orally?

Sorry to hear you haven't been sleeping, and hopefully you will feel better on this new regime, but you will need to give your body time to adjust.

Hurdity x

[Rowan]

Linsey44 just wondering  why you are taking Utrogestan if you have had a hysterectomy, you did say you were in surgical menopause.

Most ladies start of with just estrogen and see how they feel before adding other hormones. Of cause I don't know the reason for your hysterectomy but for a lot of ladies it is a relief not to to have to take progesterone.

Sorry in advance if I have misunderstood your post.

[Linsey44]

Hi SL hyster was last yr then ovaries and tubes this year due to BRCA2 faulty gene.  Told by consultant that due to adenomyosis history then progesterone was req'd.

Hurdity thanks for help.

Its a shame that tibolone didnt work well enough as I had no other probs with it.

[Dancinggirl]

Just to answer your question about using oestrogel.  I used it for many years - it's great.  I always put it on my inner thighs each morning, waited 10 mins before getting dressed and then you mustn't swim or wash that area for around 2 hours to allow absorption. The instructions should explain all this I think.  DG x

[Rowan]

Do hope your new regime works Linsey, most women seem happy on the estrodiol gel and you can taper it to your needs.

Make sure you get plenty of fibre in your diet as Utrogestan  is know to cause constipation, even your native progesterone causes this too as it relaxes the bowel and causes digestion to slow down.

Hopefully it will help with your sleep, I do find my Nat Prog cream calms and helps me but I only use a small amount as it can make me feel down if I use too much. I really prefer melatonin to help with my sleep.

[Linsey44]

Thank you SL I will increase fibre cant stand it when I cant go to loo and wasnt aware of that. DG thanks for answering question re swimming.  I will sit down and read leaflets properly only got meds yesterday.

Linsey x

[Linsey44]

Thanks stellajane.  I have now taken time to sit down and read leaflets properly you are right to take ultrogestan without food.  It also says take the oestrogen at same time.

Only taken it twice and I am using 2 pumps at night only, but might change to one morning and night.

Bit wary about using it on arms will use it on inner thigh and see how it goes.
Thanks

[Hurdity]

I don't understand why the instructions say not to take Utrogestan with food, when it says later that the bio-availability is greater when taken with food.

That information is taken from a paper here which says that absorption is enhanced in the presence of food!
http://www.ncbi.nlm.nih.gov/pubmed/8513955

Hurdity x

[Linsey44]

Hurdity, thank you, its interesting.  How you manage to find all this info is mind boggling. I will maybe try it for a couple of weeks to see if it makes a difference. X

[Taz2]

I've found this as well

"Utrogestan 100mg Capsules should not be taken with food and should be taken at bedtime. Concomitant food ingestion increases the bioavailability of Utrogestan 100mg Capsules"  from this site http://www.medicines.org.uk/emc/medicine/19895

I don't understand it - seems to be a contradiction.

Taz x

[Rowan]

One thing I have learned about research and information is that for every statement there is a contradiction

[Linsey44]

SL much like everyones opinion in the scottish referendum.

Today i have split my oestrogel dose and will take Ultrogestan at night

[Taz2]

I meant it seems a contradiction in the same sentence - telling you to take it without food but mentioning that you get more of a take-up with food. I am confused.. again..

Taz x

[Hurdity]

Hi yes Taz that's exactly what I was meaning! That statement is borne out by the paper. Therefore from the way I understand it - if you take it with food, more of the progesterone will get into your system than otherwise. Since much of it is lost through digestion and the liver and this is incredibly variable between women, I would have thought this was a good thing ( ie increasing bio-availability) but perhaps there could be more side effects?

Linsey - I just looked at the spc for Utrogestan and then did a Google search based on the information to see if there had been any research.

silverlady - the research seems clear but the pharma instructions aren't - there's a missing piece of the jigsaw so we have not been told and it's easy to see it doesn't make sense to the discerning lay person (nor to a professional I imagine)!

Hurdity x