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[Kittyjay]

Hi- I returned to a cycle 2 months ago -utrogestan 200 vaginally with estradot 75 patch. (Took continuous utrogestan before but was exhausted ALL the time!) .
I'm on day 22 of the 15-26 part using the Utro and feeling blooming awful. Really low, can't stop crying mixed with agitation and panic. I hate this feeling.
I start a new job tomorrow and really need to lift my mood for the coming week. do you think I could stop the utrogestan after 8 days for this cycle? Would it still cause a bleed?
I'm seeing my GP in a couple of weeks and asking to go on a 3 monthly cycle which is what I first tied 3 years ago aged 41, but had breakthrough bleeds - hopefully 3 years later this may change.
I just need to get this utro out of my system for now! Any advice very gratefully received. Thanks everyone x

[Briony]

Please wait for others to confirm what I am about to say, but I think that Prof Studd says it's OK to have a shorter 7 day course of Utro if you react badly to the progesterone. He suggests doing it at the start of the month. I guess, as a one off, taking it for only 8 days would be OK, so at least it would ease the timing with your new job (are you a teacher?). Weirdly, I was OK during the Utro days but had a horrible dip afterwards so stopped that regime and moved to a lose dose BCP instead  (Qlaira) which helped. I am a similar age to you.

Hope tomorrow goes OK xx

[Kittyjay]

Thanks Briony- ironically I felt 'better' on the continuous utrogestan apart from overwhelming exhaustion hence trying a cycle again... Yes I'm a teacher and have to be firing on all cylinders ...especially at start of term! I think I will stop utro as of last night's and hope it picks up. I have appointment at GP before the next progesterone phase so hopefully he will let me do a longer cycle. (I'd rather have breakthrough bleeding than feel like this) thanks for your reply x

[Briony]

Will be interested to hear how you get on. All the best tomorrow. I'm a teacher too, so I understand the need to be firing on all cylinders.    xx

[Hurdity]

Hi Kittyjay

I would be cautious about experimenting long term without scanning etc but of course it won't do you any harm just once - and could be OK in the future. However Prof Studd's advice is all very well but this is the minimum for progesterone intolerance and a certain percentage of women would expect to get endometrial hyperplasia ( which can lead to cancer) due to thickening of the lining - on this low dose.

Also it can't be a one-size fits all and must vary accoridng to a woman's oestrogen dose since the dose of progestogen needed to thin/shed the lining is duration and dose dependent. Therefore, for example a woman will need more progesterone on 75 mcg than 50 mcg patch - other things being equal. However also less is needed with vaginal use due to uterine first pass effect (gets to where it is needed - the uterus first before going into blood stream or wherever else).

The other thing to think about is whether you react to progesterone withdrawal - I used to feel terrible the first morning following the missed night (and for a couple of days) - which for you would be tomorrow. Are you sure you want to risk that on your first day at school (unless it's a non-pupil day!)?

I am surprised that you are feeling tearful and having agitation and panic (rather than just exhaustion from the prog) but maybe as you are peri-menopausal (I presume?), then your own cycle is kicking in?

Yes you should still get a bleed after 8 days - the progesterone will have changed some of the lining from proliferative ( growing due to oestrogen ) to secretory (ready for implantation) so some of this should be shed even after only 8 days - maybe not all though? Also assuming you've had time to build up any lining this cycle!

If you are feeling better today I would be inclined to continue for the rest of the week to avoid the progesterone withdrawal symptoms and then do this over the weekend (I always time my cycle so that this happens at the weekend ie last Utro of the cycle on Thursday).

Three months is a long cycle on 75 mcg patch and Utrogestan and breakthrough bleeds may be likely - I think I can only manage 2 months and even so I think my small fibroid ( from two years ago) might have grown.

Good luck anyway and glad you've got a docs appointment!

Hurdity x

[Kittyjay]

Hi Hurdity- thanks for your detailed reply- I'm grateful. I've been hugely surprised at my tearfulness and low feelings this last week- I really wasn't expecting it as I used to feel great on utro. I get so so confused as to how I feel at different points of the cycle as it seems to be ok one minute then awful the next....! I think even an 8 week cycle would seem a blessing right now but I need to chat through with GP I know. Lots to think about but hopefully my mood lifts and I can think straight for the next few days. Thanks again x