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[Sandie77]

Good Morning,

I am 43 and recently diagnosed Early Menopause, last period was age 42. Amenorrhea was put down to my Fibromyalgia and then newly diagnosed Hypothyroidism but now we know differently.

I have big problems with drug sensitivity and have opted for Sandrena gel and Utrogestan 100mg to start with. The pharmacist says take Utro' on days 1-25 of cycle but I don't have a cycle???why would it not be taken every day?

I have read on some posts that Utrogestan can be taken vaginally and thought I may be less likely to get a bad reaction that way. Is that just the normal capsules and would I need an applicator? Also is this method proven to deliver enough progesterone to the uterus? Is this technique approved by gynaecologists?

I have also heard of the Utrogestan being taken only 7 days a month for those that are intolerant to progesterone, I am not looking forward to the return of horrid PMS and mood swings.

So many questions I know! So pleased to have found this brilliant website, thanks to All xx

[Hurdity]

Hi Sandie77

 

Sorry to hear about your early menopause. I think there is also a forum especially for women in your position - The Daisy Network?

We've had a lot of discussion abotu the 3 day break in Utrogestan. We guess that the thinking behind it is that if your uterus lining does build up then it does allow for a small withdrawal bleed if necessary and the higher the oestrogen dose I presume the more likely this is to happen.

The other alternative is you could mimic your own natural menstrual cycle (if you don't mind periods again) and take a higher dose of utrogestan (200mg) for 12 days per 28 which would give a monthly bleed. This does mean that you experience the progesterone fluctuations but some women prefer this rather than take progesterone all the time. The reason is that oral progesterone is quite unstable so you need to take it at a higher dose to enable enough to get to the uterus. The higher doses can cause some drowsiness and fatigue. Yes Prof Studd recommends 7 days per month as minimum for progesterone intolerant women but that can lead to greater incidence of endomterial thickening.

If you are post-menopausal then you can take it every day and still get protection of the uterus - in fact some docs say this is fine ( there have been scientific papers on this).

I use it vaginally but then I am on a long cycle - it is not licensed in UK like this but many private gyanes prescribe it this way for those who have side effects from oral use.  Yes it is proven - it is licensed for vaginal use for fertility treatment in UK and for vaginal use as part of HRT elsewhere in Europe (if side effects with oral use). In fact I seem to remember that systemic levels from vaginal use were higher than from the same dose taken orally! If you want me to dig out the references I can but it will take some time. You don't need an applicator although some seem to be given them along with the utrogestan. I've been taking it for over 4 years and never get an applicator. I just poke it up as far as I can at bedtime. Yes they are all the same capsules.

Hope this helps and do ask more questions if you have them

Hurdity x

[Dorothy]

Sorry to hear you've started so early.  There are a few of us on the forum and we have all found MM really helpful.  The charity for early meno is the Daisy Network - they have a website with a few general articles available to the public, but you have to pay to join the forum - I'm too stingy to pay when the MM one is brilliant and free so I can't tell you what it's like!  Be interesting to hear if any other MM members have joined it.

Hope you manage to find the right treatment for you soon.

[Dancinggirl]

Sandie77 Hi and welcome to MM
I had a premature meno and started HRt at 37, which is now over 20 years ago.  I had to try a variety of HRTs before eventually going to a private meno clinic and being given Oestrogel with a separate progesterone which worked really well for me through my 40s.  When all the scares came out in 2002  I got really worried and stupidly took myself off HRT at the age of 49. I then suffered for 3 years with horrid flushes, night sweats and waded through my days with headaches, exhaustion and depression.  Then one day a lady friend, who was 80 at the time, noticed I refused a glass of wine. I explained it made my flushes so bad and she firmly told to me go back on HRT a.s.a.p. - she was still on HRT and her gynae had told her the risks were really quite small.  I then took myself off to an NHS meno clinic that put me back on HRT - I had to try a few before ending up with the Mirena and Oestrogel. This combo wasn't too bad but in hindsight during the first year I did feel very sedated so I don't think the synthetic progesterone was quite right for me. 
Aged 57 my GP wanted me to take another break from HRT to see how a I coped. It wasn't tooooo bad but I got horrid headaches, the vaginal atrophy and bladder problems became worse so I went to see a private gynae who specialises in the meno who has now got me back on HRT.
I am on One pump Oestrogel per day with 100mg Oestrogel everyday - this is quite a low dose but it keeps me ticking over really well.  I did try doing a longer cycle (like Hurdity) with Utrogesan for 14 days every 6 weeks but I got bad breakthrough and heavy bleeding. I was reluctant to try the conti Utrogestan but I'm finding it really good and I hope I can stay on this for the foreseeable future.
I wouldn't worry about PMT at this stage - Utro in natural and you may find you feel really good on it as I do. The licensed way to take Utro is as your pharmacist has said and as you are probably still in the peri stage(so not deep into post meno as you haven't gone 2 years without a period) then the 3 day break should prevent problematic bleeding - you may have a slight bleed after this 3 day break. I haven't used Sandrena - I like Oesrogel as it gives you greater control over dosage - I think the Sandrena comes in sachets which give slightly higher doses but is still the same principle as Oestrogel.? I wouldn't go off license with the 7 days of Utrogestan as this needs to supervised with a private gynae with regular scans and it won't necessarily make the PMS any better unless you prove to be severely progesterone intolerant and this is very rare.
I take Utrogestan orally at night on an empty stomach and it really helps me to get a good 5-6 hours sleep which is fabulous for me. I would try this first and if you find you feel really sleepy in the morning then try using it vaginally. As Hurdity has explained, in the UK it isn't actually licensed to be used vaginally which is silly but vaginal use can aggravate the bladder and perhaps is not ideal when used continuously - sex could be a problem!!!!
I am very sensitive to drugs generally but these bio identical hormones suit me really well.  Do keep in mind  that what you are using will simply replace the hormones your body needs - this is not a drug. In the first few weeks, you may find you get some stomach cramps, odd spotting or bleeding, tender breasts and even some headaches - this is all normal and my gynae describes this as your body welcoming the hormones and waking up the areas that need it - things usually settle within 3-6 months. You may well be very surprised at how good you feel.  ENJOY feeling good and getting your life back on track.   DG x

[Sandie77]

Thank you all so much for your replies, I feel quite emotional as I hadn't realised quite how alone I felt. It's great to talk it through with others in the same situation.
I may well have more questions as I go along.

Hope you all have a great weekend xx