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[Briony]

Does anyone who still has periods take Utrogestan (100mg) for days 1-25 and if so (or even if not) does anyone know where it states 'on paper' - or web- that this is possible/safe?

I initially took 50mcg patches and Utrogestan 200 mg for 12 days. Loved the combination of both but suffered terribly from withdrawal symptoms once I stopped.

Switched to a low dose bio identical BCP and was thrilled with the improvement. Helped me massively. Only trouble was that at times, it wasnt enough to over-ride my own cycle - so I got random days/hours of fatigue, spotting and the chills. GP said this was because it wasnt a high enough dose of estrogen (bio identical so less potent than regular pills) and moved me to Marvelon.

After a month of hideous side effects, daily, horrid cramps, constipation/wind, fluid retention and moodiness/jitters, I gave in this week (was due a break anyway) and have an apt to see my GP tomorrow.

I really dont know what to try next but am considering either a 100mcg patch/4 pumps of gel which I believe is strong enough to suppress ovulation, but is still bio identical? I would only agree to this is I could take Utrogestan almost continuously, with a 3/4 day break at the end as you can if you are post menopause.

I remember a while back someone on here did the same thing but cant find who it was? If anyone has any experience or advice, it would be greatly appreciated! (am half expecting my GP to say no - as I know it's an unusual route -  hence the reason I am desperate to have 'evidence').

Thanks so much, B

[GypsyRoseLee]

I can't help with advice for this, but I will be very interested to hear what your GP has to say about trying this regime. It sounds like it could be a sensible move forward for you (and possibly me, too).

I think I was also okay taking Utro, whilst on HRT, but I couldn't cope with the chopping and changing and reacted to it.

I really hope your appointment goes positively tomorrow. Keeping everything crossed.

How do you feel tonight, having been Pill free for a couple of days? My symptoms kicked in within 48 hours of being Pill free.

[Dancinggirl]

Briony - you would need to run this by a specialist gynae.  4 pumps of Oestrogel is a very high dose and 100mg Utro per day may not be enough to stop your womb lining from building up with so much oestrogen.  It's always about the balance.  I'm not sure why you want to stop ovulation?!! Many women start HRT in the peri stage when ovulation and hormone fluctuations will occur but a low dose of HRT can balance this out.  You may be able to take Utro continuously (25 days per month)but you might be better to use just one pump of Oestrogel.
You need to get specialist advice about this.  DG x

[Hurdity]

I absolutely agree 100% with Dancinggirl - that would be a very high dose of oestrogen.

The thing is the BCP contains a very high dose of oestrogen to suppress ovulation but also a very high dose of strong synthetic progestogen sufficient to oppose that dose of oestrogen.

If you supress ovulation then you will have none of your own. I wouldhave thought you would need a very high dose of utrogestan to counter this. I can't imagine a gynae sanctioing this on a continuous basis except if you used a high dsoe of syntheitc progestogen too.

Defo a specialist needed!

Re your original question - I think it was jedgirl possibly - to give better control of bleeding - but not to suppress ovulation. I think the oestrogen she was on was a top up and ovulation would be going on in the background. I think she is on 12-14 days now but don't quote me - jedigirl I might be wrong? Sorry if I am!!!

Hurdity x

[GypsyRoseLee]

On Prof. Studd's website he recommends 5-6 pumps of gel per day to cure PMS or peri menopausal issues. All I have read says that younger women struggling with peri symptoms need high doses of oestrogen, not small doses.

[Hurdity]

That is a lot isn't it - but presumably they are still ovulating and making their own progesterone, or are given extra at some point? I am genuinely puzzled (because I don't know enough about it) and would be interested to read an explanation of why the lining doesn't build up or if he intends ovulaton to be suppressed on this high dose?

Hurdity x

[GypsyRoseLee]

It puzzles me too Hurdity. My consultant was very dismissive of me even trying a 50mg patch as it would be 'too low'. Plus, Prof. Studd suggests the 5-6 pumps with just 7 days of 100mg Utro!

[Trufflecat]

I am two weeks into trying 50mg patches of oestrogen plus utrogesten 100 for 25 days. (Evorel sequi didn't suit me). I was still having regularish periods. I did suggest only using Utrogestan for 7 days but my GP wants to ,'try what it says in the book first' so I am going it a go

[Briony]

Thanks so much for your replies.
Sorry didnt reply last night. Had a horrible migraine after stopping the Marvelon trial and couldnt focus on the screen let alone write. I felt like my brain and eyes were on fire 

Since then, have been to my doctors. She says that I do need to suppress ovulation, just as the pill does, so I will stop getting the crazy fluctuations I have. By taking anything less than 100mcg patch/4 pumps, I am simply topping up my own system - so will still have symptoms (hence the reason the 50mcg patch didnt help). It sounds a lot, I know, yet this level of estrogen is still less than that of a standard (synthetic) BCP which is far more potent.

The 100 mcg patch/4 pumps prescription is the second line therapy for PMS (if a 4th generation pill does not work) and is recommended by the PMS Society and Nick Panay (they are less convinced about 200mcg patches which Studd originally promoted). This whole document is worth a read, especially the bits on alternative therapies:

 http://www.nickpanay.com/Papers%20pdf/Royal%20College%20of%20Obstetrians%20%20Gynaecologists%20PMS%20Guidelines.pdf

She has suggested I try  days 1 to 25 with 100mg Utrogestan and see how I get on (I loved taking 200mg cyclically but hated the dip at the end).

To be honest, I do partly regret stopping Qlaira and may well end up back on it for the sake of a bit of spotting and the odd blip. However, might as well give this a try as, like you Hurdity,  I am in favour of nil by mouth when possible.  I would have much preferred the gel this time (you ladies have sold this to me!) but the doctor said dose control is better with patches and I was too tired to argue (still got a fuzzy head). She did say I can swap to the gel if I want to later on.

Thanks again for your comments/support. I hear what you are saying about taking the Utro continuously and will definitely keep an eye on things. Perhaps a Mirena would be better?

 B x

[Hurdity]

Thanks for that really helpful information Briony - I've bookmarked the info.

Yes as you say the paper does suggest the use of Mirena coil as the most effective method of protecting the endometrium from these very high doses of estradiol to suppress ovulation, but that there is initially some systemic absorption which could be a problem for those who are progestogen intolerant. It also says there is no long term info on the effect of this regime on breast or endometrial cancer.

Sorry to hear about your migraine - hope you feel better soon.

Good luck with it all and really hope you find something that suits you in the medium term - until you are near menopause and the hormone rages have passed!

Hurdity x

[GypsyRoseLee]

I am so pleased your GP listened to you. I will be very, very interested to see how you get on with the high dose oestrogen and daily Utro. Did your GP say why she thought you reacted so badly to Marvelon this month?

As I understand it, younger peri women need very high doses still. Regular HRT just doesn't cut it. 4 pumps isn't that high compared to the BCP, after all.

I got to fed up this afternoon that I just took 10mg of Amitriptyline to just quell this nasty anxiety/dread I am struggling with.

I am torn between going back to my GP and just throwing in the towel and asking for 20mg of Citalopram. Or stopping Gederal and sticking on 2 x 50 Estradot patches (have loads left) and using them until I see my consultant in 3 weeks.

[dazned]

GRL don't say throwing in the towel ,you're doing all you can to feel as well as you can ,so trying a different approach isn't throwing in the towel at all it's still taking positive steps towards your end goal ! If citlopram achieve that for you so be it ,whatever it takes is my motto . Read section 9 on the nick panay link Briony so helpfully shared with us .
Onwards and upwards.