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[sap22]

Hi - I'm a bit concerned about my prescription, and thought I'd check it out with people here to see what you think. I am 52, and last period was September 2015, so haven't been one year free of a period. I have been given Estradot 50mcg patches (twice weekly) and Utrogestan 100mg one per night. Additionally, vagifem twice per night for 2 weeks, then 1-2 vagifem 2-3 times per week.  I have had bladder issues for months (low level biofilm infection) before just about getting on top of it.  I am checking because I read that Estradot is for people who haven't had a period for at least one year and because I understand from a discussion with someone that this is rather a lot of utrogestan... does anyone have any comment as I think I might get back to the doctor and question.... thanks in advance xx

[Dancinggirl]

Hi sap22
Here is the link on MM about the HRT regime you have been given - it sets out the two different ways( conti and sequi) you can use this HRT combination  :http://www.menopausematters.co.uk/to_progestogens.php

The Estradot patch is the oestrogen part and Utrogestan is the progesterone part.
You have been told to do the continuous version, using both together, which should eventually result in no bleeding at all - some bleeding and spotting is likely in the first 3-6 months.  You have also been told to use the local oestrogen in quite large doses as I presume this is to really try to get your bladder and other symptoms under control. Utrogeston continuously does need to be 100mg each night or you could get problematic bleeding. You could start with the sequential regime to see how you feel on the Utro and this would bring a monthly bleed - I think maybe your doctor thinks you are ready to do the conti regime.
I would do as you have been prescribed - those that use less Utrogestan are the small percentage of ladies who are very sensitive to HRT in general so need to use less, however this needs very careful monitoring by a specialist gynae.
DG x

[andius]

You have the standard dose for a post-menopausal woman of your age even though you haven't been a year without a period...I think your doctor had pity on you and decided to start you with conti and vagifem for the dreaded vaginal/bladder symptoms.  Thank goodness you didn't just get the vagifem which can take a while to work when you don't have any systemic estrogen on board.  You have been given a medium dose of estrogen and the lowest dose of progesterone that is commercially made (even though you have to take it every night). If it works well for you, you will know in 3-4 mo.  Good luck!! Don't look for problems and you may not have any!

[sap22]

Hi sap22
Here is the link on MM about the HRT regime you have been given - it sets out the two different ways( conti and sequi) you can use this HRT combination  :http://www.menopausematters.co.uk/to_progestogens.php

The Estradot patch is the oestrogen part and Utrogestan is the progesterone part.
You have been told to do the continuous version, using both together, which should eventually result in no bleeding at all - some bleeding and spotting is likely in the first 3-6 months.  You have also been told to use the local oestrogen in quite large doses as I presume this is to really try to get your bladder and other symptoms under control. Utrogeston continuously does need to be 100mg each night or you could get problematic bleeding. You could start with the sequential regime to see how you feel on the Utro and this would bring a monthly bleed - I think maybe your doctor thinks you are ready to do the conti regime.
I would do as you have been prescribed - those that use less Utrogestan are the small percentage of ladies who are very sensitive to HRT in general so need to use less, however this needs very careful monitoring by a specialist gynae.
DG x

Dear Dancing Girl - thank you so much for your detailed message and link which has put my mind at rest.  I did tell the specialist menopause doctor I had a horrible bleed some time ago on Vagifem and felt like a hormonal teenager (!), so maybe that's why she did the continuous. The local oestrogen is in large doses because I have had bad vaginitis, heat, discomfort etc, combined with previous bladder issues. I will give it a go...just done two nights of vagifem with the help of the gel hyalofeem which I tolerate well, so fingers crossed and I will take the plunge and thank you again for sharing your knowledge.xx

[sap22]

You have the standard dose for a post-menopausal woman of your age even though you haven't been a year without a period...I think your doctor had pity on you and decided to start you with conti and vagifem for the dreaded vaginal/bladder symptoms.  Thank goodness you didn't just get the vagifem which can take a while to work when you don't have any systemic estrogen on board.  You have been given a medium dose of estrogen and the lowest dose of progesterone that is commercially made (even though you have to take it every night). If it works well for you, you will know in 3-4 mo.  Good luck!! Don't look for problems and you may not have any!

Hello Andius - just wanted to thank you for your message. Reassuring and I will stop looking for problems, if you don't think it matters that I am not one year without a bleed.  Will give it a go... thanks again xx

[Tinkerbell]

This is exactly what I was prescribed by my meno specialist, at that time I was 52 and last period had been 8 months before.

[sap22]

This is exactly what I was prescribed by my meno specialist, at that time I was 52 and last period had been 8 months before.

Thanks Tinkerbell - it's nice to know that, as I'm so new to all this palava!!