Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Dolly]

Thanks Freckles & Hurdity,
I am peri-menopausal, 48 with irregular periods of anything from 2 -8 weeks between them and vary from couple of days to 17 days (worst) in duration 

My current period started on Monday so if I use that as day 1 and then start the Utragestan on day 17 for 10 days that would mean I would finish the Utragestan on day 26 and I thought (not sure why) it was a 28 day cycle so would start on day 19 and finish day 28? Sorry if I am being a bit thick 

I haven't started the gel yet so am I right in thinking I could start that now continuously but still count Monday as day 1 of the cycle.  My foggy brain is struggling.

Dolly x

[Hurdity]

Hi again Dolly

Not thick at all - difficult to get your head round at first! Yes it is a 28 day cycle but theoretically initially ties in with your own cycle. The withdrawal bleed should occur on or around Day 1 - so you take the utro from days 17-26 ( for a 10 day prog regime). The first night without the prog would be Day 27 and by Day 28 the progesterone levels will have dropped - leading to a bleed fairly soon. It is not an exact science anyway since during peri-menopause as in your situation - your cycles are irregular - although some may be anovulatory, especially those that occur more frequently eg after 2 weeks. Once you have started then just note the day of the week you started the Utro and just take it 4 weekly from then on (if this is your cycle length). If you get random bleeds then you might need to adjust the start date.

So - yes start the gel now and count the start of the bleed as Day 1 and then start the utro on Day 17.

Hope this helps and good luck

Hurdity x

[Mary G]

Dolly, Freckles has given you some excellent advice and I can't really add much.  I was also prescribed daily Oestrogel/100mg 7 day Utrogestan regime and it works very well - if you use the Utrogestan capsules vaginally it hits the target, works better at clearance/thinning and it has fewer side effects. 

So my advice would be not to overdo the Utrogestan to the extent that you end up giving up on HRT altogether and if necessary, take less of it and have regular scans. 

I hope that helps. 

[Dolly]

Thank you all.....again....
Well my GP just called, she spoke with the consultant who advised her to tell me that I should take the hrt exactly as she has prescribed Utragestan 200mg orally for 12/14 day..can't remember which..she has never heard of using it vaginally!.....otherwise I risk thickening womb..cancer...I will then have to have painful intervention (hysteroscopy\biopsy) etc etc etc....pretty much exactly what you all predicted.

I find this so unfair....I do understand they have guidelines....they have to be careful ......I am regularly scanned.....surely they should be flexible enough to allow the patient some input into treatment​ and take their needs\wants into consideration.  As I am not experienced or knowledgeable enough yet with taking hrt I would prefer medical agreement\guidance. Am so disappointed.  I applied the gel for the first time this morning so will discontinue until I have thought some more.

I think I need to find a more sympathetic\open minded consultant.  The GP was lovely but lacks any real knowledge about hrt. . Does anyone know if the specialists listed in the search on here are knowledgeable\open minded enough to be flexible in their approach etc?  Feeling very deflated.
 
Dolly x

[Mary G]

Dolly, I suggest you ring Professor Studd's office now and make an appointment - he does telephone consultations if that helps.  There is no way he will prescribe 200mg Utrogestan for 12/14 days if you are progesterone intolerant so you will not be wasting your money - that is why I am recommended him to you.  Putting it bluntly, he told one member that 200mg Utrogestan for 12 days each month is bollocks!

It is incredible that your doctor has never heard of Utrogestan being used vaginally, it is in every other country.  It is exactly the same capsule for both methods of use but the boxes in other EU member states are marked 'for oral or vaginal use'. 

Your consultant is sticking to the book which does not work for everyone and certainly would not work for me.  As Freckles so rightly points out, the NHS over prescribe the progesterone part of HRT because they don't offer women regular scans.  Obviously this doesn't matter if you can take shed loads of progesterone and are not affected by it but it is a complete non-starter if you are intolerant. 

There is only one way to find out if you are taking enough progesterone and that is by having a uterine scan and having your lining measurement taken.  You certainly won't find out by just talking to a doctor from the other side of a desk. 

Please don't give up on this and make that phone call!

[MicheleMaBelle]

Mine was Dolly but he's in Scotland- he was willing to make some tweaks but not go as far as some.
Could you e mail Dr Currie re using it vaginally and perhaps at a slightly lower dose? You can then take response to your GP but maybe you'd be better to arrange private consultation based on recommendations/ geography.

Mx

[Katia]

My consultant won't hear of it vaginally either. I take 100mg. I managed a week had a week of every other day and the consultant said I had to take it every day. It's making we feel sad and like crying and I want to sleep day and night. My hair is better with it every day though. The gel and the patches are the same hormone. I think it's just personal preference.

[Freckles]

Dolly I had the same inadequate response and knowledge from my GP, as I've posted before
Like many women posting on MM who've also inadequate clinical information and HRT  treatment from either their GP, NHS Specialist or both, I bite the bullet and paid out £350 (from memory) to see Prof Studd last August.
I fully agree with Mary G. 
200mg of progesterone for 12/14 days a month if you are progesterone intolerant is "bollocks" as Mary G said. Wholly unnecessary treatment regime
Do ring re see seeing Studd.  Your health is SO important and the NHS rigid adherence to HRT treatment "guidelines" (which are primarily financially and not clinically driven) and the "one size fits all approach" clearly does not work for many women.
You won't IMO get  better treatment options from your local NHS from what you've posted so far
Given the choice of a GP's opinions and your NHS Consultant who has never heard of Utrogestan being used vaginally (that's so worrying in itself) and a world renown Professor in HRT (i.e. Studd) who actually started the first HRT clinics in the UK ... mmm ...  tough choice (!) but I'd invest the cost of a weekend away and my future physical and psychological health by seeing Studd*
*Other independent HRT specialists are available"- just in case I get flamed yet again for recommending the Studd treatment regime and/or assessment.
Just commenting on my own personal experience- which of course is what MM is all about. Isn't it? 

[Freckles]

Just to add- if you don't try Studd or his regime, you'll never know if it is life changing/works for you?
Was for me and I know he and his team are considerate of women with different HRT issues
Nothing to lose except about £350 and if it doesn't suit, at least you can go back and/or email him and have the treatment tweaked to suit you as an individual.
Rather than being treated by generic NHS "guidelines" by a NHS Consultant who doesn't even know Ultrogestan can be used vaginally in most countries!
That's worrying in itself!

Good luck regardless, but  it sounds like you'll get a less than clinically helpful treatment  from your  local NHS service and therefore more ongoing stress and problems.
.
Freckles X 

[Freckles]

Katia- I think it's "personal preference" as to whether you accept treatment regimes that are making you distressed, sad and crying each day or whether you challenge those regimes as being clinically unnecessary and/or unsuitable for you.
Daily intake of 100mg of Ultrogestan seems wholly unnecessary to me (and  wholly in contrast  to the rigid NHS "guidelines").
Maybe pull your "big girl knickers up" and research posts on here and clinical papers?
Then maybe think about querying your treatment?
For some of those who may be have difficulty re abstract thinking on MM, as seems to be the case judging by PM's I've had, that's a local *metaphorical* expression that just means taking charge of your life, health, decisions and accepting responsibility for the same.
It doesn't mean*literally* you wear big knickers! Although of course you may do. I do!
Freckles X

[MicheleMaBelle]

You need to calm down Freckles and let people make their own minds up! In my opinion your views are not sufficiently balanced.

And if I object to my forthright views, I'm not bothered. I'll leave the forum like a few others before me as we're fed up with the " bad vibe"
Get back in your box.

[Freckles]

Michelemabelle- I'm just stating my personal views and personal experiences, which I thought was the whole of point of the MM forum?
And as I have consistently stated, women have, or should have, valid choices to make about their HRT treatments and be informed as much as possible about the many different options that are available to them.
Whether that is on the NHS or otherwise.  Which if you read my posts, you will find to be the case.
As indeed have many established posters on MM also done consistently.
Often NHS services provide inadequate HRT treatment for women. as attested on MM.

I have no problems with alternative views being expressed to mine- I am just giving my opinions, which folk can consider or ignore, as they choose.
Like me they read and comment or just scroll past.
Many posters on MM post comments that could be considered "not sufficiently balanced" including yours, as well as many others.
I don't think I need to "calm down"  or "get back in your box" as you suggested, as I don't think I have posted anything inflammatory, inappropriate or in any way excessive.
If you think I have,  do please advise me of both how and why you think that is the case in your view.
I truly don't understand what you mean by the "bad vibe" on MM - unless you mean women posting with views that don't wholly agree with yours?
I'm sorry you seem to be so upset by my post. 
I found your reply unnecessarily personally insulting and inappropriate.
I don't know if the moderators on MM might also consider it to be the case?
I would be sorry if you left MM because you have difficulties in reading alternative view points to yours (like mine, amongst many others).
I'd suggest however that there is no need to post something so personally aggressive and insulting in your reply when you disagree with someone (like myself) has posted.
Just some things to think about perhaps?
Freckles x

[MicheleMaBelle]

That's fine Freckles but I consider your views to be inappropriate in certain cases- just because the Studd regime works for you, doesn't mean it works for everyone and you need to be careful about advocating that it's the be all and end all. There was an intervention by Dr Currie recently about this and the opinions voiced about deviation from the NHS guidelines. You seem to have ignored this. In two recent examples you banged on about less progesterone and longer cycles for a woman who had no apparent issue with her progesterone regime and another who hadn't even started the progesterone part of her cycle. You need to take into account what people are saying at times.
I have tried the same regime as you ( privately) and it's not worked for me so it's not all about the NHS failing us and I don't think that you truly recognise this as you are quite inflammatory in your comments about NHS treatment.

There are lots of different views on here and I recognise and respect most of them - I apologise if I've offended you but I do believe that you don't present a truly balanced view as you are too fixated by what has worked for you. Studd isn't a guru and it's different strokes for different folks.

I am happy to accept that tweaking is required. I am happy to accept that HRT doesn't work for everyone. I am happy to accept that everyone can have a voice and an opinion. I am happy to accept views that differ from mine. What I'm not happy with is someone who doesn't take the whole picture into account. And if that means me being kicked off this forum, so be it...

[Freckles]

First  I thought your post was wholly  unnecessarily abusive and inappropriate to mine.
A *full*apology as to your post being inappropriate and ill judged to me and other MM posters would have been appreciated.
It wasn't provided.
Second, I acknowledge Studd's regime works perfectly well for me and many, many, other women (whether privately or on  the NHS).
Third, just because it did work not for you, if indeed you have ever fully tried it, it doesn't mean that women should not be made aware of it as a reliable, valid and  and clinical alternative to the current NHS rigid "guidelines", and which doesn't suit them, does it?
Nor is it necessary for you  to dismiss that particular treatment regime just because it didn't allegedly work for you?
Fourth, valid information is so important BEFORE you start any HRT treatment, whether its progesterone or oestrogen, the dosage and method of delivery.
I don't see any problems in advising women to consider this information, the problems in some NHS prescriptions, alternatives and to  consider all treatment options, not just the NHS treatments you advocate and you consistently saying posters should contact Dr Currie online for her pre -paid advice.
I don't know  of course if you and Dr Currie have any form of formal or informal agreement in advocating her services?
Of course NHS GP's and NHS Consultants vary considerably in their clinical efficacy and knowledge.
I'm simply saying that there are many views about HRT treatment out there, uniformed and otherwise, and my personal preference, was, due to wholly inadequate response from my GP, I had no alternative but to go privately for my health.   That worked for me.  The proposed NHS option was woefully inadequate and entirely clinically irresponsible.
The NHS does, IMO, frequently fails to provide appropriate HRT for thousands of women, as often attested by the frequent posts by distressed women on MM.
I don't think it's "inflammatory" in any way to recognise their distress and their inappropriate and inadequate HRT  treatment and to make suggestions about alternatives to consider when their current (and usually NHS) treatment is ineffectual.
I do consider the "whole picture". 
lf women find their NHS treatments work, and post accordingly  I scroll on by. They are pretty rare in case you haven't  noticed!
It's when (as is so very frequently the case on MM) women experience appalling symptoms that I sometimes offer my experiences, suggestions for alternatives treatments re method of delivery and dosage.
The NHS is NOT omnipotent.
Truly don't understand what you find problematic with that?
I think it's about being women being informed about alternatives to that being provided by their local NHS GP's/ Consultants, when it clearly doesn't work for them
HRT treatment options can be confusing at best.
What I do  find relevant and interesting is that you state you are "happy to accept that everyone can have a view and opinion.  I am happy  to accept views that differ from mine. What I'm not happy with is someone who doesn't take that whole picture into account".
 So unless someone doesn't take the "whole picture into account" by your definition of whatever that is,  you won't agree with their personal experiences and views?
Simply, it's not a political issue re the NHS, and when the NHS fails to deliver appropriate care I don't see anything wrong in advising women of alternative treatment options.
Long post I know but I thought it necessary to clarify things.
You clearly do have issues contrary to what you said  about " happy to accept that everyone can have a view and opinion.  I am happy  to accept views that differ from mine"
 I'd suggest you do just that and just scroll on by in future if you don't agree with a post. 
I haven't said anything different from many  other  posters with similar views as mine.
Posting offensive and  abusive personal comments  just because you disagree with a post isn't necessary or helpful.  To say the lvery east .
I'm not going to engage in any further comments as I think the above says it all.
 I haven't reported to you to the moderators, although it may be the case others might.
Best wishes
Freckles x
 

[Hurdity]

Thank you all.....again....
Well my GP just called, she spoke with the consultant who advised her to tell me that I should take the hrt exactly as she has prescribed Utragestan 200mg orally for 12/14 day..can't remember which..she has never heard of using it vaginally!.....otherwise I risk thickening womb..cancer...I will then have to have painful intervention (hysteroscopy\biopsy) etc etc etc....pretty much exactly what you all predicted.

I find this so unfair....I do understand they have guidelines....they have to be careful ......I am regularly scanned.....surely they should be flexible enough to allow the patient some input into treatment​ and take their needs\wants into consideration.  As I am not experienced or knowledgeable enough yet with taking hrt I would prefer medical agreement\guidance. Am so disappointed.  I applied the gel for the first time this morning so will discontinue until I have thought some more.

I think I need to find a more sympathetic\open minded consultant.  The GP was lovely but lacks any real knowledge about hrt. . Does anyone know if the specialists listed in the search on here are knowledgeable\open minded enough to be flexible in their approach etc?  Feeling very deflated.
 
Dolly x

Hi Dolly

So sorry to hear you have had this experience. I presume it was the consultant you originally visited that prescribed you the gel and utrogestan, that your GP referred back to for advice about vaginal use?

There are two issues - firstly the dose and duration of the progesterone regime, and your consultant is right that taking it on a shorter cycle could risk thickening the uterus lining - this is strongly supported by evidence from trials and led to the NHS Guidelines. However as Dr Currie said (I think I quoted her post earlier in this thread) for progesterone intolerant women this can be varied under supervision but regular scanning/monitoring would be necessary.

Regarding the vaginal use of progesterone - this is not a matter of safety or not, but some quirk of our own prescribing guidance and approvals process. As I said earlier, there is evidence to show that vaginal use provides at least as much if not more progesterone to the uterus - by avoiding the liver (first pass effect) and the digestive system. Unfortunately there have not been large trials about this but in France ( as I think I've already said) for example, the patient information leaflet states that vaginal use can be used as an alternative to oral use for those who suffer adverse side effects. It is quite alarming that your consultant ( presumably private) had not heard of vaginal use when the information is out there for all to find!

Aside from Studdmania, (you really do not need to consult him unless you really want to - supremely eminent though he is!) - I think Michelemabelle's suggestion of sending an e-mail to Dr Currie at minimal cost of £25 is a good one - with your specific questions (notably aboit vaginal use of progesterone), and giving your history/menopausal status. She generously offers this service through this website as part of her mission to help other women through these difficult times and recognising that most women just do not have the funds to consult private gynaes - nor should they need to. As for who else to consult - it depends where in the country you live - I am sure someone will be able to recommend someone if you get nowhere - but do consult Dr C!

Please do not stop the HRT - please carry on with the gel - it may well be that you are fine with the Utrogestan dose as it is - and sometimes it is the synthetic progestogens like in the Mirena that cause more side effects. The most common sdie effects from utrogestan are excessive tiredness and sometimes nausea - but as with all medication some sdie effects wiill settle - and vaginal use does mitigate some of these.

Good luck and please don't be put off by the discussions - this topic always causes controversy because there is tension between those who advocate radical departure from NHS regimes and those who advocate caution unless under medical supervision.

Good luck and please ask if there is anything else we can help with

Hurdity x