Hi Babyplum, welcome to the forum. You asked for others' experiences - I've just started my 3rd trial of Utrogestan, which as you say, is known for its sedative properties. I find the capsules make me drowsy within an hour, which is a bonus for me because I have long-term problems sleeping for several reasons. However, throughout menopause I've also had the worst fatigue of my life, with unbelievably poor stamina, very unlike the formerly good energy levels I took for granted.
Is your tiredness unnatural drowsiness, a feeling of physical exhaustion or both? The distinction I'm thinking of here is that by midday my body feels worn out & weak as though it's reached its physical limits - I ache from the waist down as if I've done several days' manual labour & have to sit or lie down in order to recover enough to manage the afternoon upright! This is what I think of as physical exhaustion - it's disproportionate to effort expended & a right nuisance!
When not on Utrogestan, if I'm comfortable and not stressed, I quickly become naturally drowsy & fall asleep within minutes of sitting down, at any time of day, as most people do when getting insufficient sleep.
However, on the Utro I can feel its sedative effects within the hour & the drowsiness it causes feels unnatural - drug induced.
I've also found that during any time in my life when I've been lucky enough to sleep a bit better, my body has started to relax and I've actually felt more tired during the day. So, as you say you are sleeping better, I wonder whether you could be having a similar reaction.
Trying to get an idea of whether your tiredness is definitely being made worse by the Utrogestan. If you do feel drowsier especially "drugged", I would suspect the Utrogestan. If it's more physical - worn out, aching muscles, weakness etc, then I'd hope this would improve after a while on the right HRT regime & it should be well worth hanging on in there for at least the recommended 3 months if you can find a way to cope meanwhile.
I think some women find Utrogestan simply too sedating, but remember from my longest trial (5 weeks) the effect diminished as time went on. I had to stop it for reasons other than fatigue and am just 3 days into this latest trial with a different dose of Oestradiol.
Using the Utrogestan capsules vaginally, as Annie says, is said to reduce systemic effects and gives good protection of the uterine lining. It can be more irritating to the local area when used this way though.
If your gynae prescribed either 1 or 2 pumps of oestrogel, then as others have suggested, you could increase to 2 and see how you feel. I think this might well counteract the sedating effect of the Utrogestan. I hope you feel better soon.