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[Hurdity]

Hi Peroxideblader - you don't have to go to a private menopause doctor in order for your prescription for utrogestan to be varied from the licensed dose. However as has been said it does need to be done under medical supervision - to check that the dose is sufficient to protect the uterus.

Re anal use - I'm not sure whether any research has been done on this with Utrogestan? The other type of progesterone used for fertility and which I was prescribed for HRT before Utrogestan was available is Cyclogest (for fertility) and these were designed for rectal or vaginal use.

The key thing is whether the coating of the Utrogestan capsules will dissolve quickly in the rectum as it does in the vagina - in order to release sufficient quantities of progesterone into the system to protect the uterus.

My gut feeling ( ) is that you would get more from anal use than with oral use as less would be lost through digestion - but that assumes the above - ie the coating dissolves and sufficient prog diffuses through the gut wall? I also think it might be quite difficult pushing those little round 100 mg Utro balls up there as they are so small  . Provided your doc is OK with this and will agree to scan you after say 6 months as dazned says, and a year to check your uterus lining - then no reason not to give it a try?

You could ask Dr Currie if you want via £25 consultation?

Hurdity x

[CLKD]

Whilst we shouldn't need to go privately as shown many times here and probably repeated across the UK, many GPs aren't up to speed or not interested in enough in womens' health over-all to be supportive.  In the 8-10 mins slots allowed by the UK Government it really is difficult to get symptoms discussed, though I am extremely lucky in that my GP, nor his Staff, ever rushes me and when I'm confused, I make an appt. to go over points missed.

It is known that medication delivered via the anus is absorbed much quicker than by mouth.  The tissues there are thin so uptake is almost instant.

The question has been asked; answered; absorbed and now the lady can make her decision?

[dazned]

I was advised by my gyne Meno specialist that it was fine to use it anally. I would have thought that he was basing his answer on some sort of medical findings alongside his own experience in his field. Any research can be viewed/skewd different ways by different doctors depending on where they are coming from .

[CLKD]

...... as well as whether they are after a Research Grant ;-)

[Mary G]

Good post CLKD.

[Taz2]

I'm not sure if this gives any answers or even how scientific it is. Scroll down to "rectal route of administration" I appreciate that it is concerned with PCOS and not menopause but think the result must be similar http://www.redorbit.com/news/health/264835/different_routes_of_progesterone_administration_and_polycystic_ovary_syndrome_a/

Taz x

[CLKD]

   Mary G and Taz - every day is a learning curve ;-)

[Peroxideblader]

Thanks everyone and I agree going anally is not well documented but if it's that or orally I'd rather try it as vaginally is no good for me. As I've said I've had pain meds that way and it worked great. Guess I'll just have to try.
As for the Dr currie email route how can she diagnose prescribe or discuss my regime via email and what info would I need 8f I did try as I am going down the 100mg utrogestan route with only using one pump of oestrigen any higher would be too much but I'd rather have medical back up too. Has anyone successfully emailed Dr currie and how precise or helpful was the outcome

[dazned]

I think others have had some success with that option.Only thing would concern me is that you have to get your own gp onboard with what she says and they don't have to I guess.

[Peroxideblader]

My own gp had never even heard of utrogestan so when she prescribed it she asked what dose I'd read was best so i said 100mg 11 days a month less sude effects so thats what she prescribed she said she'll go off my opinion.  Which is great for me but worrying that I dictated the dose that's why I asked about Dr currie

[Hurdity]

Hi Peroxideblader

It sounds like if your doc is listening to your idea of the right dose ( quite worrying in itself as the information is all out there if she only looked for it) then surely she would take even more notice of Dr Currie's response?

If you wanted to consult her then best to give as much information as you can but briefly eg your age, what your periods have been doing (re cycle length), symptoms, any medication you're on, what your doc has prescribed you and your concerns - (eg side effects from oral use, and bladder problems from vaginal use) and then ask your question.

I e-mailed Dr Currie about coming off HRT before having a hysteroscopy due to unscheduled bleeding/spotting and her reply was really helpful, and my doc complied - although I went to a different doc with the reply than the first one who had told me to stop HRT.

I also earlier found some info on rectal use of progesterone but didn't post it as it wasn't specifically about Utrogestan but you might find it interesting:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217976/

Again it is in connection with fertility and in vitro fertilisation - and compares progesterone pessaries (the Cyclogest ones I mentioned) used rectally and vaginally, as well as utrogestan used vaginally.

You could also maybe ask Dr Currie whether she would recommend Cyclogest pessaries but you might find your doc unwilling to prescribe this (even if Dr Currie suggests it) as it is not licensed for HRT - although my local GP prescribed this for me for 4 years as I mentioned, until I changed to utrogestan.

Interesting link Taz also - but as you say it is concerned with PCOS. What I got from it was how variable absorption is from rectal use (this would be Cyclogest pessaries, not utrogestan) - but this is the case with any HRT both oestrogen and progesterone - that there is great inter-individual variability!

Let us know what you decide Peroxideblader, and how you get on

Hurdity x

[Peroxideblader]

Thanks everyone. And hurdity thanks for the informative post too.  I might email Dr currie I'm not sure yet as I've pretty much got what I want hrt wise and what seems the best dose. I might try it and if I come across more issues I'll have to maybe try her as my gp hadn't a clue..I don't see one particular doctor you get who you're given and I've seen them all over the years and they're all totally unknowledgeable or ignorant on menopsuse..hence why my main source of information and support is on here..thank heaven for MM

[weathergirl]

My concern with using it vaginally or anally is the dyes in the gels.  I'm wondering if it's not untoward to be exposing sensitive tissues to the coloring in the capsules repeatedly like this?  I doubt it's anything that's been studied. 

The capsules are meant to be broken down in the digestive process with the strong acids in the stomach and other enzymes and what not.  But when we use it in the vagina, the capsule is slowly melting via body heat, and staying in contact with the vaginal tissue there for an extended time - hence the discolored secretions the next morning.  The 200mg capsules I get in the U.S. are a sort of brownish/red color.   The 100mg ones are yellow or pink, depending on the manufacturer. It's just a thought. 

I'm so hoping this is not something to be concerned about.
Anyone have any thoughts?   

[Hurdity]

In the UK they're not coloured - the 100 mg are pretty much white - or maybe very pale cream. The 200 mg ones were too - maybe they were cream but no colouring to my knowledge. How weird that they are brightly coloured in US! I quite agree I wouldn't want my vagina to be bathed in dyes - especially as I avoid all artificial colouring from food ( but I do dye my hair - there are limits  ).

Hurdity x

[Cassie]

Mine are pure white I cannot imagine why they would have dye in them....