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[CarrieM]

I' m hoping someone can give me a bit of advice, as I feel like throwing in the towel with HRT.

I'm on my third attempt at oestradiol patches and utrogestan, and feel like giving up again. I'm taking 100mcg 25 days a month and I'm on day 19. I'm taking it vaginally, against the advice of our local menopause specialist. Yesterday I started to bleed, it feels like a normal period, although it's 3 years since my periods stopped. Does this mean the utrogestan is working, or not working? I'm confused!
Since starting the utrogestan, I feel sedated, like I'm on permanent sleeping pills. Yet unfortunately it's not helping me sleep at night - I'm having more night sweats since I've been on it.
I'm wondering about switching to a cycle, but the thought of taking double the dose for nearly half the month seems worse than what I'm doing now.
I've read on MM about ladies taking 100mcg for only 7 days a month, but I know neither my GP or gynae dept at the hospital will prescribe anything other than the recommended dose.

So my questions are - does the bleed mean it's working or not? And where should I go from here - every day I've felt like stopping, and I'm struggling to get to the end of the 25 days.

Carrie xx

[CLKD]

Maybe put the name of the product into the 'search' box here to see what pops up?  Then make notes ;-)

[Hurdity]

Hi CarrieM

Strictly speaking the 25/28 dosage of utrogestan is intended as continuous combined ie no bleed HRT. However the 3 day break means that if the lining has built up during the month then this will enable some or all of it to be shed (because of the reduction in  progesterone - triggering a bleed).

You haven't said what dose of oestrogen patch you are on - but the effect on the uterus is dose-dependent ie the higher the patch dose the more the oestrogen will act to thicken the lining and therefore the more progesterone is needed to protect it. Have you had any bleeding during the 3 day break in any of your cycles?

I feel the same as you - too sedated while taking it which is why I maintain a cycle even in my 60's.  If you are still getting night sweats then maybe you need a higher oestrogen dose - something to discuss with your doctor maybe?

The 7 day progesterone regime is unorthodox and may not protect your womb lining especially on higher doses of oestrogen so would need to be in close cooperation with your doctor so that you could have regular scans. It is really intended as an absolute minimum dose for women who are progesterone intolerant.

As to your question about the bleed - I don't think anyone can answer that. It is also possible for women to experience ovulation after more than 12 months has elapsed since their last natural period - and this is more likely the younger you are.

Personally I would not want to take utrogestan for 25 days so I do a longer 6-8 week cycle  200 mg x 12 vaginally every 6-8 weeks with the consent of my (NHS) GP.

I hope this has given you something to think about but do get back to us if you have  any more questions

Hurdity x

[Dancinggirl]

I got erratic bleeding when using Utrogestan. I found Utrogestan gave me more side effects than most other progesterones. The Mirena was my best progesterone as part of HRT and I used Oestrogel alongside - the bleeding stopped after the first few weeks and the slight sedative effect also wore off more quickly as well. Less progesterone is circulated around the body. 
You could try Provera in a sequential regime with the gel - many women do better on Provera so it could be worth trying. DG x

[CarrieM]

Thank you all for your replies. I have been feeling really desperate today after another sleepless sweaty night! I found that a previous dose of 50mcg stopped my night sweats, and this patch of 75 was working but as the utrogestan has built up in my system, my nights are getting worse and worse.
Hurdity, I've not actually managed to take the utro for as long as 25 days to see if I have a bleed in the 3 day break, I'm bleeding after 19 days while i'm still taking it.
I was trying tp persevere for the full 25 days, but I'm stopping it now, it's doing me no good. I'm concerned about taking it cyclically at double the dose, i can't see any benefit in this.
Dancing Girl, thank you for your input. The menopause specialist at my local hospital suggested the mirena, but i was hesitant about this as it has the same prog at double the dose as the femseven i was taking, which didnt suit me. Can you remember how long it took for the side effects to subside, and do you have none at all now? I will also look into provera.
In desperation I rang Prof Studd's office today to enquire about phone consultations and cost. He's booked up until November, and i'm not sure i want to go down the private route anyway.

Thank you, lovely ladies, for your comments.

Carrie xx

[Dancinggirl]

I just had a bit of sedation for a few months after the Mirena was fitted - I slept so well!!
The bleeding stopped after about 12 weeks ( it just slowly tapered off) but I was very post meno and using just 2  pumps of Oestrogel ( average dose). I occasionally got a bit of lower stomach cramps but it was great to have 4 years of relatively few problems - this got me through a very tough time in my life e.g.  house moves and financial problems.
The Mirena is a favourite with many gynaes as it often solves many issues. DG x

[CarrieM]

I think after reading around on this site I will ask my doctor for provera. Will let you know how I get on! Xx

[Keepgoing]

Hi I take utro on a cycle and when I'm on it I do sweat a bit at night and I am more warm during the day and when I stop it I don't sweat...x

[CarrieM]

Thank you keepgoing. Do you take 200 mg for 12 days? I didn't take it last night and I feel miles better this morning - slept better and don't feel groggy xx

[Keepgoing]

Hi Carrie because I take it vaginally I think 100g is enough my thinking is when you take it orally you lose half in your body but you lose none vaginally so I only take 100g for 10 days I can't handle anymore and I do get a bleed so it is working xx

[CarrieM]

Hi Keepgoing, that seems more reasonable, i could maybe manage 10 days at that dose - are you monitored by a specialist though? I've been told I can't have regular scans on the NHS just because i'm taking HRT
Carrie xx

[Mary G]

CarrieM, you could try doing the 100mg Utrogestan (vaginally) for 7 days and have regular scans or if you are post menopause, have you thought about the new Duavive which means no progesterone and no periods?  There is information about Duavive on here so it might be worth considering. 

I am currently on the Oestrogel/low dose Utrogestan regime but just about to switch to Duavive.

[peri]

I would be interested to know how you get on with the duavive Mary G x

[Mary G]

peri, I am waiting to get my (hopefully) final period out of the way and then I will be conducting two trials, Duavive proper and Bazedoxifene (the SERM part of Duavive) with 2 pumps of gel every day and I will see which works best.  I will be having my usual regular womb scans of course to make sure all is working properly.

I'll start a new thread when I get started!

[CarrieM]

Hi

MaryG, I've not heard of Duavive but i will certainly look into that. I am also interested in the 7 day vaginal utro regime and got as far as ringing Prof Studd's office on monday enquiring about costs. But i thought I would look into other options first
xx