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[FunFifty]

Hello,  having tried various forms of HRT and GP thinks I am sensitive to progesterone i am now about to start a new regime (having been off any form of HRT for around 6 weeks) of Oestrogel and Utrogestan vaginal pessaries.  I am a 50 yr old peri menopausal still with periods and my period is due in a week to 10 days.  I am not feeling great, irritable, slight hot flushes etc and it is bearable.  My question is should I start the Oestrogel now or wait until my first day of my period?  I'm thinking that starting it on 1st day of period may keep everything in sync OR does it not matter?  how do others feel about the Oestrogel/Utrogestan pessary combination?  any advice/views etc be very welcome.  Thank you

[Hurdity]

Hi Funfifty

If your periods are still pretty regular then I would wait - but otherwise you could just start the oestrogel and when your period starts you start counting Day 1 as the first day of the bleed and start the Utro on Day 15 as per instructions. This means you might be taking oestrogen only for a while longer but this won't matter as long as your periods are regular. If you are skipping them and the gaps are quite big, then when you are due theoretically is academic so in this case just start and count the first day you start taking the oestrogel as Day 26 - and then your will have 16 days of oestrogen before starting the utrogestan. If you are completely out of sync then you can re-adjust. Does that make sense?

I can't comment on the estrogel as I've only ever used patches but have been using Utrogestan for 6 years (on a long cycle) and it's all good. Previous to that I took Cyclogest ( prog pessaries) on a short 28 day cycle - for almost 4 years.

I'm in mid 60's now and not thinking of stopping hRT any time soon (still bleeding though - now every 6-8 weeks ) so that is testament to its success with me

Hurdity x

[FunFifty]

Hello Hurdity, Thank you for your reply. Really helpful indeed.  On the Utro have you tried both tablet and pessary format? is there a difference?  My Consultant prescribed Tablet format but the GP gave me pessary format and as I now have the pessary I'm wondering whether I should just use those first and switch to tablets later?  or will that mess things up?  just interested if people have had different experiences on the Utro pessaries and tablets?

Thank you 

[Hurdity]

Hi Funfifty - sorry I missed this as haven't caught up with posts on this board.

I presume you have been given the 200 mg Utrogestan vaginal pessaries which are given for fertility? The 200 mg version used to be available for HRT and was withdrawn but it's just a question of packaging and they were exactly the same - small oval creamy coloured fairly soft-shelled capsules.

I have only ever used Utrogestan vaginally - but have only ever been prescribe the one for HRT - firstly the 200 mg but now the 100 mg (you use two of them) as the 200 mg is not available except as above. Some women are prescribed the 200 mg vaginal capsule for HRT by doctors who know it's the same thing,  and from what I gather you get an applicator with it which of course you don't with the one for HRT as vaginal use is (absurdly) off licence.

There can be more side effects from oral use than vaginal if this is what you mean because the progesterone goes through the digestive system and has to be metabolised by the liver, and it is the metabolites that can give rise to some of the unpleasant side effects especially, from oral use.

Does this help explain? Let us know how you get on.

Hurdity x

[FunFifty]

Thank you Hurdity.  Yes it does.  I now have the 100 mg oral capsules and have to take 2 x 100 mg for 12 days.  I also now have an oestrogen patch instead of the gel (my request).  Problem I have is that I still haven't had my period yet so still not on any oestrogen and feeling lousy and hot sweats starting!!!!

Thanks for getting back to me. x

[lifeatfifty]

Hi hope you don't mind me giving my tuppence worth.

I have been using estrogel and utrogestan now for 5 months. For the first 2 months I used 2 x 100mg orally and hated it. I felt incredible dizzy and spaced out even if getting up to the toilet in the middle of the night.

I'm now on the 1 x200mg vaginally with applicator. It's much better.

I too would hold out until your period starts, if you can.

I found the estrogel helped instantly with the hot flushes.
I'm trying for a 28 day cycle. I use estrogel morning and night and then my progest pessary on day 21 - day 28. (8 days)
I have read various threads that state this is not the usual method of taking it. My doc suggested trying from day 21-26 this month?

I find I do get antsy and PMT symptoms and cramping on the Utro. I also sleep really badly. I  have a bleed about 4 days after stopping progest. I was counting day 1 as the day after I stopped my Utro but have been told to count from first day of bleed.
My 'period' (ie how much I bleed) would be very dependent on how much estrogen I was producing myself. I find every second month I am very estrogen deficient so I increase my gel a little.

I too am perimenopausal, although one gyno said I was definitely menopausal after blood work. Since seeing someone 'privately' I have had blood work showing that I am peri.

I hope that helps with your decision to wait a few more days?