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[racjen]

I've been taking Utrogestan 100mg daily (vaginally) without a break for the last 2 - 3 months and up till now it hasn't caused any problems, but reading through some of the posts on here the penny dropped last night that maybe it has now built up to the level where it's started giving me nasty side effects - particularly nausea and diarrhoea, but also gradually worsening depression. Is that likely? I didn't take it last night and lo and behold, this morning I don't feel sick, my stomach has settled and my mood has lifted...There seem to be as many patterns for taking progesterone as there are users of this board, so I'm now really confused about how often I should be taking it to  balance the oestrogen - help!

[Dancinggirl]

This is why many women stick to a sequential regime and put up with a monthly bleed. Try using Utro for 12 days each month (you will get a bleed after that) and see how that goes. Dg x

[racjen]

Thankyou both, that is really really helpful. I think I've been so fixated on the oestrogen/testosterone thing I'd managed to completely ignore that there are issues around progesterone too. Will definitely give my body a break now for a couple of weeks and see how I get on.

[Dancinggirl]

racjen -  I just want to mention that Mary G is under a private gynaecologist, so is being monitored with regular scans which she pays for - this is very costly and many can't afford this. Regular scans are not available on the NHS, and following the Professor Studd (private gynaecologist) regime of 7 days of Utrogestan per month, can result in a build up of the womb lining in many women - this will result in problematic bleeding, which is what happened to me.
I saw a different private gynaecologist and he was of the opinion that one should use at least 10 days of progesterone to ensure a proper shedding of the womb to prevent problematic bleeding. There will be good reasons that the licensed dose of a particular progesterone, prescribed on the NHS, is set as it is and to deviate from this without professional supervision is unwise. 
Mary G - your statement "You don't have to stick with the NHS stated dose, it is way too high" - is very sweeping - please be careful with you advice.

I do agree that it is worth trying the vaginal route with Utro and that a lower dose is possibly appropriate because less will be lost in the liver and gut when used as a pessary.  I am sure that the pessary option will be fully licensed here in the UK at some point. Using it vaginally can be good for many women but unfortunately some, like me, found it caused thrush type symptoms. We are all different and finding the right HRt treatment is trial and error.

Mary G - could you please tell me where there is research that backs up your claim that progesterone effects stays in the body? Bad headaches are a common menopause symptom, whether using HRT or not.  Headaches often occur when progesterone is stopped just before a bleed starts and I understand this is the body reacting to the withdrawal of progesterone, not the effects of the progesterone itself.  Many women actually feel very good on progesterone, particularly Utrogestan, so choose to use it daily for this reason.

A small percentage of women are very sensitive to any HRT and I feel we really shouldn't frighten women into expecting problems when there is a good chance they will be fine once their bodies adjust and settle with any hormone replacement.

Give the sequi regime a go racjen and hopefully over the next few months you will start to feel the benefits. Keep us posted - we are here to help.  Dg x

[Mary G]

I was only giving my own personal experience DG, I wasn't trying to scare anyone or upset them but I was trying to be honest about my experiences.  I'll delete my post if it is causes so much upset.

[Nina]

I am one who uses 100mg daily with no problems. There are many of us who do this! It is not ‘way too high' MaryG, you always trot out the same stuff. Are you actually John Studd 

[Cassie]

Good grief girls put the claws away! I also am on a low dose of utrogestan for a short period each month have been so for many years could never handle the higher dosage.

[Dancinggirl]

It is very important that we express our views and advice responsibly.  If we advice something that is ‘off license' then it is vital we recommend that this be done under professional supervision. We would all like the NHS, and particularly GPs, to be more clued up about treating the meno but here on MM we are trying to inform and support in a sensible way - empowering women to seek help and ask for what they need from their doctors.
Cassie - absolutely no claws involved - just trying to encourage a sensible and balanced approach.
If you follow this forum on a regular basis, then you will find that many women have a great deal of trouble with the Studd approach, so it definitely does not suit every women and none of us should hail his regime as the ultimate approach.

Let us all be careful how we express our opinions please - I include myself in this  - DG x

[Mary G]

I have read posts on here from women who have had problems with Oestrogel and had to ditch it but I have never heard from anyone who has specifically had problems with Professor Studd's 100mg 7 day Utrogestan dose.  Please, can we have some feedback from women who have had problems with it?  Have you used this low dose and ended up with problem bleeding and/or womb lining build up? 

Of course we must be informed about all problems that women encounter with all forms of HRT otherwise there is no point in having an open forum.

[Cassie]

DG I was referring more to the guests comment, seemed a bit silly really, anyrate hope every  one has a lovely week.
 

[dahliagirl]

That was a bit of a post and run sort of guest.   

[Dancinggirl]

Mary G - As I mentioned in my post - I have tried Oestrogel with 10 days of 100mg Utro each month and got constant erratic spotting and bleeding. I have read quite a few posts with similar experiences.  This is why my gynaecologist explained that using progesterone for fewer days each month can be an issue.
My understanding is that Utro isn't as stable as synthetic progesterones and I think this is why the NICE guidelines err on the cautious side and recommend the higher dosage.

My meno started in my mid 30s and so I have used HRT on and off for over 25 years -  I have also tried just about every HRT type there is, so I do feel I can speak from experience. However, I always try to emphasise that what I have experienced will not be the same for others. When women come to this forum for support, my main mission is to put myself in their shoes and I endeavour to offer the support they need in a positive way. I know I can be forthright at times but it is with the best of intentions.

DG x

[Cassie]

DG if I may ask out of interest, when you were experiencing the spotting and erratic bleeding what did the ultrasound show as in lining of your endometrium, any other reason for the spotting, such as possible polyps, fibroids etc?

[Dancinggirl]

Cassie - I did have to pay to have a scan because of this erratic bleeding - no polyps or fibroids but there were some patches on the lining, showing it wasn't shedding properly.  I then moved to using Utro 100mg every day after the scan, in the hope the spotting/bleeding would stop, but it didn't. I also got a lot of cramping that was very unpleasant.
Utrogestan isn't good for everyone and I've read on this forum that many women who don't get on with Utro actually do better on Provera.
Way back in my 40s I used dydrogesterone which really suited me but it doesn't come as a ‘stand alone' pill any more which is a shame.
I have given up systemic HRT now - my experience with Utrogestan really put me off experimenting any more and at 61 I really don't want the hassle of bleeds and cramps.
DG x

[Hurdity]

Hey where's Nina gone? She's been on the forum for a few years - so it's a pity she's left... Nina if you're reading this - don't go - always good to share experiences and regimes... and we're all trying to help each other.

Also - great post Dancinggirl. While recognising the need for individualisation of doses, it is so important for us not to recommend unlicensed regimes without stating this. Quite a few of us do so (non-standard regimes) but with the consent of our docs and in full possession of the implications. Only your doctors have access to your medical history and if you are not medical yourself then caution needs to be exercised.

And for anyone that didn't see this - especially new members - Dr Currie intervened on precisely this issue on the utrogestan/estrogel support thread:

Just to confirm, while Professor Studd is very experienced and extremely knowledgeable, his regimens are not always in line with current recommendations, particularly around use of progesterone.
As always with providing menopause advice, this should be individualised and flexibility should be applied, as long as there is a clear understanding of national and international recommendations. Some women are intolerant of progestogen and progesterone and so it is appropriate to adjust the regimens, as long as it has been fully explained and discussed.
Best wishes
Heather

racjen - I think I mentioned on another post that I take progesterone vaginally on a long 6-8 week cycle (200 mg x 12 days) which gives me an oestrogen holiday (or is it a prog holiday?). My doc approved of this - because when I was on the standard 28 day cycle my bleeds dried up so it meant I could extend the cycle and get a small bleed. Personally if you are post-menopausal I would prefer to do this than the 7 day regime and I would suggest you think about taking it cyclically - but if you are still early-ish peri then the 28 day or monthly cycle would be advisable initially. Maybe a compromise on 10 days might work if your doc agrees? If necessary see if you can get a referral to a menopause clinic?

Hurdity x