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[4meSons]

Had yet another appointment with GP today and I must sing her praises, she does listen and is very open to advice I've read on this site. We talked about the regime prof studd prescribes but she was utterly amazed about using the utro vaginaly but then again I am the first patient of hers to use it. She is going to research it and is also referring me to local meno clinic which I am pleased about. She says she is unable to prescribe T which I already knew.
So in the meantime I am to start back on the gel and start at 2 pumps and go back in 2 weeks when we will sort out the utro. Do any of you ladies know where I can find any evidence to show her about the vaginal route ? It would be very helpful if you could guide me in the right direction x

[CLKD]

She could of course, speak with Prof Studd ;-)

[Salad]

It's great when your GP is supportive - it feels like someone has got your best interest in mind 

I don't know anything about the 'vaginal route', but popped in to ask why she is unable to prescribe Testosterone? My GP supported the use of Testosterone for me.

Maybe she felt the Meno Clinic would do it instead.
Good luck!

[4meSons]

I was under the impression that it could only be prescribed by specialists but I'm probably wrong as I normally am lol
Knowing she supports me and has been since all this started 3 years ago I feel I can really open up to her x

[Hurdity]

Hi 4mesons - yes I put together a post a while back with abstracts of papers in the utrogestan/estrogel support thread. I'll try to find it for you
.
Hurdity x

[Hurdity]

Here it is:

Sunnydays I have just copied and pasted some notes I made some time ago from various papers. I haven't re-read them before posting. I'm sure there are others too:

http://www.ncbi.nlm.nih.gov/pubmed/22321028'

Endometrial response to concurrent treatment with vaginal progesterone and transdermal estradiol.
Fernández-Murga L1, Hermenegildo C, Tarín JJ, García-Pérez MÁ, Cano A.
Author information
Abstract
ABSTRACT Objective To describe the effect of the intermittent administration of vaginal progesterone and a low-dose estradiol patch on endometrial stability, as assessed by the rate of amenorrhea and endometrial stimulation. Methods This was an open study in which 64 moderately symptomatic, postmenopausal women were treated in the outpatient clinic of our University Hospital for different intervals up to 1 year. The treatment consisted of a combination of patches delivering 25 µg/day estradiol and intravaginal pills containing 100 mg of micronized progesterone. Patches and pills were administered concomitantly in a twice-a-week protocol. The endometrial response was assessed by endovaginal ultrasound completed with suction biopsy when required. Results Both cumulative amenorrhea and no-bleeding rates increased progressively and reached 88.9% and 100.0%, respectively, by the 12th month. Isolated or repetitive episodes of bleeding, bleeding and spotting, or only spotting were reported by three, four, and 12 women, respectively. Endometrial thickness remained unaltered. Endometrium was atrophic in the seven women in whom a biopsy was performed. Conclusion The substantially reduced progestogen load determined by this combination achieved an acceptable incidence of spotting or bleeding when associated with a low estrogenic dose. There was no apparent endometrial stimulation. Additional studies are required to confirm this observation.

http://www.ncbi.nlm.nih.gov/pubmed/15222511

Efficacy of oral micronized progesterone when applied via vaginal route.
Choavaratana R1, Manoch D.
Author information
Abstract
The aim of the study was to compare the efficacy of oral micronized progesterone when applied by the vaginal route. The comparative study of serum progesterone levels between oral and vaginal micronized progesterone administration was conducted in sixty female volunteers. The subjects were equally divided into two groups to receive the drug either via the oral or vaginal route. The subjects' profiles showed that there was no significant difference in general characteristics between these two groups. The blood tests for estrogen and progesterone levels were performed on all volunteers before and after the drug administration. The data collected from the experiment revealed that the serum progesterone levels achieved by oral administration (5.06 +/- 2.95 ng/ml) differed significantly (p < 0.001) from those achieved by vaginal administration (8.26 +/- 4.09 ng/ml). The data also revealed that the serum progesterone levels of the oral administration group (4.23 +/- 2.68 ng/ml) did not differ significantly (p = 0.925) from the other group (4.15 +/- 3.40 ng/ml) when the serum estrogen level was less than 30 pg/ml. On the contrary, when the serum estrogen level was at least 30 pg/ml, there was a significant (p < 0.005) difference in the serum progesterone levels between these two groups (6.32 +/- 2.99 ng/ml for the oral route and 9.76 +/- 3.23 ng/ml for the vaginal route).

http://www.ncbi.nlm.nih.gov/pubmed/20575654

Transdermal estradiol and oral or vaginal natural progesterone: bleeding patterns.
Di Carlo C1, Tommaselli GA, Gargano V, Savoia F, Bifulco G, Nappi C.
Author information
Abstract
OBJECTIVE:
To evaluate the effects on bleeding pattern of two different doses of natural progesterone (NP) administered per os or per vagina in association with transdermal estradiol in a continuous, sequential estrogen-progestin therapy.
METHODS:
A prospective, randomized trial was conducted on 100 patients randomized into four groups. Each group received transdermal 17beta-estradiol treatment at the dose of 50 microg/day. Groups A and B received NP per os at the dose of 100 mg/day and 200 mg/day, respectively. Groups C and D received NP per vagina at the dose of 100 mg/day and 200 mg/day, respectively.
RESULTS:
After 12 cycles of treatment, no significant differences were observed in endometrial thickness between groups, suggesting that all treatments are effective in balancing the effects of estradiol on endometrium. Regarding bleeding control, patients in Groups C and D showed a higher number of episodes of regular bleeding than patients in Groups A and B and fewer episodes of spotting. The better control of bleeding was associated with a higher treatment compliance in patients who received vaginal NP, with a larger percentage of women completing the study.
CONCLUSION:
Transdermal estrogen replacement therapy combined with 100 mg of micronized NP administered per vagina from the 14th day to the 25th day of each 28-day cycle leads to good cycle control and provides excellent patient satisfaction without serious side-effects. This therapy could be a treatment of first choice in early postmenopausal patients.


E-mail from information manager at Ferring ( previous manufacturer of Utrogestan)

The product monograph talks of two trials of vaginal use as part of HRT – they're small patient populations – 20 and 30 patients in each.

One study used 100mg once daily vaginally for 21 days of 28 day cycle – the study lasted a year and was undertaken in 20 patients. Symptoms were significantly reduced, bone density remained and no adverse effects were seen. The endometrium was safely protected from the estrogenic effect of 1.5mg transdermal Oestrogel.

Another of 30 patients over 36 months studied the use of 100mg vaginal Utrogestan every other day. For most patients there was absence of bleeding and good patient satisfaction. There was a reduction in mean endometrial thickness and at the end of the study endometrial atrophy was seen in all cases. Five of the 30 women dropped out due to vaginal bleeding.

The references are:

Spritzer et al Exp Clin Endocrinol Diabetes 2003; 111 (5) 267-273

Vilodre et al Gynecol Endocrinol 2003; 17 (4) 323-328.

Hope this helps

Hurdity x

I haven't read them recently nor searched for anything more up to date but it should be a good starting point for your GP.

Hurdity x

[4meSons]

Oh thank you hurdity that is great 
I started reading through that thread yesterday but only half way through, going to continue as it's really interesting and helpful. X

[Hurdity]

Bump for Honey43 - info about vaginal use of utrogestan.

Hurdity x