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[Jaylow]

I'm about to change from femseven sequi patches to estrogel and utrogestan tablets. The dosage I've been given is 2 pumps a day of the gel and 2x 100 mg of the tablets for 10 days of each cycle.

It seems strange to go from constant oestrogen from a patch to a once daily dose of the gel, should I apply the pumps at 2 separate times of the day to spread it out?

The utrogestan tablets say for oral use. I believe they can also be taken vaginally, can I mix and match? I assume when I'm having a bleed they're not going to work vaginally?

Does 2x 100mg tablets for 10 days sound an ok dose? I don't believe the gynae i saw usually deals with this regime, I asked for it and he looked it up in his medical book.

And finally, I'm coming to the end of my second phase 2 patch of femseven, before now I've started a bleed on day 2 of the second patch. This time I haven't had a bleed, despite having the worst pms symptoms since I started on it..will it still be ok to start the estrogel without the bleed?  Thanks

[Cassie]

That sounds fine and yes you can use vaginally you dont use them when you are bleeding the bleed comes approx 4 days after you stop the utrogestan. So you would start for instance on the 1st and take them for 10 days and will then get a bleed on approx day 14. I only use 1 x 100mg of Utrogestan for 10 days per month but I have an annual scan to check on my lining. They work better vaginally.

[Hurdity]

Hi Jaylou - the way absorption of the gel works is slightly different from the patch - you still get a more or less continuous dose if used every day. To some extent, as I understand, it is stored in the deeper layers of the skin after absorption on the surface and absorbed into the bloodstream from there. From memory (!) the estradiol is partially converted to estrone in the body which acts as a reservoir for conversion to estradiol so maintains levels within certain values - although if you miss a dose then levels will fall. If your bleed comes early then you may have to use vaginally during your bleed but perhpas in this instance oral use would be OK - after all any fall in  progesterone levels (from the change to oral from vaginal use) won't trigger a bleed if it's already started.

Good luck with your new regime and keep us posted!

Hurdity x