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[Binks]

Cycling every theee months with utrogestan and eostrigel - any advice on number of days to take utrogestan for?

[Hurdity]

Hi Binks

I am interested to know that you are on a 3 month cycle - are you in UK and is this with a private gynae or on NHS? I ask because it is less usual nowadays only because of the risk of endometrial thickening and breakthrough bleeding which can happen especially if you are not post-menopausal.

How old are you and where in menopause, last period (s) etc? Have you been on HRT before or are you just starting?

I take utrogestan vaginally on a long cycle of 6-8 weeks (my GP is happy with this) - and because I used it vaginally I take the same dose as if I was on a monthly cycle and taking it orally ie 200 mg for 12 days. This is because more gets into the system when used vaginally. I am not sure what sort of bleeding control you will get if you take 200 mg orally for 12 days. Has your gynae/GP not suggested how long to take it for?

it also depends party on your oestrogen dose so if using low dose oestrogen then you masy well be fine ( if post-meno or nearly so) but on high doses may be more likely to bleed before the 3 months is up - or rather 10 weeks (I presume you will be doing 10 weeks oestrogen only followed by 2 weeks oestrogen + progesterone?).

Hurdity x

[Binks]

Hi hurdity

Thanks for your reply
I'm in uk being dealt with by GP who knows nothing

I put myself in three monthly ( after taking no progesterone for 6 months ) as I saw it in the nhs website. I told dr and she seemed to think it's ok.

Even with no progesterone for 6 months I had monthly gripy pains but not an actual period since February and only two- 3 natural periods last year so suspect I'm nearing the end .

Nov dec jan I was on patches and had no period with them even though I should have had. Suspect oestrogen levels are no very low , too low to build womb lining without meds.

I was using one pump of oestrogel but dr said increase to two as I was very anxious ( not normal for me ) I'm not happy about increasing the dose so will stick in one

After 5 nightmare days in 200mg utrogestan I'm ready to throw the towel in , I'm so tired it's like living in glue. My utrogestan are little cream coloured round capsules ... is this what you use vaginally or are they made especially  for vahinal use ??  I would rather use vsginally - like crinone gel etc but dr says it's not licenced for hrt so won't let me have it.

Have booked another dr app with diff dr on 27th  June so will be able to get different advice and by then will know if the 200 x 12 days is enough to make me a period !

Do you think I need to be sent to meno clinic??

[Binks]

Ps as given no advice at all from gp was planning on taking progesterone starting the first day of every three calendar months - as I said , no break though in 6 months without prog, only a real period in Feb ish .

How much oestrogen are you on??

I'm 50 and started with mild flushes at 44. Main debilitating symptom has been arthritis which despite being diagnosed as osteo vanished within two weeks of taking hrt ( I requested after research )
I do wish I'd startsd taking it years early before my symptoms led to me having to resign from my job as a headteacher as I couldn't cope with joints - now lost pension and everything 😢

[Hurdity]

Yes the capsules are the same when used vaginally - it is used like this off licence. Annoyingly small balls of Utro! There should be fewer side effects when used vaginally if you are suffering from taking them orally.

The 3 month cycle you saw on the NHS website is misleading because it actually refers to a specific HRT preparation Tridestra. Many gynaes do not like very long cycles these days due to increased risk of endometrial hyperplasia or breakthrough bleeding. AFter being on oestrogen only without a bleed it may well be heavy (possibly!) and it might start before the 12 days has elapsed.

I have been on 50 mcg oestrogen patch for most of the time I've been on HRT although several months after starting tesosterone in 2015 I increased my dose to 62.5 mcg so that I didn't become too T dominant. My bleeds are slightly heavier as a consequence but still nothing like my natural periods were. if you've only been on one pump of oestrogel maybe this is low for you and the lining may not build up so much - depends partly on body weight and BMI how much is absorbed , amongst other factors.

Sorry to hear about your job - that must be a blow and especially with regards to your pension. With treatment however, and if you feel better and on an even keel most of the time,  perhaps you could resume teaching again?

Hurdity x

[Mary G]

Binks, my gynaecologist put me on a 3 monthly progesterone cycle because I am severely progesterone intolerant but I also need high doses of oestrogen do it didn't work for me, I had breakthrough bleeding.  That said, it does not mean it will not work for others and she has other patients (mainly German because this regime is popular there apparently) who manage it successfully with lower doses of oestrogen. 

So it might be worth a try.  If you have access to regular scans then there is no reason not to try it because if you hit any problems, you will soon find out. 

If you are progesterone intolerant then you need to find a flexible HRT regime that works for you.  It's far better to take a lower dose of progesterone and have regular scans than to give up on HRT altogether.

I hope that gives you some ideas.

[Binks]

Hi Binks

I am interested to know that you are on a 3 month cycle - are you in UK and is this with a private gynae or on NHS? I ask because it is less usual nowadays only because of the risk of endometrial thickening and breakthrough bleeding which can happen especially if you are not post-menopausal.

How old are you and where in menopause, last period (s) etc? Have you been on HRT before or are you just starting?

I take utrogestan vaginally on a long cycle of 6-8 weeks (my GP is happy with this) - and because I used it vaginally I take the same dose as if I was on a monthly cycle and taking it orally ie 200 mg for 12 days. This is because more gets into the system when used vaginally. I am not sure what sort of bleeding control you will get if you take 200 mg orally for 12 days. Has your gynae/GP not suggested how long to take it for?

it also depends party on your oestrogen dose so if using low dose oestrogen then you masy well be fine ( if post-meno or nearly so) but on high doses may be more likely to bleed before the 3 months is up - or rather 10 weeks (I presume you will be doing 10 weeks oestrogen only followed by 2 weeks oestrogen + progesterone?).

Hurdity x

HI Hurdity = thank you for your response.

I am 50, two years of scanty periods ( age 47-49) I am 50 now.

Started on patches last november, only had one period since then.

The urtogestan hasnt triggered a period, but i am only on 1 pump of estrogel

I got the three months from guidance on the NHS website and self diagnosed  as I am SOOOO sensitive to prog, I had several aura migrainse in 12 days, I never get migrains.

Managed to get testosterone blood test as I am convinced they all work in partnership and have never been checked, Asked ot have FSH checked but she said it wasnt worth it..... I would have liked ot have seen the difference between 2 years ago and now, my lack of periods migh not be HRT but final meno.

[Binks]

HI Mary G

I aqm only on 1 pump of estrogel which is the lowest does, i could prob have more to totally reduce feeling hot, but i can cope!

i have never had bleeeding issues, breakthrough or otherwise. My meno symptoms were wrongle diagnosed as osteo arthritus, i researched esotrogen defficiency and demanded treatment . I spent years struggling. within 2 weeksI was back at the gym, arthritis magically disappeared. NO accountability.