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[Florence69]

Hi again ladies I'm looking for advice or reassurance about utrogestan dosage
I've been taking 200mg vaginally for 14 days starting the 1st of every month. I use 2mg sandrena with it. My question is do you think it would be ok to do say 10-12 days 200mg ? I feel ok taking it but feel rubbish when I stop and my bleed arrives, which is really heavy with lots of clots which is another reason I was thinking 14 days is too long
What do you think as I don't seem to be able to make decisions anymore !
X
Flo 

[Dancinggirl]

The number of days you use progesterone isn't why you bleed heavily, it is the build up of the womb lining that causes the problem.  It is very important that the womb lining sheds each month and though 12 days may be enough to ensure a good shedding, it wouldn't mean you get less bleeding - in fact, if the lining doesn't shed properly, then you are more likely to get erratic bleeding at other times.
It could be worth having a scan to see if you have fibroids or polyps as this may be why you are getting heavy bleeds.
Having a Mirena fitted (instead of using the Utrogestan) usually means less chance of bleeding and over 60% of women get no bleeding at all after the first few weeks - so worth considering?  DG x

[Ladybt28]

The leaflet I got given here at the NHS clinic last week clearly states the dosage of 200mg for 12 days in the last half of cycle (days 15-26) with withdrawal bleed occurring the following week.  This is the cyclical dose as per the NHS guidelines.

100mg dose can be taken for days 1-25 with bleeding less likely and this called the continuous dose.  I can't take it continuously and some women can even manage the 12 days on the cyclical dose.

If you have been taking it 14 days I can see no reason not to drop to 12 as these are the NHS guidelines.

The women who are progesterone intolerant and cant manage 12 days feel pretty terrible all the time whilst taking the progesterone, not just at period time.  Did you suffer from bad periods before the menopause?  Maybe it's not the dosage?

[racjen]

The private specialist I saw (Dr. Sarah Gray in Plymouth) said that the minimum safe dose of Utrogestan she'd recommend is 200mg for 10 days every 3 months, or 100mg for 10 days every month (this is taken vaginally, but the same capsule as the oral one). Obviously this is less than the NHS guidelines, but they're very much one size fits all and probably have a massive margin of safety, but taking it vaginally does mean you absorb more and get fewer side effects.

[Dancinggirl]

Ladies - if you read Florences's post, she is not having problems with Utrogestan (she feels fine while using it) but she is having problems with the withdrawal and the heavy bleed. If you read my post, I try to address this issue, as reducing the number of days you use Utrogestan won't make a diffidence to the nature of the bleed if the womb lining is building so much due to the oestrogen, it will result in a heavy bleed.  IF there are fibroids or polyps that are causing the heavy bleeding then that needs to be addressed.

Florence69 - you could try reducing the amount of oestrogen you use as this might lessen the amount you bleed but I suspect you would do well with a Mirena.  DG x

[racjen]

Oh sorry, but to be fair the title of Florence's post is 'reducing the number of days taking utrogestan, is it safe?' So I was answering that question, but re-reading the post itself I see she's actually asking a different question...

[Florence69]

Sorry ladies if my title is misleading you, i think what I am asking is probably 2 separate questions
1) is it safe to reduce the amount of days I take utrogestan to 12 and still protect my womb
2) is it the estrogen or progesterone that affects the bleed
Reading your replies I think you have answered and unless I'm reading it wrong 12 days is within the guidelines and it's the estrogen that builds up that affects the bleed ....is that right ?
X
Flo

[Dancinggirl]

It can be the amount of oestrogen you use that will cause heavier bleeds, especially if you are peri menopause but there may also be others reasons for heavy bleeds e.g. fibroids.
12 days of 200mg Utrogestan each month is the standard dose.
DG x