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[auntyjoy]

Hello everyone,

I'm back after posting a couple of queries when I first boarded the good ship peri-menopause two years ago and then going awol for a while.

I am, by all accounts, very lucky to have a GP who has a special interest in menopause and she has seen me through the last two years prescribing 2-3 pumps of Oestrogel and 200mgs Utrogestan 10-12 days a month. I also have Teststerone gel which is prescribed by a private GP (recommended by my NHS GP. Like I said, I'm very lucky) and this combination has worked brilliantly for me.

I have just had my annual review with my GP who had just returned from a women's health conference with new advice that peri-menopausal women who have been on the 12 days 200mg Utrogestan for at least a year should now be on 100mgs daily and asked me to try this.

I think I'm correct in thinking that this regime was previously only for post-menopausal women so I was wondering if anyone else has had this advice and how it works for you? I'm 54 and I think I'm still peri-menopausal - missed my Utrogestan one month recently (forgot to pack it on holiday) but still had a bleed so my GP felt my own hormones must still be kicking in.

Thanks in advance!

AuntyJoy

[Traceylr]

greetings auntyjoy,
 I take utrogestan 100mg every night (vaginally ) after swopping from taking it orally due to awful side effects. It took about 4 months to stop getting a tiny bit of a bleed more of a discharge really every two weeks. I also reduced my estradot patch from 50mcg to 37.5 mcg  ( changed twice a week) think this also helped ) and  had no  effects from the tiny oestrogen reduction  , the bleeding stopped and I feel really well on this regime . But it has taken me 2 years to get to this combination and balance without help from gps so you are really lucky to have such good support from yours .
I am coming up for 56 and been post meno for 4 years.
The bleeding you had may have been from not taking the utrogestan rather than your own homones 'kicking in'? .
As had been said on this fantastic resourceful forum it's all about getting the balance right for you . Hope this info is useful.

[SueLW]

Hi

I would say the bleed you had after forgetting to take your tablets on holiday was simply caused by not taking the routine doses. 

Try the reduction and see what happens.  If you bleed go back and talk to your GP.  Sounds like you are lucky to have her!

[Fruit loop]

Hi,
Just wanted to say I was put on 100mgs uterogestan on days 1-25 of my cycle, even though I'm 53 and peri .What a mistake was on it for 8 months and it caused horrendous anxiety especially as my own cycle was interfering. Please make sure this advice is correct before you start down this route for me it was the worst thing ever.

[sheila99]

That's interesting. I'm in peri & also on oestrogel & utro 200mg for 12 days per cycle. If you try the 100mg please let us know how it goes. I feel so tired on utro I'm not sure if it would be better because the dose is lower or worse because I'd be on it all the time.

[Ladybt28]

Stellajane - I'm post but I can't do a no bleed regime without becoming suicidal!  Really interested in how you get on with 100mg on a 12 day cycle sheila99 as I am struggling a bit with 200mg for 14 days.  Mind you only getting towards the end of my second month but I know 14 days is a struggle and it's probably not going to get better by month 3!

Personally I always though 100mg was for a no bleed regime... well that's what the NHS paperwork says?

[Dotty]

Hi I think it's always been the guidance that after a year on hrt after the age of 50 then you can try a continuous regime . X

[Taz2]

The usual age for changing to a conti regime when you were still having natural periods at the time you started HRT is 54 I believe?

Taz x

[auntyjoy]

Oh my, thanks everyone for all the replies. What an amazing resource this forum is and I have to say a few alarm bells have rung reading through the replies. I do have a tendency towards 'mood issues' and do not want Utrogestan to make that any worse. The main reasoning my GP wanted me to try was for a 'no bleed' regime, so it's interesting to read it could cause erratic bleeding. Not keen on that idea! And I don't want to become suicidal like Ladybt28 or have a horrendous anxiety experience like Fruit Loop (love that name). As things are going pretty well for me (albeit with a few Utrogestan side effects some months) I'm a bit wary of reinventing the wheel.

I'd hope my GP does know what she's talking about, but I guess advice she gets from specialists is still open to interpretation and every woman is different.

Both my GPs (NHS and private) are also strongly suggesting a Mirena coil for me  - maybe this is her way of making me take that leap!

I'll let you know what I decide to do and what the outcome is...

AJ x

[sheila99]

I suppose taking a low dose utro is similar to Mirena. I was intending to ask for Mirena but not for a year or two until I'm sure I'm meno, the last thing I want is unexpected bleeding. Mirena seems to be the only prog suggested for peri that isn't cyclical - I wonder why?

[Hurdity]

Hi auntyjoy

If you were taking utrogestan cyclically and then didn't take it one month then your bleed could either have been spontaneous breakthrough bleeding due to over-thickening of the lining - this is abnormal bleeding, or it could have been because you are still in early peri-menopause and you ovulated and your own hormones came into play. There really is no way of knowing unless you have a pretty good idea of where you are in menopause or maybe had some telltale pms signs? Oestrogen breakthrough bleeding would be less likely to have any prior pms symptoms (apart from maybe cramping?).

Taz is right re the age 54 advice - when it is assumed that 80% of women have reached menopause - but of course it also depends where you were when you started the HRT eg I was 2 months off 54 and had had a period 5 months earlier so was not post-meno and started on cyclical HRT. However also contrary advice is given in some of the HRT preparations - that you can start a conti regime 12 months after starting cyclical HRT, try it (the conti) for a few months and if you still get too much erratic bleeding then go back to sequi - I believe Femoston might be one of these but maybe wrong? Also some docs start women on conti patches ( like Evorel) when in very late peri-menopause because a no-bleed regime may result.

However.... like the others - there is NO WAY I would take progesterone all the time ( unless I had bad endometriosis so would have to), so choose to have a cycle.

Personally I would take that GP advice with a pinch of salt in that yes - on any cyclical regime if you are late peri-menopause then you could try a continuous combined regime after 12 months and see how it goes - if you are keen on a no-bleed regime. This would be for utro or any other hRT. However Utrogestan does not have any variable doses for different doses of oestrogen so if on higher than a medium dose of oestrogen then 100 mg orally daily may well not be enough anyway. It can't be universally applicable to all women in all situations at all stages of menopause and for all doses of oestrogen. Would have to be on case by case basis I would say....

Yes Mirena coil is the obvous alternative as that really does contain enough prog to eventually give a no-bleed regime after 6 months in many women especially the further into menopause and if no uterus problems like fibroids, polyps etc.

If it's all going well for you - then why change? I am mid 60's and take Utrogesta vaginally 12 days x 200 mg every 6-8 weeks with 62.5 mcg oestrogen patch (+ testosterone gel).

Am I rambling? Hope not and hope it helps!

Hurdity x

[Nellendra]

Hi all
I am about to embark on hrt .. again.. will have gel and capsule.
oestrogen gel as Sandrena 1mg daily and a Utrogetan 100mg vaginal capsule every day.
I am 51 - in Peri- last period was June 2019, before that Dec 18 and sept 18..
 I had my testosterone checked and it came up 0.9 . I'm wondering if I should ask the doctor for testosterone gel too?
What do you ladies think?
Xx