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[EnglishRose]

I went to see a menopause doctor today due to my anxiety depression and other physical symptoms
We decided on Utrogestan 200 mg 12 nights a month  and oestrogel 1 to 2 pumps a day.

I've been on Progesterone every day no break for years via cyclogrst Pessaries Which I melt in my bra and rub into my skin. Currently on 400 mg after reducing from 500mg
Each 100 mg reduction causes me terrible pms symptoms 2 weeks later so was advised to gradually reduce it till I'm no longer using it and just taking Utrogestan

I think I won't start Utrogestan until I'm totally free from Cyclogest otherwise I'd be still Progesterone dominant which is exactly the reason I went on Oestrogen to be taking the Utrogestan pills on top of the Cyclogest at any amount seems illogical plus how much of the stuff is stored in my fat cells after all these years?

I'm a bit worried about onky taking Progesterone 12 days after using it every day. I wonder if ppl have so many problems with Progesterone because they're forever stopping and starting. I suffer terrible withdrawals when ever I reduced my Cyclogest.

I understand she is trying to recreate a 28 day cycle..

I'll be applying the Oestrogel either way bc I'm deficient and having a really hard time now after a decade of peri menopause symptoms which were up and down but nothing as bad as where I am now.

Anyone got experience with these types of HRT?

Thanks in advance 😊

[Dotty]

Yes I'm on Oestrogel and Utrogestan and they work fine for me x

[NorthArm]

How about you do as the specialist has suggested? Start using the oestrogen as directed, whilst simultaneously reducing the cyclogest by 100mg a week. Once you're on the oestrogen only part, you'll probably find you'll have a big bleed. Wait until day 15 after starting your bleed (or oestrogen only if you don't have a bleed), then start taking the Utrogestan 200mg (at night, as it's very sedating) for the twelve days. You should have another bleed at that stage. As with any hrt regime, you will need to give it about three months to settle, and you may have some iffy days, especially as you're coming off such an incredibly high dose of progesterone. Like you say, you're already feeling pretty bad, and have done for a while. There is no magic bullet, it's taken you a few years to get to this stage, so expect it to take a little while to settle in.
Good luck with it all xx

[Hurdity]

As I said before on earlier posts I doubt very much that you are actually getting anything like that dose of progesterone from melting the waxy Cyclogest capsules and rubbing into your skin because is is simply not designed to be administered in this way. However why not do as NorthArm suggests to minimise withdrawal effects?

If you are post-menopausal and want to avoid the fluctuations of starting and stopping the prog which can give pms symptoms - then you can use it daily if you like it, along with the oestrogen. This would give a no-bleed regime eventually.

If you are peri-menopausal then yes you will need to use it cyclically.

Hurdity x

PS there is a long-running Oestrogel Utrogestan thread - scroll back through the threads on this board and you will find it....

[EnglishRose]

How about you do as the specialist has suggested? Start using the oestrogen as directed, whilst simultaneously reducing the cyclogest by 100mg a week. Once you're on the oestrogen only part, you'll probably find you'll have a big bleed. Wait until day 15 after starting your bleed (or oestrogen only if you don't have a bleed), then start taking the Utrogestan 200mg (at night, as it's very sedating) for the twelve days. You should have another bleed at that stage. As with any hrt regime, you will need to give it about three months to settle, and you may have some iffy days, especially as you're coming off such an incredibly high dose of progesterone. Like you say, you're already feeling pretty bad, and have done for a while. There is no magic bullet, it's taken you a few years to get to this stage, so expect it to take a little while to settle in.
Good luck with it all xx

Thanks
I'm dropping another 100 mg today which is half of a Pessary.
I'm expecting a bumpy ride bc I'm reducing Cyclogest and increasing Oestrogen so until I'm totally off Cyclogest I won't be taking the micronised progesterone.

Ty for your advise x

[EnglishRose]

As I said before on earlier posts I doubt very much that you are actually getting anything like that dose of progesterone from melting the waxy Cyclogest capsules and rubbing into your skin because is is simply not designed to be administered in this way. However why not do as NorthArm suggests to minimise withdrawal effects?

If you are post-menopausal and want to avoid the fluctuations of starting and stopping the prog which can give pms symptoms - then you can use it daily if you like it, along with the oestrogen. This would give a no-bleed regime eventually.

If you are peri-menopausal then yes you will need to use it cyclically.

Hurdity x

PS there is a long-running Oestrogel Utrogestan thread - scroll back through the threads on this board and you will find it....

Thanks Hurdity

You're absolutely correct I've been on Progesterone a long time and whilst I accept that rubbing into my skin might not deliver as much as it being absorbed by the vagina I have without expecting it suffered the worst withdrawal after dropping 200mg for two weeks after deciding I was good on 200mg only.
I've never before or since had 3 weeks of insomnia depression anxiety rage etc...It took me a few days to suss out what the common denominator was and so I increased back to 2 Pessaries and gradually got better but it took 3 weeks and a trio to the doctor in a panic as I had no idea wth was going on with me.
It has to melt inside the vagina before it's absorbed same as me melting it in my hand and when it's usdd vaginaly most is absorbed by the reproductive organs which is exactly why I prefer the exterior skin so it's more systemic.

I used to use Progesterone cream called Natpro at 400mg and when I made the switch to nhs Cyclogest (to save money) I don't recall any issues so based on my personal experience, it's absorbing good enough.

But I do respect your knowledge on the subject of hormones and I'll look now for the thread you mention.

Thank you
❤️

[EnglishRose]

Yes I'm on Oestrogel and Utrogestan and they work fine for me x

Thank you.

[Hurdity]

It has to melt inside the vagina before it's absorbed same as me melting it in my hand and when it's usdd vaginaly most is absorbed by the reproductive organs which is exactly why I prefer the exterior skin so it's more systemic.

I used to use Progesterone cream called Natpro at 400mg and when I made the switch to nhs Cyclogest (to save money) I don't recall any issues so based on my personal experience, it's absorbing good enough.

Just to clarify - it is not exactly the same - vaginal progesterone like Cyclogest is designed to be transported directly to the uterus through the cervix - but systemic absorption is also a consequence. The vaginal tissues are very different from the external skin the latter which is designed to be a barrier - so systemic absorption would be very different. Products designed to be absorbed through the skin are formulated very differently.

As you say you were using progesterone cream - but this is neither standardised nor regulated so despite what it says on the tin - you can't say how much you will actually be getting through the skin.

If you were using it for therapeutic purposes then it doesn't really matter what or how much is absorbed - it is when used for uterine protection to oppose the oestrogen part of HRT that it becomes crucial to use a propely licesned and regulated progesterone product and dose.

Incidentally there is no reason why you can't continue to use Cyclogest pessaries in the way they are designed (as pessary or suppository) as part of your HRT - but as this is unlicensed for HRT ( they are used for fertility) then your GP may not allow you - although this is how I first started HRT from my (enlightened) GP before Utrogestan was available.

Whatever you decide - I hope you manage to arrive at a dose/regime that suits you and more to the point makes you feel better overall without detriment to your overall health and well-being!

Hurdity x

[EnglishRose]

It has to melt inside the vagina before it's absorbed same as me melting it in my hand and when it's usdd vaginaly most is absorbed by the reproductive organs which is exactly why I prefer the exterior skin so it's more systemic.

I used to use Progesterone cream called Natpro at 400mg and when I made the switch to nhs Cyclogest (to save money) I don't recall any issues so based on my personal experience, it's absorbing good enough.

Just to clarify - it is not exactly the same - vaginal progesterone like Cyclogest is designed to be transported directly to the uterus through the cervix - but systemic absorption is also a consequence. The vaginal tissues are very different from the external skin the latter which is designed to be a barrier - so systemic absorption would be very different. Products designed to be absorbed through the skin are formulated very differently.

As you say you were using progesterone cream - but this is neither standardised nor regulated so despite what it says on the tin - you can't say how much you will actually be getting through the skin.

If you were using it for therapeutic purposes then it doesn't really matter what or how much is absorbed - it is when used for uterine protection to oppose the oestrogen part of HRT that it becomes crucial to use a propely licesned and regulated progesterone product and dose.

Incidentally there is no reason why you can't continue to use Cyclogest pessaries in the way they are designed (as pessary or suppository) as part of your HRT - but as this is unlicensed for HRT ( they are used for fertility) then your GP may not allow you - although this is how I first started HRT from my (enlightened) GP before Utrogestan was available.

Whatever you decide - I hope you manage to arrive at a dose/regime that suits you and more to the point makes you feel better overall without detriment to your overall health and well-being!

Hurdity x

Valid points 👍

I only know my blood tests from May
Oestrogen <18
FSH 70
Progesterone 20

I don't know what a normal progesterone level is at my age given my FSH is high and Oestrogen low and I know these tests vary hour by hour day by day so it's not set in stone
However, when I had my bloods done 5 years prior the doctor said they were normal. (What ever that means)
I know better now to ask for copies of results 😆

[NorthArm]

Hi roseenglish

Have you started the oestrogen yet?

[EnglishRose]

Yes 3 days ago

I was advised to try 1 or 2 pumps

I tried 2 but got a tight chest feeling like physical stimulation which lasted 5 hours
I'm going to stick to 1 pump and increase after 2 weeks

I've just reduced my Cyclogest by another 100mg too so now on 300 mg
Plus I'm doing the loading dose for Vagifem day 10.

I'm due on my period and experiencing vagina pain and burning to the skin around my bottom and vulva like acid type feelings. I had this for the first time on my last period.

😐

[NorthArm]

I really hope it goes well for you xx

[EnglishRose]

I really hope it goes well for you xx

Thank you

I'll go take a look at your story/posts ❤️