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[joziel]

  Maybe I should try it with warm water... will report back!!

[Jan1234]

Hurdity thankyou for this i wondering now if perhaps i stick with ultrigeston vaginally now and just take it ever other night might help me with the bleeding and spotting im constantly getting

[Hurdity]

Please don't laugh at this anyone 

But I was worried about the capsule dissolving okay vaginally so it could be absorbed (since it's designed to be taken orally). So I did a little test..

I put a capsule in a little glass of water and left it. I actually forgot about it for many hours. When I came back, the capsule was still undissolved in the glass. It had gone from being hard to being soft-shell and squishy, but I did have to squash it gently between my fingers before the progesterone inside came out.

Soooo, I'm now worried these oral capsules won't dissolve okay up there!?!? 

Good idea there - but fortunately unnecessary! When we say that use of vaginal utrogestan for endometrial protection is unlicensed - this just means in the very strict sense that (absurdly) it is unlicensed for this use in UK.

Rest assured that:

1) Utrogestan (200mg capsules) is licensed for vaginal use for fertility treatment in UK
2) Utrogestan is manufactured for oral and vaginal use by Besins - I made a post on this and gave the translation from the French spc - which I will bump for you
3) Utrogestan 200 mg capsules used to be licensed for (oral) use as part of HRT but just with a different leaflet/packaging but withdrawn in favour of just the 100 mg capsules

You have nothing to fear about it not dissolving!

What is lacking are large studies looking into the effect of vaginal use on the endometriumm but the studdies quoted in this thread demonstrate what has been done, though I imagine there must have been work done by Besins also to allow licensing in France/other Europea countries (in fact this may well be quoted in the French product info but I didn't translate this part).

To emphasise that the French product info recommend the same  dose (as oral intake) to be used if taken vaginally, as does the BMS paper. Any recommendation otherwise is very much off-licence and seems to be used by some specialists - for women - under close supervision and monitoring.

As always it is important to be aware that the relationship between oestrogen and progestogen doses (in the context of endometrial protection) is dose dependent - ie higher doses of oestrogen are likely to require correspondingly higher doses of progestogen.

This is the thread:
https://www.menopausematters.co.uk/forum/index.php/topic,45782.0.html

Spot on also joaniepat....

Hope this helps

Hurdity x

[joziel]

Hurdity thanks!

Are you sure it's the exact same product (I mean, same additives and inactive ingredients) orally as vaginally?? I thought I'd looked into this and the vaginal pessary had different ingredients in it to the oral capsule.... Not the 200mg of utrogestan but the other inactive ingredients and excipients??

[Hurdity]

Yes that is my understanding.

Check out the thread I linked to - relevant information quoted here:

"In the French database of medicines (the "base de donnees publique des medicaments") this product is listed as: "UTROGESTAN 100 mg, capsule molle orale ou vaginale " (soft oral or vaginal capsule) - similarly for 200 mg.  In the info it gives the indication for vaginal route, amongst other uses, if side effects are experienced with oral use:

"Dans toutes les autres indications de la progestérone, la voie vaginale représente une alternative à la voie orale en cas:

• d'effets secondaires dus à la progestérone (somnolence après absorption par voie orale)."

Translation: In all other indications of progesterone, the vaginal route respresents an alternative to the oral route in the case:
.. of  side effects due to the progesterone (sleepiness after absorption by the oral route)."

(Strange symbols due to change in forum software I think which affected older posts....)

Excipients the same - just less detail in the 100 mg

https://www.medicines.org.uk/emc/product/352/smpc#gref
6.1 List of excipients
Sunflower oil, refined
Soybean lecithin
Gelatin
Glycerol
Titanium dioxide
Purified water

https://www.medicines.org.uk/emc/product/3244/smpc
200 vag
Capsule contents:
Sunflower oil, refined
Soybean lecithin
Capsule shell:
Gelatin Glycerol
Titanium dioxide (E171)
Water, purified


Hope this helps

Hurdity x

[joziel]

Thanks, that's great. I wish they'd stop putting titanium dioxide in almost every medicine though. It's not great for us and we are supposed to avoid it as a food additive so it sucks we are then forced to consume it every day forevermore in meds...

[Hurdity]

bump for sherbet

[violetbat]

Thanks lady.
I didnt know of anyone else using 200 vaginally. So you've  answered my question.

Think I will use 200 to be safe side.

Xxxx

I am on Everol 100- before that 4 pumps of gel
I choose to use 200mg vaginally for 12 days a month just to be on the safe side. Some months the side effects are miserable- mostly pmt like cramping and crappy mood the entire time-other months it’s not an issue. Wish it helped me sleep though!

[Hurdity]

bump for chucklesista

[Furyan]

Thanks Hurdity for collating the relevant research into one thread and for all replies since. Helpful to see the key research in one place to compare with one another and my own ‘experiments’. I recently asked my GP to switch me from Evorel Conti (which I cut in half) to Evorel 25 combined with 100mg Utro. Mainly because it didn’t sit right with me to be taking synthetic P.

Anyway, I took Utro vaginally every 3 days and felt fine. But three weeks in I started to spot so, as per previous specialist advice, changed to vaginally every other day. Symptoms wise, no difference as I’m fine HOWEVER a week later and heavy spotting continues - like a lightish period. This is new to me as, of the various regimes I tried over the past year, I haven’t had any bleeding apart from when once trying to stop estrogen.

I should say - I’ve been a little erratic since starting HRT and haven’t taken estrogen consistently as I originally thought it could be causing all the weight gain, bloating etc which depressed me.

So, is it normal to bleed when we change HRT regime? I’m thinking I couldn't have built up much lining surely, as never taken estrogen alone and I’m on such a low dose? Getting paranoid 

Once again, thanks ladies for sharing your honest and ‘real’ experiences - kinda comforting through this dark HRT minefield x

[Furyan]

Oh - and I read elsewhere several times that the bleeding could be due to high progesterone to estrogen ratio. Given the research posted to this thread, I would have thought that 100 vaginally every other day would be fine for a low estrogen dose like that supplied through Evorel 25? Or maybe it’s too much!

[Mary G]

Furyan,  if you are using a 25mcg patch then 100mg vaginal Utrogestan every other day should be ample ie equivalent to 50mg progesterone every day.   

I'm using one generous pump of Oestrogel with 50mg progesterone every day and my womb lining is below the 5mm danger line for a continuous combined regime.

[Furyan]

Hi Mary G - thanks for your reply. That’s what I initially thought but your reply is very reassuring because my patch dose is equivalent to your one pump of estrogen. Also hoping that my progest dose affords flexibility to increase the estrogen patch should I need to (which I hope I don’t!). My update today is that the spotting was much lighter today so I really hope it was all just a case of the body adjusting to the change in regime and I was just shedding unwanted lining. Here’s hoping for some consistency with our regimes from now!

[Hurdity]

Bump for Rufus657

[tnshoe]

So, so helpful. My doctor just told me to stop using the progesterone vaginally after another doctor recommended I try it to reduce the side effects. Education, education, education. This has become a full time job for me!
I am in the US but started HT for perimenopause thanks to finding Dr. Louise Newson through podcasts. I began my journey in May 2024 and am finding it both relieving and frustrating!
Thank you for sharing so much info and allowing me to join!