The thing about utrogestan is the standard doses are one size fits all - and probably for those in post-menopause the dose is to protect uterus from medium doses of oestrogen and lower, not higher doses like 100 mcg. Hence breakthrough bleeding if higher doses of oestrogen are used, and if oestrogen is well absorbed.
I presume you are post-menopausal? If that is the case the two alternatives are to take it cyclically (at 200 mg for 12-14 days) and see if the bleed is predicatable and is sufficient to protect your womb, or increase the continuous dose. You could compromise and take the actual licensed duration of the progesterone (25 days out of 28) when taken "continuously" but take the 200 mg.
Actually also depending on route - if you were taking it orally then you could try vaginally - as for the same dose more gets to the womb so should prevent the breakthrough bleeding. However most women would not want to take it this way continuously. If you were already taking it vaginally then no alternative but to increase the dose - or if thids doesn;t work then the Mirena coil should prevent the bleeding.
Hurdity x
