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[pricey]

Hello ladies,

Bumping this up again for advice. Having read around the last few days, I'm considering trying the vaginal 100mg alternate days on a continuous regime. I was thinking of doing the 25/28 day regime to allow for a bleed if the lining builds up, but is this 3 day break necessary or practical on an alternate day schedule? I seem to absorb and tolerate utrogestan well vaginally but at 55 (and on HRT for 5 years) I would welcome less/no bleeds if that is achievable. My own cycle still kicks in from time to time on sequi  and has done so again this month.

X

'My last trial.of a conti regime didn't go so well, but Oestrogel and Utrogestan (200mg vaginally for 12 days) seems to be suiting me   I very occasionally have slight breakthrough bleeding at the time my own cycle would be due - this was relentless on other therapies.. As I'm 55 now and have been on HRT 4 years, I'm wondering about trying the continuous approach again..My doctor was happy for me to experiment with this. If so, what dose of Utrogestan vaginally would you recommend and would this be every day or alternate days?.Also,  I've seen recommendations of 25 out of 28 days  - does this mean using Oestrogel only for 3 days a month and why would that be?

It's all quite complex!
Thanks in advance."


X

[Sooze]

Pricey,
I've been doing Sandrena 1mg and Utrogestan 100mg vaginally on alternate days for just about a year.  It took to around May last year before I stopped having episodes of spotting, none of which were heavy enough for anything but liners, but it was a bit erratic to start.  My gynaecologist was OK with this regime because I was well post meno, the Sandrena dose is on the lower side of average, and when I got a scan my uterine lining was very low. I feel I have a good balance re control of symptoms vs side effects.

As it's not a regime she has advocated for many she's going to do another scan April/May time to check all is OK.
HTH,
S

[Hurdity]

Pricey the licensed dose as you know is 100 mg daily or 25 out of 28 days although as Sooze says some gynaes recommende the alternate day Utrogestan for vaginal delivery and medium/low doses of oestrogen. This would not be 25 days out of 28 but every alternate day continuously. Must be done under medical supervision though and like I said depend on your oestrogen dose. Also if your own cycle is still breaking through at 55 do you mean you are getting radnom bleeds at nowhere near the "right" time which you think are due to ovulation and have you had these checked out? Do you normally get a monthly withdrawal bleed on the sequi HRT anyway?  Yes it is quite complex!

If you want to do 25 out of 28 days you would do this every night orally or vaginally.

I know what you mean about the bleeds (hateful especially in your 60's )- but I am on long cycle which is an alternative ( under supervision and depending on your oestrogen dose) once you are post-meno. Good luck and let us know what you decide!

Hurdity x

[pricey]

Hi Hurdity,

Most months I have the withdrawal bleed only. Others I can tell my own cycle has kicked in (tension, sore breasts) and I get a bleed (not always in synch with the withdrawal bleed). 

Would you class 2 pumps of Oestrogel as a low or medium dose? Is the 25/28 advantageous over fully continuous because it will allow for a bleed if the lining has built up?

I had a scan about three years ago and nothing abnormal found. My gp has had no concerns as my bleeds when not synchronised are typical periods, lasting the usual amount of days, not random bleeds. I tried a 6 week longer cycle, but I think I have got more out of synch. I suspect if i wasn't on HRT I would be missing some cycles.

Thanks for your help.

X

[YogiNic]

Hi
I have been on Femoston 1/10 for the last few months which has not been working too well for me.
My GP recently prescribed Oestrogel along with Utrogestan Tablet. I am due to start this on Monday, however I am a little confused about how to take this and dosages.
The instructions on the pharmacy label says 2 pumps of gel (1 on each inner thigh/shoulder) every day along with 1 x Utrogestan tablet every day for 25 days with a 5 day break.  But do I stop taking the Gel on the 5 days too?
I still have a period aswell as spotting/break through bleeding throughout the month

Anyone else on this who can give advise?
Thanks for any help

[Sooze]

Pricey,
My gynaecologist would not have OK'd my regime without being 100% certain I was definitely post meno.  If my own cycle was kicking in it would mean that any bleeding would be likely to be more irregular and heavier, and I would need more oestrogen to control symptoms, and hence alternate days Utrogestan would not be enough.
HTH,
S

[Hurdity]

pricey - if it's only the occasional cycle then 25/28 would be fine and yes would allow a bleed if your cycle did kick in although you would still get possible random bleeding if it kicked in at the wrong time. Also partly depends too how you tolerate the utro - if you're happy to take it more or less continuously and feel OK then your bleeds may well be lessened by taking it evenly like this? If you want to have a chunk of time without it then do the 12 days Utro. If you want to acclimatise to the utro without fluctuationa then alt day may be better but as you say if your cycle kicks in you might bleed but if you don't mind this then fine. 2 pumps gel is classed as medium dose but soem who absrob very well it could be quite high and others it could be low if they don't absorb - it's an individual thing! Good luck.

Hurdity x

[Hurdity]

Hi
I have been on Femoston 1/10 for the last few months which has not been working too well for me.
My GP recently prescribed Oestrogel along with Utrogestan Tablet. I am due to start this on Monday, however I am a little confused about how to take this and dosages.
The instructions on the pharmacy label says 2 pumps of gel (1 on each inner thigh/shoulder) every day along with 1 x Utrogestan tablet every day for 25 days with a 5 day break.  But do I stop taking the Gel on the 5 days too?
I still have a period aswell as spotting/break through bleeding throughout the month

Anyone else on this who can give advise?
Thanks for any help

When taking HRT you take the oestrogen part all the time ie don't stop. the licensed dose for utrogestan for cyclical use if you are still having periods on a 28 day cycle would be take the Utrogestan on Days 15-26 after Day 1 which is the first day of your previous bleed. The 30 day cycle would be for women whose periods had already started to go a bit awry. If your cycle is normally around 30 days then go for that. Day 1 is still the first day of your natural bleed and then start taking the utrogestan day 15.

However if this is a specialist consultant then go with it - but I am a bit confused by the 25/30 because it is neither continuous nor properly cyclical?

Let us know what you eventually decide (maybe start your own thread as we will be leapfrogging over pricey's thread?).

Hurdity x