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[EMILYCLARE]

Hi, I'd love some advice/reassurance & experience from others please.
I'm 48 and yesterday was prescribed Utrogestan & Oestrodose.  My GP says to take 1 100mg Utrogestan once a day for 25 days and then have a break for 7 days.  I'm also doing 2 pumps of Oestrodose.
My concerns are, a) when I was taking the progesterone only pill last year, I felt terrible, just not myself at all and so stopped taking it (I was despressed and anxious). It took months for my periods to return again. I'm worried that the much higher dose of Utrogestan will affect me in the same way? I'm suffering with despression and anxiety already, hence me trying HRT.
Also, I've seen so many others say they take Utrogestan for only 12 days a month, not sure why I'm supposed to do 25 days?
I guess I'm just worried that all this will make me feel worse than I already do?!
I'm still having periods, fairly regularly but last month I was still bleeding lightly after 14 days. The night flushes have returned for a good month or so and I now have them during the day too.  It's really the anxiety that's bothering me most though, waking in the night almost having a panic attack.
Sorry to go on and thanks for reading.  I'd love to hear experiences. 

[Dotty]

Hi welcome to the forum.

As you are peri menopausal, you should take 200mg of Utrogestan for 12 days of every month. X

[sheila99]

I agree with Dotty.

[EMILYCLARE]

Thanks, that's what I've read elsewhere, 200mg for 12 days (day 1-12).  Why would my GP change this do you think?
Will I get symptoms that tell me I'm not taking enough Utrogestan or taking it for too many days a month?
I did speak to the pharmacist and she said to do as the GP has suggested.  Just feeling really confused by it all :-(

[EMILYCLARE]

I've just found this online (netdoctor) which explains it and reassures me.  I got that wrong the 1-12 days!   

How do I take Utrogestan capsules?
Utrogestan tablets can be taken in one of two ways each month, as described below. Follow the instructions given by your doctor for which method you should use.

Either: Take two 100mg Utrogestan capsules once daily at bedtime for 12 days from day 15 to day 26 of each 28-day cycle of oestrogen. This usually results in a withdrawal bleed (similar to a period) the following week.
Or: Take one 100mg Utrogestan capsule once daily at bedtime on days 1 to 25 of each 28 day cycle of oestrogen. This usually causes less spotting and breakthrough bleeding.

[Dotty]

Hi the daily dose of 100mg is for post menopause. The advice used to be for 25 days but is now generally advised to take it every day.

If you are peri menopausal then you can take it everyday or for 25 days but you are likely to have breakthrough and / or irregular bleeding. X

[corianne]

Hi Emily Clare,
I'm not an expert just hoping to reassure you a bit  I had a terrible time with the Progesterone only pill (Provera)  which I had with the Estradot patch.
My Gynae thought I could be Progesterone intolerant and prescribed Estrogel and  Utrogestan - 200mg for 12 days of my cycle (taken vaginally) as hopefully less side effects than other Progesterones. (I am 47 and Peri)
It can be a worry trying a new Progesterone when you've had a bad experience in the past, but as someone else said to me if you try it and it doesn't work you can stop straight away, so don't let past experiences put you off trying something which could work well for you.
There are so many knowledgeable ladies on here I am sure any concerns or advice you need can be found, I am in no way an expert and still finding my menopausal feet
I do hope you find something that works for you, and start feeling better soon.
xx

[sheila99]

Thanks, that's what I've read elsewhere, 200mg for 12 days (day 1-12).  Why would my GP change this do you think?

The usual answer is because the GP doesn't know any better! Read through old posts, you'd be surprised how many peri women are incorrectly prescribed a conti regime (I was one). The idea is that it works with your body not against it so you take progesterone in the second half of the cycle when your body is producing it too. There is no way of telling if your lining is building up unless you have a scan, that's why it's important you have a proper bleed.

[Gnatty]

Hi, I am a new member too and I have exactly the same issue. Perimenopausal aged 54 heavy close together periods so was hoping HRT would help with usual problems but also maybe regulate, lighten periods. But - my GP also prescribed 100mg utrogestan 25 days out of 28. No ill effects but I don't want to take more utrogestan than I need to. Sooo - how do I switch to a 12/14 day cycle? Am on day 20 of taking utrogestan. Should I just stop and start again in a fortnight?

[sheila99]

If it was me I would continue until day 25 or when you bleed then go on a sequi regime after that. I have found my own cycle is stronger that the hrt one so for me it's a case of fitting the utro in with what my body's doing.

[Gnatty]

Thank you Sheila - so would day 1 be day 1 of period then start utro  say day 14? Sorry - I think it should probably be obvious -  its really easy to overthink what should be relatively straightforward....

[sheila99]

Yes, day 1 is the first day of your bleed then take 200mg utro days 15-26.

[Hurdity]

Just to be clear - I've already poisted this elsewhere a few days ago:

Here is the product information from the medicines database:

"The recommended dose is 200 mg daily at bedtime, for twelve days in the last half of each therapeutic cycle (beginning on Day 15 of the cycle and ending on Day 26). Withdrawal bleeding may occur in the following week.

Alternatively 100 mg can be given at bedtime from Day 1 to Day 25 of each therapeutic cycle, withdrawal bleeding being less with this treatment schedule."

https://www.medicines.org.uk/emc/product/352

This is the official line.

I understand this is the licensed dose. In practice, the 200 mg for 12 days per 28 days cycle is normally given for peri-menopausal women (or by choice if post-meno) and the 25 day out of 28 (or daily use) for post-menopausal women.

There is no reason why in peri-menopause you should not take  100 mg days 1-25 if you prefer to take it this way and I would suggest whichever way you feel best on and which best controls your bleeding.

Hurdity x  to EmilyClare and Gnatty

[Dotty]

https://pcwhf.co.uk/wp-content/uploads/2019/01/PCWHF-Easy-HRT-prescribing-guide-31_01.pdf

See page 5 for Dr Newson’s guide on prescribing Utrogestan. X

[Hurdity]

Thanks Dotty for posting this easy to understand guide - and she makes it clear that the alternative ways she prescribes Utrogestan to those who are intolerant, is off-licence.

Hurdity x