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[beesue]

help knowledgeable ladies!
I must be thick (or maybe it's the menopause???)

I've been on tibolone for 8 years, it agrees with me. I'm 65 and have not had a period for years. Reluctantly, I decided to wean myself off because I've been diagnosed with hypothyrodism (Hashimotos). Concerned with breast cancer. Been off HRT since February.  Having typical menopause symptoms (sweats, bladder issues, dry vagina and painful sex).

Unfortunately, last week my elderly dementia mother was diagnosed with cancer. I am her primary carer and I am finding it difficult coping with menopause and caring and now her palliative treatment.

Discussed this with my doctor who agreed taking a form of HRT will help alleviate some of the stress.
She's given me Utrogestan 100 (progesterone tablets) and EstrodermMX50 patches. 

Ultrogestan Instructions say: recommended  dose 200mg daily at bedtime, for 12 days in the last half of each therapeutic cycle (beginning on Day 15 of cycle and ending day 26.

Do I take 2 tablets of Ultrogestan daily without a break? 

Or do I have to have a break of 11 days?  Will that mean I will have a bleed?

I am reluctant to ring my doctor with my stupid question.  Help please!!

[PippaSM]

Hi,
I'd assume that, given your age, you'd be put on continuous Utrogestan, which is usually 100mg a day, every day (or 100mg taken vaginally every other day). This can sometimes result in a bit of breakthrough bleeding at first but once settled, would mean no bleed.
The cyclical HRT mentioned in the patient leaflet is usually for women who still having periods, who then often get switched to the continuous regime after , twelve months.
Check with your GP, obviously, but having a bleed, after your periods have stopped seems really unnecessary, so being on the continuous regime would probably suit you better.
Best of luck.

[Mary G]

Sorry to hear about your mother's diagnosis, it must be a very difficult time for you.

Is there any particular reason why you can't simply go back to tibolone if it worked so well for you before?  It seems like a bad time to start on a completely different HRT regime if you did so well with tibolone and in your situation, I would be very reluctant to start bleeding again. 

As far as I know, tibolone is no more risky than any other type of HRT. 

[beesue]

Thank you MaryG and PippaSM
I have found helpful information from Liverpool Women's NHS Trust regarding Ultrogestan. Attached for info.
Interestingly, Ultrogestan is a bio-identical hormone, new generation Progesterone.  Safer than older progesterones, with less risks.  My doctor said there is a decreased risk of stroke and DVT which is probably why my doctor has put me on this instead of restarting Tibolone. (Tibolone was developed in 1960s, introduced for medical use in UK in 1991.  Tibolone is also considered safe!)

https://www.liverpoolwomens.nhs.uk/media/3548/taking-utrogestan-patient-information-leaflet.pdf

Either way of taking is fine so decision time!  Thank you again for your help MaryG and PippaSM