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[Dediva Ann]

Hello ladies

It’s been a long time since I posted.  I almost completely gave up hope and gave up on HRT having tried pretty much every oral combination.  I am nearly 54 now. Then - thanks to the support and information from ladies on here - I managed to persuade the only GP at my practice prepared to think outside of the box (he has sadly since retired) to allow me to try the Estrogel / Utrogestan regime. I have been on it for a year now.  I use 3 pumps of Estrogel daily and 200mg of Utrogestan vaginally for 12 nights from day 15 of my cycle.  I then get a very light bleed for about three days.  There has been a teeny tiny benefit to my libido (which was key for me though I’d like a much more significant improvement!) and I don’t get some of the worrying symptoms I experienced with other forms of HRT.  However my body feels decades older, my joints are agony and in the week after my period I get a whole load of horrible physical symptoms (especially gastric) and the most terrifying and dangerous mood crash and am rendered incapable of doing anything for days.  Also throughout my cycle I have no choice but to nap almost every afternoon which is not practical at all.

I noted that the Patient Information Leaflet for 200mg Utrogestan Vaginal states it is specifically for IVF and did ask my old GP if I could switch to 100mg (which I note is for HRT.) He wasn’t happy for me to reduce the dose saying it wouldn’t be safe.  Since he left I have been begging for an HRT review with one of the new GPs and would like to go armed with some information.  Can I reduce to 100mg Utrogestan? Would I still use it for 12 nights only? Might reducing the dose help with the issues I have described above? Would it be safe? Or is there something else that should be tweaked?  Any advice / thoughts would be hugely appreciated.

Thank you.

Dediva Ann

[Itwillpass]

Hello, I’ve just started this exact same hrt but on 2 pumps of gel, day 7 today. Not noticed any improvement yet (in fact last two days been very dizzy & exhausted) but doc said I can go up to 4. I’ve also been given the 200mg like you say the leaflet states for ivf which kind of confused me but doctor says it’s the right one & to use for 14 days at night, sorry I’m not much help but will be interesting to see if anyone else can advise x

[sheila99]

It's a beurocracy problem. The 100mg is the same thing but licensed for hrt, the 200mg is only licensed for ivf. No medical reason why. According to the manufacturer you use 200mg x 12 days for sequi or 100mg daily for conti. Same dose is used orally or vaginally. According to newsonhealth you can halve the dose if used vaginally so 100mg x 12 days for sequi or 100mg every other day for conti. Some who are intolerant use as little as 100mg x 7 days BUT newsonhealth treat privately and their patients have scans to check there is no build up. If you go off piste it might be an idea to arrange your own scan after a few months to make sure all is well.

[Cassie]

I use 100mg x 12 days the 200mg was far too strong for me.

[Itwillpass]

Thanks ladies, I’m on sequi so will do the 200mg for 12 days (doctor has put on label 14 days but I trust your advise more)! Hopefully I’ll be okay on it but to be honest being in peri I’m so up & down I never know how I’ll get on 

[Dediva Ann]

Thanks for the invaluable responses ladies.  What you say @Shelia99 & @Cassie helps to back up my feeling that the 200mg dose is too high for me.  I now feel more confident about asking to reduce to 100mg vaginally for 12 nights.

Good luck @Itwillpass. It really is hard to gauge when you’re feeling all over the place but I reckon (even with the difficulties I’ve experienced) that this is the best HRT regime - for me anyway, though it took a good few months before I noticed any improvement.  See how you get on. BTW I was originally on 2 pumps of Estrogel but when I didn’t seem to be getting any benefit was told I could increase to 3 or 4.  And yes it definitely is 12 days for the Utrogestan.

[Itwillpass]

Aww thank you @Dediva Ann I’ve tried oral, patches, now this so I’ve got everything crossed this time, it’s so difficult when you read about ladies feeling better within days of starting hrt but don’t get any relief yourself 

[sheila99]

Itwillpass it's too soon to tell yet. Flushes should go within a couple of weeks but my anxiety and insomnia took 3 months.

[SarahJane1234]

I use 15 tabs vaginally over 12 days in the cycle and it seems to work OK.  I do have a bleed every month so far - I've been on it about 6 months now

[sheila99]

I've never heard of that one. Which days do you take the additional three?

[Helen greenwood]

Hi everyone ..I'm new to this ..it's wonderful to be able to read all your comments..I've been having a bad time with the menopause ..the hot sweats ..brain fog..paplantations..not sleeping..feel like I want to rip my skin apart.. before I go down the hot line..anyone got any suggestions plz.. I  exercise .. I eat well.. don't smoke.. just drink once a week.. cut out caffeine and other certain things..I don't know what else to dox

[Ellie2]

Hi everyone ..I'm new to this ..it's wonderful to be able to read all your comments..I've been having a bad time with the menopause ..the hot sweats ..brain fog..paplantations..not sleeping..feel like I want to rip my skin apart.. before I go down the hot line..anyone got any suggestions plz.. I  exercise .. I eat well.. don't smoke.. just drink once a week.. cut out caffeine and other certain things..I don't know what else to dox

Hi Helen.
I also did/do everything "right".
Exercise, nutrition, sleep hygiene, mindfulness, no smoking, almost no alcohol, very little caffeine.
I think I needed to accept that it is possible to do everything right but still struggle and that accepting help (in this case HRT) was the best I could do for myself. I kept beating myself up for not being consistent enough or for "slipping up" and that just made everything worse.

I hope you can get help for your symptoms 

[sheila99]

Having a healthy diet and lifestyle is certainly important but meno symptoms are caused by oestrogen deficiency which sadly can only be 'cured' by adding the oestrogen your body no longer produces.

[Itwillpass]

@helen I have a healthy lifestyle, exercise, diet, not overweight etc peri menopause has hit me like a freight train I am totally floored, I believe replacing oestrogen is my only way forward.

@sheila99 I don’t suppose it would work taking 200mg vaginally every other day over 12 days 

[Hurdity]

It will pass - why would you do 200 mg every other day? If you were going to halve the dose then 100 mg daily would be so much better. Progesterone is unstable in the body so better to have less more often so you don't get peaks and troughs and therefore potentially more sdie effects. You can use the 100 mg vaginally - the same capsules are manufactured for oral and vaginal use. There used to be a 200 mg HRT utrogesta which I used to get. The 100 mg are a right pain because they are tiny little balls to poke up!!

Hurdity x