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[patti]

Hi ladies, I have been on oestrogel 2 x pumps plus utrogestan for days 14-28 since I was 56 and 12 months after my last natural period . However, I’m now finding the bleeds are getting more painful and just like the periods I used to have  . I’m now 60 and don’t really want to have bleeds anymore - can I just take utrogestan continuously as I do the oestrogel- and not get a bleed anymore ?

[Dotty]

Hi yes you can. It might take a few months for the bleeding to slow down . x

[patti]

Thank you Dotty, do I use same dose of utrogestan 1 x100 mg tab vaginally every night together with the oestrogel - with no break ?.

Kind regards
Patti x

[Hurdity]

Yes the licensed dose is 100 mg per day for continuous HRT regimes (cyclical is  200 mg per day for 12 days per 28) irrespective of delivery ( oral or vaginal) since vaginal delivery is not licensed in UK for HRT (annoyingly!).

However some specialists suggest that when used vaginally half the equivalent oral dose can be used. This is based on a few small studies but given each woman will vary it may not necessarily be right for you. Since your bleeds are heavy on your current cyclical regime then I definitely would not start on the reduced dose (ie alternate day vaginal utrogestan). In fact it may well be that your periods are heavy because your current progesterone regime is not quite sufficient for the oestrogen dose. Some women achieve high oestrogen levels on only two pumps of gel.

Also have you ever had a womb scan to check for abnormalities eg fibroids or polyps?

As Dotty says - you may well get bleeding on and off for several months when you change to continuous Utrogestan especially as your womb lining may have built up.

I know what I would do in your position - I would do one or two cycles of 200 mg vaginal utrogestan before moving to continuous - that way you would help to clear any endometrial build up more efficiently and possibly limit the bleeding when you start the continuous regime?

All the best and let us know how it goes...

Hurdity x

[patti]

Thank you Hurdity,
I have had a scan years ago when my periods where very heavy and they detected fibroids ( I wish I had had a hysterectomy- but was not thought to be that bad and had 3 x small children to run around after !)
However, I will try your suggestion of a couple of cycles on 200 mg Utrogestan - as I really don’t want to have break through bleeding -

Patti x