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[Bungo]

GP prescribed utrogestan 100mg for 28 days a month. I hadn't even realized and was taking every night. Only realised because don't have enough utrogestan for the final month(I got 6 months supply together). Need to go back to GP for a new 6 monthly prescription. I really really want to take every night as Im prone to insomnia and don't want to risk not sleeping those nights. Why did she prescribe 28 days anyway?Is that what
its licenced for? Most people here take every night with no break?

[Dotty]

Yes you take it every night. x

[sheila99]

Where are you in your meno journey? It can be prescribed that way so you can bleed if there's been a build up so is useful in late peri/early meno. If you're further into meno most people take it every day.

[Bungo]

Am 52 years, very late perimenopausal. Fsh over 70 each time and LH over 30.. I've had a light period on month 2 and 3 and very occasional spotting but that's settling and anyway didn't bother me. So my body did what it will do, regardless of not having had the 3 day break. So I can't see what can't continue taking nightly with no break.
I no longer have spikes in oestrogen ,.these stopped 2 years ago . Have had peri symptoms since I was 45 years

[sheila99]

You could speak to your gp but I think she's right in the way she prescribed it. The problem is that you don't know if your lining is building up unless you have a scan to check. IMO it isn't worth the risk though of course it's up to you and your gp.

[Bungo]

You could speak to your gp but I think she's right in the way she prescribed it. The problem is that you don't know if your lining is building up unless you have a scan to check. IMO it isn't worth the risk though of course it's up to you and your gp.

But doesn't newson recommend that even peri women move to continuous after 6 months or a year? I didn't bleed for 10  years on cerazette ( I stopped that in  May) and that was ok so can't see how this is different..I'll have to pay to see a menopause specialist if GP won't prescribe without a break . Fingers crossed. I had a scan in Feb and had some small fibroids  so was going to ask for a scan early next year anyway to ensure hrt isnt causing the fibroids to grow. So maybe that will reassure her enough to allow me continue taking nightly..The lining would hardly grow that quickly in 4 months?

[sheila99]

There are areas where newson and the nhs disagree. She starts people on high doses of oestrogen and gives them T straight away, the nhs gives you a lower dose and increases only if necessary. They don't prescribe T until oestrogen levels are optimum. Newson says you can halve the dose if utrogeston if used vaginally, the manufacturer disagrees. Not sure who's done more testing but I suspect it's the manufacturer. Her patients are private so probably having regular scans anyway. BCPs work differently from hrt as they don't allow the lining to build up so it doesn't follow there will be no build up on hrt. There must have been some as you've had 2 bleeds plus spotting unless it was caused by the fibroids. Moving to conti after a year may be OK for some women but for others it's too soon. Perhaps she's being cautious because you don't know what your periods would be doing if you hadn't been on the pill. Hopefully the scan will show no thickening and she'll agree.
Have you tried stopping utro for 3 days? It may not be as bad as you fear. Insomnia was one of my worst symptoms but it was due to oestrogen deficiency and went after 3 months on hrt. Is yours is too you may find you no longer need utro to help you sleep.

[Bungo]

That's interesting re newson. .I'm just too chicken to stop using the utrogestan even for a night..I've had months of insomnia  triggered by just 2 nights of poor sleep. I thought even post menopausal women could have bleeding until the settle on continuous?  My GP is clueless to be honest. Is utrogestan  continuous regime meant to be 28 days, wondering where she plucked that no of days from. She's on maternity leave now so I don't know what her locum will give me. I know I should try without for a few days but I'm so scared.Insomnia is suggestible so I know just thinking it will cause insomnia means it will. I was almost suicidal 3 years ago when couldn't sleep for months, even sleeping tablets couldn't cure the insomnia I was so far gone..I'd prefer go for ultrasound every 6 months

[Dotty]

Hi you can use Utrogestan continuously whether you are in peri or post menopause. The only downside is that if you are in peri then you may get irregular bleeding.

The guidance is to start continuous HRT when you have been on HRT for a year….you are right on that.

The old guidance for post menopausal use of Oestrogen was to take it for 25 days out of 28. The up to date guidance is to take it every night in post menopause. x

[Dotty]

https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

This document might help you x

[Bungo]

Thanks Dotty. I'll show that article to locum GP. I'm getting myself all worked up now that I'll be made change to sequential or not allowed also have Vagifem etc . I'm settling into the current regime and loath to change it until need to. And hopefully won't ever need to!

[Dotty]

There’s no reason why you can’t take it continuously. Good luck x

[Bungo]

So it's just the unscheduled bleeding that's a problem and the inconvenience of same, as opposed to any actual risks to womb?

[Bungo]

And just to clarify, continuous technically is 28 days a month but most women take the 31 days with no break..I think my GP was going with the technical/licenced continuous regime and that's why only gave for 28 days.

[Dotty]

Continuous used to be to take 25 days out of 28 so a 3 day break, but up to date guidance is to take it every day.