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[Greenie71]

Good morning ladies.. a bit of a personal question….

 After 3 years of constant spotting on HRT yet another new  doctor at my surgery has suggested I take Utrogestan vaginally at night instead of orally, All going well but what about sex? I forgot to ask the doctor 🤦🏼‍♀️

How long do the capsules take to dissolve?
Do I wait till after sex to insert the capsules?
Will sperm affect the capsules?
Also, are there any know side effects of taking it this way as I cannot find any information anywhere…. Grrrrr….

Also im reading you only need half the dose, I’m currently using 2 x 100 utrogestan oral capsules as a pessary is this correct……

Many thanks in advance……
Much love x

[CLKD]

Morning.  Why not wait until you know whether you are going to be intimate?  That's what I do with VA treatment.  Less messy ;-)

[sheila99]

Have you had a scan to rule out other causes? Best to wait til after sex. I don't know how long they take but when I've gone to the loo a couple of hours later there's mess, no idea if it's all been absorbed though. I would stick to the manufacturer's recommended dose which is the same as when taken orally because he's presumably changed it so you get a higher dose closer to where it's needed. Are you using 200mg cyclically or every day?

[Greenie71]

So sorry it’s taken so long to reply, I actually couldn’t find my original question to return to your answers… 🤣
I have had all investigations done and alls well…
I have  found that even after 24 hours I have residue and am worried I may not be inserting the ball thingies high enough and that consequently am not getting the correct dose… But I have not had any spotting since I started taking them this way so that’s a miracle in itself……

Why is everything HRT difficult… grrrrrr..
I shall call the doctor in the morning for some advice….
Thank you for your advice, much love

[Hurdity]

Hi Greenie

The licensed dose is 2 x 100 mg utrogestan for 12 days per 28 day cycle taken orally. The French info gives vaginal insertion if there are side effects from oral intake but as sheila says this is at the same dose. Off license some specialist suggest when used vaginally half the dose can be used based on some small studies but this is for low to medium doses of oestrogen and will depend also on the individual woman.

Re sex - there is no research on this as far as I know since in UK it is meant to be taken orlly, though there should really be information  from Besins about this in the French info - though I don't recall that there was. Personally I would say that using Utro vaginally may not work so well with sex - but of course depends on the frequency  (and I'm not asking!). Now and again surely won't have too much effect but if daily (the intimate act!) - then maybe....

I insert my "ball thingies" as high as I can. (pesky little balls!)

The 200 mg vaginal utro pessaries ( licensed for fertility) come with an applicator so maybe you can ask for these?

Hurdity x

[Claire MM]

If you have ovestin cream then the applicator for that according to a friend works on utrogestan capsules used as a pessary. Also I would use ovestin/local estrogen from my own experience of using progesterone as a pessary. I believe progesterone blocks estrogen receptor sites which is what we want in the womb to stop proliferation but not ncessairily in the vagina - so I would use estrogen cream/pessaries locally to avoid low estrogen in that area - this has just been my own personal experience. The dose I think really depends on whether it's continuous or cyclical but it is my understanding that some people halve the dose as not so much is needed to flood the system because orally a lot is taken out by the liver? Whereas vaginally it is close to where it would be naturally produced in the ovaries. But pay attention to how it affects you, I took 200 at night as a pessary for two months and I got really tired and UTI symptoms, I think it was too high for me personally although it completely stopped bleeding. It probably depends on how much estrogen you are on aswell. Wishing you the best, lots of people do use it as a pessary and get on better than orally so I hope that is true for you :-)

[Penguin]

Hi I went straight to using it vaginally, the 200mg x 12 days pm. Even if I get the ball thingies right up to my cervix and don't get up to do a wee for a couple of hours, there is still gunk coming out the next morning. Would you consider using a condom on the utrogestan days as that way at least any semen wouldn't mix up with the progesterone and impact absorption?

[Claire MM]

I only used 100 vaginally of utrogestan cyclically but I would also still get that gunk when I went to the loo in the morning. I would probably opt for sex first but you could definately consider a condom, I'm not sure if semen would affect absorption, I see why you would wonder that xx

[Claire MM]

I just googled and found this but I think this refers to utrogestan pessaries which are 200, if you are taking 200 and you feel OK on that side effect wise then you could consider asking for them instead, I have no idea what they are like so don't know if you can cut them down if you find it too high a dose, that would be my only concern. The cyclogest I use are even more messy however (!)

'Utrogestan is normally absorbed within minutes of insertion, however, it is advised that you wait 15 minutes before showering and 30 minutes before having sexual intercourse or swimming.'

[Hurdity]

Hi ClaireMM

That's interesting that you found that info about Utro and sex - do you have a link to the study please or wherever you read it because someone must have looked into this ( presumably in relation to fertility)? I find it hard to believe that it is all absorbed that quickly, after all it has to "melt" the coating of the capsule and then the fluid contains the prog has to go through the cervix - into the uterine cavity. Intuitively I would have thought ther longer period of time this is allowed to happen, the better! Hey ho....

Re cutting the utro - no this is not possible, The 200 mg are just bigger versions of the 100 mg, and for vaginal use, so much easier to insert (with a finger anyway!).

I used Cyclogest for years and yes they are yuck because the prog is encased in hard wax!

Hurdity x