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[SummerBat]

I am 46 and very definitely peri not meno. I was on utrogestan and gel for about 6 months. Two pumps of gel and I could never really get a decent answer about whether to increase that or not when symptoms persisted. My main issue was that I only felt decent on the part of the regime when I could take the utrogestan. The first few days of taking it were bliss, with stable mood and proper sleep. However, taking two as I was, it would all start to get a bit much towards the end of the cycle and I would end up very bloated and uncomfortable with a pretty unmanageable drop off when I stopped for the bleed at the end (poor mood/mental health/no emotional regulation). So I asked if I could go continuous and was told no. I carried on for a few months and asked again. I was told no, because it will cause abnormal bleeding that would have to be investigated. I tried it for a month anyway and it was a very lovely month (with no bleeding outside of the expected (I stopped for three days at the end to cause a bleed and it did). So not exactly continuous but 25 days of 100mg per day. Still the DR said no. So now I'm on Qlaira and it's better than the sequential regime but not by much. I'd go back to sequential because it's body identical but this pill has reduced my periods a great deal and that's very good. Just wondering if anyone had success going on a continuous regime privately or by NHS - but whilst still peri? Thank you.

[Hurdity]

Hi summerbat

If you are able to tolerate Qlaira then that's great as you are still young, you will be getting bio-identical oestrogen, even though the progestogen is not, and suppressing the cycle which eliminates the massive hormonal fluctuations of peri-menopause.

What you describe - the gradual build-up of aadverse symptoms when taking progesterone, is typical, as well as the withdrawal until it has left the body. If you were very much early peri-menopausal (depending how frequent your periods were before starting HRT) then I can see that this classic HRT regime may not suit you.

How long have you been taking Qlaira? I understand from others that it can take a few months to settle so if you;ve only been taking it for a couple of months or so, I would give a 2 or 3 months more and see how you feel.

As for the utrogestan - 25 days out of 28 is most definitely NOT a continuous regime. The 3 days break is desgined to allow a bleed if one is needed and while this was originally devised for later in menopause, it may well work well for those earlier in peri too, though if you have a strong fairly regular cycle - then perhaps not. There is no reason not to, and in fact the dosage instructions give thius as an alternative to 200 mg daily for 12 days per 28:

"The recommended dose is 200 mg daily at bedtime, for twelve days in the last half of each therapeutic cycle (beginning on Day 15 of the cycle and ending on Day 26). Withdrawal bleeding may occur in the following week.

Alternatively 100 mg can be given at bedtime from Day 1 to Day 25 of each therapeutic cycle, withdrawal bleeding being less with this treatment schedule"

https://www.medicines.org.uk/emc/product/352/smpc#gref

So it is really up to you - and if this suits you well, then that's excellent.

As always any abnormal, unexpected bleeding should be referred to the doctor, but in peri-menopause then the cycle can override the HRT so bleeding can occur at the "wrong" time.

Hope this helps

Hurdity x