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[Hurdity]

Back to you.  There are various options.  You have a very good womb lining measurement so for now, I would take 100mg Utrogestan vaginally for 7 days, hi have a bleed and then have a rethink.  For some bizarre reason that nobody ever been able to explain, Utrogestan is not licenced for vaginal use in the UK but you can use all Utrogestan capsules vaginally. 

If you are post menopause, you can take 100mg Utrogestan every other day.  Many women do this successfully and there is nothing wrong with it.  You just need to have a yearly TVS scan which is easy to arrange and costs about £100 in the UK I think.

I don't think anyone on here should be telling women to take only a 7 day regime of utrogestan. Even the Studd clinic I gather is not advising this any more. Under medical supervision in exceptional cases yes. And certainly not without a scan - and not everyone can afford this luxury especially nowadays.

Again re taking Utrogestan every other day - yes there have been some limited studies (in small groups of women) showing this is effective in protecting the endometrium for low and medium doses of oestrogen, and again is unlicensed - but can be tried under medical supervision provided the oestrogen dose is not high.

Sorry you don't have support of your GP pastiesupper - it is very difficult. There is the option of writing to Dr Currie at low cost - although obviously this cannot replace a physical examination nor seeing your notes, but it can provide something to show your GP?

All the best with sorting out a regime that works for you.

Hurdity  x

[Mary G]

Back to you.  There are various options.  You have a very good womb lining measurement so for now, I would take 100mg Utrogestan vaginally for 7 days, hi have a bleed and then have a rethink.  For some bizarre reason that nobody ever been able to explain, Utrogestan is not licenced for vaginal use in the UK but you can use all Utrogestan capsules vaginally. 

If you are post menopause, you can take 100mg Utrogestan every other day.  Many women do this successfully and there is nothing wrong with it.  You just need to have a yearly TVS scan which is easy to arrange and costs about £100 in the UK I think.

I don't think anyone on here should be telling women to take only a 7 day regime of utrogestan. Even the Studd clinic I gather is not advising this any more. Under medical supervision in exceptional cases yes. And certainly not without a scan - and not everyone can afford this luxury especially nowadays.

Again re taking Utrogestan every other day - yes there have been some limited studies (in small groups of women) showing this is effective in protecting the endometrium for low and medium doses of oestrogen, and again is unlicensed - but can be tried under medical supervision provided the oestrogen dose is not high.

Sorry you don't have support of your GP pastiesupper - it is very difficult. There is the option of writing to Dr Currie at low cost - although obviously this cannot replace a physical examination nor seeing your notes, but it can provide something to show your GP?

All the best with sorting out a regime that works for you.

Hurdity  x

I said take 100mg Utrogestan for 7 days for now ie on this occasion until pastie gets some proper help although I realise that is highly unlikely with her current doctor.

I gave her a comprehensive list of options and I mentioned TVS scans numerous times on my subsequent post.

Interesting, gynaecologists here think all women on HRT should have annual scans.

[Penguin]

Back to you.  There are various options.  You have a very good womb lining measurement so for now, I would take 100mg Utrogestan vaginally for 7 days, hi have a bleed and then have a rethink.  For some bizarre reason that nobody ever been able to explain, Utrogestan is not licenced for vaginal use in the UK but you can use all Utrogestan capsules vaginally. 

If you are post menopause, you can take 100mg Utrogestan every other day.  Many women do this successfully and there is nothing wrong with it.  You just need to have a yearly TVS scan which is easy to arrange and costs about £100 in the UK I think.

I don't think anyone on here should be telling women to take only a 7 day regime of utrogestan. Even the Studd clinic I gather is not advising this any more. Under medical supervision in exceptional cases yes. And certainly not without a scan - and not everyone can afford this luxury especially nowadays.

Again re taking Utrogestan every other day - yes there have been some limited studies (in small groups of women) showing this is effective in protecting the endometrium for low and medium doses of oestrogen, and again is unlicensed - but can be tried under medical supervision provided the oestrogen dose is not high.

Sorry you don't have support of your GP pastiesupper - it is very difficult. There is the option of writing to Dr Currie at low cost - although obviously this cannot replace a physical examination nor seeing your notes, but it can provide something to show your GP?

All the best with sorting out a regime that works for you.

Hurdity  x

I said take 100mg Utrogestan for 7 days for now ie on this occasion until pastie gets some proper help although I realise that is highly unlikely with her current doctor.

I gave her a comprehensive list of options and I mentioned TVS scans numerous times on my subsequent post.

Interesting, gynaecologists here think all women on HRT should have annual scans.

In a lot of other countries it is standard for women to have an annual check up with a gynaecologist which would include a TVS. It's a shame the UK can't do this. The cheapest I have found pricate scans in UK is Ultrasound Direct for £145. They said they provide a full scan report, which is sent to your GP if any anomalies found. Of course they check things other than lining, e.g. ovaries etc so worth doing if you can afford it.

[Mary G]

Exactly Penguin, it's standard procedure in other places and it's worth noting that apart from checking the health of the womb and ovaries a transvaginal scan will pick up abnormalities in other organs like the kidneys, bladder and even rectal tumours. 

As we know from women on here, things get missed and women often find they have conditions that would have been easily detected on a TVS.

HRT wise, it's important to give progesterone intolerant women some hope and it makes complete sense to tailor a progesterone dose to something you can tolerate and the only way to do that is with the help of a TVS. 

The alternative is giving up on HRT altogether.

[joziel]

There wasn't any mention from pastie supper of having regular TVS scans there, and seeing she's previously said her GP is unsupportive, I can't see that being realistic either.

[Mary G]

There wasn't any mention from pastie supper of having regular TVS scans there, and seeing she's previously said her GP is unsupportive, I can't see that being realistic either.

Pastie didn't mention TVS scans but if she is progesterone intolerant, she will need to have them regularly if she wants to continue with HRT and take a low dose of progesterone.

If I can be blunt, the NHS (GPs) can deal with straightforward menopause cases and standard HRT prescriptions but they do not have the bandwidth to deal with complex cases.  You have NHS menopause clinics but they are oversubscribed with very long waiting lists.  As far as I am aware, NHS menopause clinics do not have on site TVS facilities but I stand to be corrected.

Therefore, pastie would probably have to pay for the scans herself.  She may also have to consider using a private menopausal specialist. 


Correction: pastie did make reference to TVS scans so my first sentence in this post is wrong.

[joziel]

Well exactly, but that's not financially available to everyone. I don't think we can be telling people to go take 7 days of progesterone a month and get a scan, when the latter part might not be something they can do - and they might still try to follow the former...

People have to follow the amount of utrogestan they've been prescribed (unless they want to take more for some reason...) and need a cooperative doctor if they want to do anything less...

[Penguin]

Well actually I only learned from the lovely ladies on here that a lesser dose / shorter duration of utrogestan was even possible (with scans) so I'm glad this information is being shared as an option along with the safety caveats. Mary G was clear that scans would be needed and it is up to the individual to decide whether to go ahead and if they can afford it etc. I don't think it's reasonable to expect people not to suggest things that have worked for them just because it is not something everyone can afford. Not everyone can afford a private meno clinic but that doesn't stop it being suggested.

[Mary G]

Well exactly, but that's not financially available to everyone. I don't think we can be telling people to go take 7 days of progesterone a month and get a scan, when the latter part might not be something they can do - and they might still try to follow the former...

People have to follow the amount of utrogestan they've been prescribed (unless they want to take more for some reason...) and need a cooperative doctor if they want to do anything less...

It's not financially viable for everyone but that doesn't mean we have to close the option down entirely does it?  Can we never discuss private scans?  There is a holiday thread on here, should that be closed down because some people can't afford holidays? Where do you draw the line?

I'm not "telling" anyone what to do I am merely suggesting what might be possible. 

Re the 100mg Utrogestan for 7 days, I suggested that pastie could do this as a one off for this month and then have a rethink because she is feeling so terrible.  I said it on the back of this comment from her:

"1 had my womb lining measured quite recently, declared nice and thin, 2.6mm I think and it was soon before a bleed."

Bearing that mind, are you suggesting that taking Utrogestan for 7 days as a one off is putting pastie at risk?  Endometrial hyperplasia develops over time not just one month.

As it happens, I took a low dose of progesterone cyclically for years and it worked very well.  Of course I have regular scans.

Women come on here with life ruining, debilitating symptoms and they need solutions as well as hope.  People have to work etc and they need to know all their options (NHS or private) and most need to find a solution quickly.  I think we owe it to them to put everything out there and let them decide for themselves. 

[Penguin]

Well exactly, but that's not financially available to everyone. I don't think we can be telling people to go take 7 days of progesterone a month and get a scan, when the latter part might not be something they can do - and they might still try to follow the former...

People have to follow the amount of utrogestan they've been prescribed (unless they want to take more for some reason...) and need a cooperative doctor if they want to do anything less...

It's not financially viable for everyone but that doesn't mean we have to close the option down entirely does it?  Can we never discuss private scans?  There is a holiday thread on here, should that be closed down because some people can't afford holidays? Where do you draw the line?

I'm not "telling" anyone what to do I am merely suggesting what might be possible. 

Re the 100mg Utrogestan for 7 days, I suggested that pastie could do this as a one off for this month and then have a rethink because she is feeling so terrible.  I said it on the back of this comment from her:

"1 had my womb lining measured quite recently, declared nice and thin, 2.6mm I think and it was soon before a bleed."

Bearing that mind, are you suggesting that taking Utrogestan for 7 days as a one off is putting pastie at risk?  Endometrial hyperplasia develops over time not just one month.

As it happens, I took a low dose of progesterone cyclically for years and it worked very well.  Of course I have regular scans.

Women come on here with life ruining, debilitating symptoms and they need solutions as well as hope.  People have to work etc and they need to know all their options (NHS or private) and most need to find a solution quickly.  I think we owe it to them to put everything out there and let them decide for themselves.

Totally agree with this!

[Mary G]

Well actually I only learned from the lovely ladies on here that a lesser dose / shorter duration of utrogestan was even possible (with scans) so I'm glad this information is being shared as an option along with the safety caveats. Mary G was clear that scans would be needed and it is up to the individual to decide whether to go ahead and if they can afford it etc. I don't think it's reasonable to expect people not to suggest things that have worked for them just because it is not something everyone can afford. Not everyone can afford a private meno clinic but that doesn't stop it being suggested.

Thank you Penguin.

[pastie supper]

There wasn't any mention from pastie supper of having regular TVS scans there, and seeing she's previously said her GP is unsupportive, I can't see that being realistic either.

Hi Joziel, I said it somewhere, I'm trying to not repeat myself too much, but yes, the annual scans are part of the plan. I already have trialled 100mg vaginal utrogestan then been scanned and my lining was thin and smooth on this dose, nothing to report at all.

I bled for four days only which is nice, the further post menopause I get, the less I am bleeding anyway, but this time it was likely because I took less progesterone. I'll take it for 12 days next time, washing it out after half an hour makes a difference to the side effects so it is reducing the dose and probably why I bled while still taking it, I was leaving it there for the first few days, so getting a higher dose, then dropping that dose made me bleed only four days instead of five or six.

Hurdity, you are right, this is not a place where should we tell each other what to do. I completely agree, we are all adults capable of making our own decisions (wish someone would tell my GP that!).

It's a place to have an honest adult conversation with other women in their early fifties, or otherwise recently menopausal and compare notes. If people don't say what they genuinely think then it's not so useful. I don't feel obliged to take any particular action based on what anyone else said here, I welcome all suggestions, ideas and food for thought in general.

I'm not a fan of hiding information or opinions just in case a stereotypical woman comes along who would be assumed incapable of understanding things properly. That drives useful conversations into private messages and potentially everyone else misses out on learning something. Besides there haven't been sufficient studies done to know anything with certainty about dosing utrogestan with oestrogel. I'm looking for any studies that compare doses and ROA of those two specific medicines.

Thank you all for your replies, it's lovely to know this support is out there. MaryG and Penguin especially, you really seem to understand which I can only interpret as you experiencing the same ill effects from progesterone as I do. Someday they will find out that women who have some particle x,y or z in their blood or brains are always going to go crazy on progesterone and they'll find a way to solve it. However it seems as low down the list of world health priorities as it's possible to be, shame that.

I'm not sure anyone can comprehend how completely it hijacks your brain and body unless they've experienced it. Although all women know hormonal fluctuations, progesterone is very differently experienced by 5-10% of women, a lot of scientists say that. About a third of the "different" women feel positively wonderful on it (or wonderfully positive ). The other two thirds of the "different" women hate it because it totally destroys their lives.

[Mary G]

Pastie supper, thanks for coming back to us and glad to be of help.  It sounds like you have a plan going forward but please keep us updated.

[pastie supper]

I see the question of sharing information was already dealt with, so I didn't need to say anything.

MaryG, you understand how awful it is, sometimes it is definitely worth bailing out of the progesterone early. It was a good suggestion, but not the reason why I stopped it early. I stopped early because I thought it was a good idea as well.

Not everyone has the strength to deliberately put themselves into a state of illness and misery and to stay there longer than a week.

It's not like that for most women, I understand that, but when it is that bad, it's not worth the theoretical protection from illness when it's making you feel worse than any illness ever has! In the short term.

Long term if I can't tolerate utrogestan I'll just have to give up on HRT altogether and go back to having menopausal symptoms because they aren't as bad as progesterone side effects.

I asked my husband what he thought, he said, "Are they expecting you to endure feeling like this for twelve days every month? That's a third of your life going forwards, is it worth it?" He thinks it's not worth it, but obvs my decision.

Still deciding.