"Umm, not sure about the accuracy of some of that Hurdity... "
As you are not sure - let me give you some further information which I hope is helpful:
Overthinning of the womb is known as endometrial atrophy - do have a read about it - plenty of info on the web. It can cause ulceration and bleeding. In an extreme case, this can happen eg especially if women have the Mirena only and are post-menopausal.
There are plenty of progestogenic side effects that are known to cause problems for some women who take any form of progestogen, and these are dose dependent ie more likely at higher doses. Taking two different progestogens may well increase the chances of adverse side effects - and I have no idea how they will interact in the body.
Yes the Mirena is designed so that more progestogen gets to the womb, but it IS absorbed systemically and approximately of the same order as might occur from a Femseven patch (some time ago I did some maths on this so if you're interested I can find it). The reason that it is put out that it acts locally is that it was first desiged, as I understand, for contraception, so contrasting with the oral forms of progestogen used for the same purpose - the amount absorbed is negligible. That is not to say that it is zero - and some women are not able to have the Mirena because of the side effects from systemic absorption. The amount absorbed decreases over time ie over the 4-5 years that the Mirena is in place. I didn't think there is research to show what happens when two progestogens are taken at the same time - it will depend on the affinity of the receptors, but I imagine the metabolic breakdown products of utrogestan will still be produced and have some side effects - that most women find undesirable , but maybe a small minority benefit from?
Breast cancer risk - as I said "Progestogens are also implicated in breast cancer risk and while links are not at all proven I would steer clear of taking more than your body needs.". Your statement "There is no increased risk of breast cancer from taking body identical progesterone/utrogestan. " is incorrect. Current thinking is that used ofr 5 years the benefits exceed the risks. This paper reviewed the impact of micronised progesterone on breast cancer risk from other published studies:
https://pubmed.ncbi.nlm.nih.gov/29384406/This is the abstract:
Postmenopausal women with an intact uterus using estrogen therapy should receive a progestogen for endometrial protection. The debate on bioidentical hormones including micronized progesterone has increased in recent years. Based on a systematic literature review on the impact of menopausal hormone therapy (MHT) containing micronized progesterone on the mammary gland, an international expert panel's recommendations are as follows: (1) estrogens combined with oral (approved) or vaginal (off-label use) micronized progesterone do not increase breast cancer risk for up to 5 years of treatment duration; (2) there is limited evidence that estrogens combined with oral micronized progesterone applied for more than 5 years are associated with an increased breast cancer risk; and (3) counseling on combined MHT should cover breast cancer risk - regardless of the progestogen chosen. Yet, women should also be counseled on other modifiable and non-modifiable breast cancer risk factors in order to balance the impact of combined MHT on the breast. I have read elsewhere that any risks are also age dependent so for under 50's not risky compared say with women over 60. I can't quote the details right now.
I'm not wanting to be alarmist at all - after all I've been taking micronised progesterone for over 15 years and I'm now 70, but I am aware of the risks, and I most certainly would not want to take too much progesterone, and especially synthetic ones.
Your dose - I presume you mean 300 mg in total daily rather than 3 x 300mg?. That is not too much as it is the recommended amount given by British Menopause Society to protect the endometrium when higher doses of oestrogen are taken.
As I said, of course that it has a sedative effect , and it is a natural substance - but it is only produced in those large quantities as part of pregnancy. It is produced all our lives and as you say is used in other bodily functions but not needed in those large quantities once we are post-menopause and no longer fertile.
I was just suggesting to melaniemas that if sleep issues were her only problem, which have not been resolved through estrogen's beneficial effects on reducing flushes and sweats, that there are other ways of improving sleep than taking progesterone and that used this way it is more like a drug, rather than needed for bodily functions. But of course this is individual choice - which I am not criticising in any way - just making various points which I hope are helpful.
Thank you for your comments, I have been lucky as I was referred to a private gynaecologist on the nhs as the waiting list was so long in my area. I’ve called his secretary this morning, so she is going to ask him for advice and call me back.
Do let us know the outcome
Hurdity x
