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[Nellf]

Any one had experience of these.  I had been on cyclogest 200mg which caused bleeding.  My menopause specialist suggested upping them to 400mg.  She also gave me utrogestan 200mg which I have been using and feel OK on.  Had to pay £127 for the prescription though.my Gp say they can't prescribe the 200mg as it is unlicensed.  So going to have to go back on the cyclogest as its the only thing my Gp will prescribe.  Very confused.  Any advice would be really appreciated

[Mary G]

Nellf, Cyclogest is coming up on here a lot lately and I have some on standby so I'm going to give it a try.  From what I have read, it is supposed to be better tolerated than Utrogestan and has a positive effect on mood.  I don't get on with Utrogestan at all but I'm happy with progesterone gel.

Could it be that Cyclogest works better than Utrogestan and that is why you had the bleed?

I can't understand why you can't have the 200mg dose of Utrogestan because it's exactly the same formula as the 100mg capsule only it's a higher dose.  Both can be used vaginally or orally.

How many boxes did you get for £127?  It's sounds like a lot of money but I'm guessing part of that was the doctor's fee.

You could ask for 100mg Utrogestan and use two capsules.

[pastie supper]

The 200mg Utrogestan is licensed for fertility treatments and no longer licensed for menopause.
So a doctor would need to be able to prescribe off label to prescribe it for menopause. If you filled out one of those online forms to get it at a virtual doctor's appointment then they would only prescribe what is licensed for your condition, menopause.

It's entirely stupid. The 100mg capsules are licensed for menopause and everyone's dose is 200mg if taken sequentially, but the 200mg capsules aren't licensed for menopause.
The pharmacists stock both sizes because the 200s are for fertility, but no reason for us not to use them as well.
Your GP might prescribe the 200mg Utrogestan if you explain the reason is just political and not medical!

[Penguin]

Any one had experience of these.  I had been on cyclogest 200mg which caused bleeding.  My menopause specialist suggested upping them to 400mg.  She also gave me utrogestan 200mg which I have been using and feel OK on.  Had to pay £127 for the prescription though.my Gp say they can't prescribe the 200mg as it is unlicensed.  So going to have to go back on the cyclogest as its the only thing my Gp will prescribe.  Very confused.  Any advice would be really appreciated

The 100mg utrogestan are definitely licensed for menopause,  you just take two of them. So they might not prescribe the single 200mg tablet (stupid reason I know), but there is no need to go back on the cyclogest.  Ask your GP for the 100mg tabs x

[Nellf]

Thanks all.  I have loads of the 109mg capsules but I can't tolerate then orally.  My gp is happy to prescribe them but not the 200mg.  My menopause specialist has advised me the the 100mg capsules are not for vaginal use.  The 127 pounds was for a 3 month supply.  Private prescription from my specialist.  Over and above the consultation fee.  Back on the cyclogest as my Gp will prescribe that.127 pounds every quarter is not really affordable for me.  So confused about the usage of utrogestan.  Also the cyclogest pessaries are so messy, even inserting them in the evening.   

[Penguin]

The meno specialist is wrong. While not licensed for vaginal use in the UK, they are elsewhere in Europe and Australia, plus probably other countries too. I insert two vaginally, as do many other ladies on here who find it has less side effects this way. There is a small amount of mess in the morning when you do a wee but that's it. Less than cyclogest, which I used for ivf. Both my current UK GP,  another at the same practice and a UK meno specialist all said vaginally is fine. They are exactly the same capsules. I couldn't do orally as I had gastritis last year and you have to take them on an empty tummy. I'd give it a go with the 100mgs if I were you.

[pastie supper]

Like Penguin says, your menopause specialist is saying the opposite of what other doctors are saying.

Search for some Youtube videos about HRT, I watched a couple by Dr Louise Newson, there are many more.
I hope I can say that, I mean no disrespect to the owner of this website, I just haven't seen any podcasts by her.

Obviously paying for the doctor's advice on this website is another option. I read others say it's about £35 for a letter from the doctor here to your doctor stating the facts, for example, Utrogestan can be used vaginally in either size. When you consider what any other doctor would charge, it's not bad, but shouldn't be necessary.

Utrogestan 100mg capsules are identical to the 200mg capsules except in size.

The 100mg capsules don't come with applicators, but yes, they absolutely can be used vaginally as I was instructed to do by the gynaecologist who runs the menopause clinic, for 12 days a month.

I was thinking of asking to switch from Utrogestan to Cyclogest because of the local irritation, I thought all the messing about without an applicator was part of the problem, it wants to stick to your fingers, nails, anything except your vaginal wall, lol.

Does Cyclogest not have applicators either?

I'm already fed up washing and reusing my vagirux applicators, one for 24 applications, be OK if we had our own bathroom, but washing these things can turn embarrassing when you have to walk through the whole house with it 

[Mary G]

I really don't get this problem with Utrogestan in the UK.

The boxes clearly state that these capsules are both oral and vaginal in fact, I'm looking at an old box right now that I found in a drawer.  The 200mg are the same ie for oral and vaginal use.

A box of 30 100mg capsules costs about €6.00 I think (it's a while since I bought it) and a box of Cyclogest 400mg costs about €18.00.

[Nellf]

Cyclogest dosent come with an applicator, I've been using the applicators I got with the utrogestan 200mg capsules and providing the wax pellet dosent break it's fine.  I'm seeing my specialist in November so much to ask.  Both my gp and specialist are keen fo me to have a coil fitted but for me, that's a last resort.  I seem ok on the cyclogest so far, but in terms of mess and stuff, I'd prefer to use the utrogestan providing I'm OK using g it vaginally

[Lesley M]

I asked my GP if I could try Cyclogest as I can’t tolerate utrogestan. He spoke with the practice pharmacist who called me and tried to get me to agree to patches.

I don’t want patches and having previously been persuaded (pressured?) into giving them a go, found they fall off me almost immediately anyway.

I do well with Oestrogel but had to stop because of my problem with utrogestan.

Eventually the pharmacist said she would gave to contact the menopause clinic and it’s all gone quiet.

So it’s interesting to hear other GPs are prescribing Cyclogest. The inconsistencies of treatment are wild.

You'd think menopause was a rare and exotic condition rarely seen in the wild, rather than something half the population will experience, many with difficulties.

[Ladybt28]

Hello everyone - I'm back on menopause matters after 4 years of being away...well where did those 4 years go!  Anyway...Cyclogest...flaming GP's....the NHS menopause clinic...where shall I start with my rant.  I cannot tolerate Utrogestan orally very well and could just about manage 200mg on a 12/10 day cycle with side effects but my HRT regime always needs to work on "lesser of evils" and having a bleed and 10/12 days was lesser of evil than continuous utro at 100mg which really sends me over the edge and is intolerable. Have tried it vaginally but I find it very astringic and makes me sore. However after 6 years of this working as acceptably as it can, I am now 62 therefore when I go to a GP and they ask about medications and I have to tell them about my HRT regime, they go doolally about the fact I'm bleeding at 62!  Long story short...well as short as it can be made when the NHS complicate things out of all proportion....they wanted me to try and take it continuously....so I tried again and of course this didnt work...intolerable...so I went to the Newson clinic and was prescribed Cyclogest 200mg cut in half every other day (so 100mg every other day) to start and to up my Oestrogel to 4 pumps from 2 over a period of 3 months and prescribed Androfeme testosterone...0.5ml every night.

So I went and asked GP if I could change my Utrogestan for Cyclogest...after 1 prescription which GP was happy with, surgery pharmacist said No..its off licence, this practice wont prescribe....GP sent my consultation letter from Newson's (GP was actually impressed by it by the way) to the NHS menopause clinic in Belfast and they came back and went...no all the advice you have been given is wrong...100mg cyclogest not enough for the oestrogel pumps (yes well it might be a bit low but I was prepared to up it to 100 vaginally) and then it came..but we dont want you using either cyclogest or utro vaginally....we are afraid you will get hydroplasia...so I said OK, will you scan me then if I use either...answer was No, we will only scan you if you have had intermittant bleeding on a continuous regime of Utro...but I've not had intermitant bleeding ever on whatever I tried!....so I said, can I go back to a cycle...that was a No with hands up in horror...your 62 we cant have that happening either!

I am at my wits end....the menopause clinic in Belfast seem to have washed their hands because my body will not do what they think it should and they will not work with me either. on what I can and cannot tolerate...I think what they are saying is that unless I do what they say, then I have to take my hrt regime apart from the oestrogel prescription into the private clinic and not talk to them about it....but that is very expensive on all levels and makes no sense.

Cyclogest is much better and I havent had any issues apart from a bit of stinging as a barrier but I slap a load of nappy cream on ever other night (how undignified) and that works! although I havent upped it to 100 yet.  I just dont get it..Cyclogest, women with progesterone intolerance...using Utro vaginally, shortened cycles....etc none of this is really new, discussions being going on coming up about 10 years!  and all GP's are supposed to have had training....as someone said... what is the point of specialist consultants if they cannot agree on what should happen and even if they can...the NHS wont prescribe!!!!   I really do not know what to do...some women are getting the cyclogest on NHS prescription...how???

[Mary G]

Ladybt, it's good to hear from you again but not with that news.  That is beyond dreadful and they sound absolutely useless and clueless.  I would have no confidence in them whatsoever particularly after they refused to monitor you and will only scan you once you have a problem.  Their ignorance is staggering and to say you can't use Utrogestan or Cyclogest vaginally demonstrates just how incompetent they are.  I wouldn't trust them to prescribe aspirin.

The only option open to you now is to do your own thing and try to get hold of some Cyclogest independently and not tell them.  I know you don't want to spend money on private treatment so why not use them for the gel and get some Cyclogest from an online pharmacy, in England from Newson (they might agree to just prescribe Cyclogest) or perhaps in the south of Ireland? 

You could monitor yourself by having a transvaginal scan every now and then just to make sure everything is OK.

[sheila99]

I'm 63, had the same argument about sequi vs conti and they have accepted I will stay on sequi. I get dopey on utro so I'm not taking it every day. The overall dose is the same and they're not watching how you take it so you could just continue with sequi. They told me there's is a slightly higher chance of endometrial cancer using sequi. I have also been irritated by vaginally use, I suspect it's because I'm close to getting va. For the last 6 months I've taken it rectally and it's given me a decent bleed. This is very much off licence so it's not a recommendation but a possible option. The occasional scan may be cheaper than private consultations/prescriptions. I use 200mg x 10 days on a 6 week cycle, also off licence so not a recommendation but I've always had a 6 week cycle so I don't feel the need to shorten it now.

[Lesley M]

I feel for you!

I’m 64 and had finally given up on hrt because I couldn’t cope with utrogestan, it was like the worst day of PMT every day, and only got worse every day I took it, orally or vaginally.

I saw here some women had been prescribed Cyclogest and tolerated it much better. So I went to my GP asking if I could try it and the first response was horror that I’d want to use hrt at then 63. GP checked with practice pharmacist who called me and tried to persuade me to use patches (again). I’m being polite when I say persuade, it felt like I was being very difficult!

I have since been referred to the menopause clinic who have sent me a letter saying I’m on the waiting list but they have no idea how long it will be!

GP suggested a coil but given my relationship with progesterone that sounds like a disaster waiting to happen.

I’m at my wits end. How is it this difficult? If I were to go private could I access this. The last thing I want is to spend money I can’t really afford only to be told the same thing again.

And if it can be prescribed privately why won’t my GP prescribe it?!

Has anyone managed to navigate this?

[Hurdity]

This is unbelievable - the ignorance amongst some doctors, pharmacists and some specialists!

It really is not difficult. These are OUR  bodies FFS!! What happened to patient choice, listen to the patient etc. If we want to remain on a cycle and put up with a withdrawal bleed as the lesser of two evils, ie rather than take progesterone continuously. then that's what we should be permitted to do.

All the replies here from menopausal women have given the correct information about the differeny progesterones!

To summarise:

1 Utrogestan comes in 100 mg and 200 mg capsules which are exactly the same apart from size and are manufactured to be used orally or vaginally. Manufactured by Besins. The French product info gives vaginal use at same dose as alternative to oral use.

2 Utrogestan 200 mg capsules used to be available as HRT for menopause because I used them for several years. That they are not licensed now is nothing to do with safety or anything - it seems to be purely a commercial reason. Now only licensed and available for fertility, sold as vaginal utrogestan when in fact they are the same as the old oral 200 mg utrogestan! This is important to stress. Your doctor CAN prescribe them off-licence for HRT - it's not like they're prescribing something untested....They can just put something on your notes, These are what I use.

3 Cyclogest pessaries (used rectally or vaginally) are NOT licensed for HRT and never have been, and available as 200 mg or 400 mg pessaries without applicators for fertility. This is what I used for the first few years of HRT before Utrogestan was widely prescribed  - in fact I introduced my GP to Utrogestan! These are off-licence so may take more persuasion for the NHS doc to prescribe - hence the variability. Looking at the dosage used for fertility, 1/3 more Cyclogest may be required than Utrogestan - I think that's what I worked out a while back, though the amounts for fertility do vary.  When I used it I was prescribed 400 mg for 11 days per month!!! No wonder I got migraines. It worked though....

Somewhere a few years ago I did a thread on this and linked to the French website which showed that they were the same (oral or vaginal) but not sure if the links will work. It may be that women need to print off the information and educate their prescribers - private or not!!!

Lady BT - hello! long time no hear from! Must have been before the pandemic?? Sorry to hear you're still having problems... yes you may need to pay for a scan if they won't do so but why should women have to do this, and many can't afford to do this .

Private specialists are able to prescribe off-licence whereas with NHS GPs it depends on their attitude towards whatever it is....

Another alternative is to write to Dr Currie as an e-mail consultation - cost £30 per "question", and show her letter to your GP - but I don't know what her stance is on Cyclogest - would be good to know.

Hurdity x