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[Newbie101]

Hello! I'm a newbie here and have been so grateful for all the wonderful advice and sharing of experiences. I'm looking for any advice on utrogestan. After a number of years trying to cope with peri-menopause symptoms followed by surgery to remove one ovary/cyst and fallopian tubes, which triggered 'full on' menopause, I finally 'gave in' to HRT. It has been amazing for me and I so wished I had started sooner. I've gone from 30+ extreme hot flushes a day to just a few mild ones, now have vastly improved mood and motivation, as well as a saved marriage .!

My main issue is with irregular bleeding on utrogestan (almost fortnightly bleeds). I've been on a continuous regime of evorel 25 patches with 100mg utrogestan orally at night for almost 6 months now and still having bleeds.  My GP, who has been wonderful, but not fully knowledgable about HRT, is concerned about this and I may have to come off both and switch to something else.  I have a family history of breast cancer and also suffer from migraines so I'm very keen to stick to body-identical HRT to have the lowest possible risk/side effects. Are there any other options? My GP hasn't heard of taking utrogestan vaginally so is unsure about recommending this. Would it help with the bleeding? Any advice would be very much appreciated. Thank you.

[CeCe]

Hello,

I bled heavily every 2 weeks or so when I used Evorel. I switched to a different patch (estradot) and the bleeding stopped. Oestrogen is the ‘bleeding’ hormone.

How do you feel on the utrogestan? Ladies who use it as a pessary have debilitating side effects when used orally (very very low mood/depression for example). If you feel ok on 100mg then menopause specialists suggest doubling it to 200mg a night to stop bleeding. Maybe you could try that, or change your patch to the gel or a different patch.

There are lots of option’s available. Hopefully you will find your sweet spot with HRT soon.

[Newbie101]

Thank you CeCe, that's really helpful.  I seem to be ok with Utrogestan - the only symptoms are sometimes feeling groggy and digestive issues which may or may not be due to the tablet. I've been unsure about which hormone is causing the bleed as some say it's too little progesterone (perhaps I'm not absorbing it orally) and some say too much? I think I would feel too groggy on 200mg of Utrogestan and wondering if that would be too high a dose with only 25mg of Oestrogen? Very confused by it all! Before starting HRT I hadn't had a period for 5 months. The GP was ok with me starting on continuous (which I asked for) because it seemed from the extreme and sudden symptoms that I had surgical menopause.

Hello,

I bled heavily every 2 weeks or so when I used Evorel. I switched to a different patch (estradot) and the bleeding stopped. Oestrogen is the ‘bleeding’ hormone.

How do you feel on the utrogestan? Ladies who use it as a pessary have debilitating side effects when used orally (very very low mood/depression for example). If you feel ok on 100mg then menopause specialists suggest doubling it to 200mg a night to stop bleeding. Maybe you could try that, or change your patch to the gel or a different patch.

There are lots of option’s available. Hopefully you will find your sweet spot with HRT soon.

[CLKD]

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[sheila99]

Is the other ovary still there? If you aren't meno you're likely to experience bleeding on a conti regime so if one ovary is still there you may be better on a sequi regime. Utro is licensed for vaginal use in the rest of Europe and in the UK it's licensed this way for ivf but not hrt. Have you had a scan to rule out other causes? I'd try vaginally first as it's supposed to be more effective this way and will avoid digestive issues, if that doesn't work then double the dose or try something else. A mirena is usually the best option to prevent problem bleeding.

[Newbie101]

That you Sheila99. Yes the other ovary is still there but post op I didn't have a period for 6 months and quickly started to experience severe menopause symptoms,  so assumed the wee ovary wasn't 'working' anymore and the surgery had resulted in menopause. The GP had encouraged me to go the Sequi route first but I asked for continuous (it was such a relief not having irregular periods). I'm wondering that even if I shifted to sequi now I would still have the same absorption issues?

 I think I'll do as you suggest, and try vaginally first to see if this works to balance the oestrogen and also request a scan. (I had a biopsy during surgery and all was good so hopefully it's just the HRT putting things out of whack)...

Is the other ovary still there? If you aren't meno you're likely to experience bleeding on a conti regime so if one ovary is still there you may be better on a sequi regime. Utro is licensed for vaginal use in the rest of Europe and in the UK it's licensed this way for ivf but not hrt. Have you had a scan to rule out other causes? I'd try vaginally first as it's supposed to be more effective this way and will avoid digestive issues, if that doesn't work then double the dose or try something else. A mirena is usually the best option to prevent problem bleeding.