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[Luculka]

Dear Ladies, I am new here, 47, and really desperate... Be patient with my writing please, as I am not a native speaker. I knew, that starting HRT can be tricky and that in the beginning, one needs to "soldier through". But what I am experiencing is really making me much more miserable than I was, when i was dealing "only" with my perimenopause symptoms. Those were nausea, heart racing, motion sickness and sleep issues starting last year and getting worse - so clearly: hormones.

My gyneacologist  made some blood tests and started me on one hub Oestrogel and 100 mg Utrogestan a month ago. Having nausea through perimenopause already, I decided to begin with vaginal route of Utrogestan and not risk any extra nausea from the oral route. First 5 days were ok, I felt my sleep improving immediately and I was very happy. I saw the silver lining and was really hopeful, that the bad days of my peri symptoms are over.

But than the gastrointestinal issues started after exactly 6 days. Horribly irritated bowel with constant need to run to the toilet, bowel cramps keeping me up at night, diarrhea, extremely loud gurgling noises from my bowel constantly throughout the day (really out of this worl noises I never experienced in my life!), bubbling in stomach and new kind of nausea. I stopped the Oestrogel to see if Utrogestan is the evil-doer. And yes, the side effects continued after being few days on Utrogestan only.

 I knew from you ladies, that I need to play a bit with the dose, experiment so I started to experiment - I took the 100 mg Utrogestan every other day, than every third day (thoinking that the dose is just too much). But the gut problems persisted. I squirt a bit of the gel-like contents out and only inserted a half full capsule: it didn't help. These horrible stomach/bowel disruption always lasts for 24-48 hours after taking Utrogestan.

I am so desperate, because I really wanted to take the best, safest version of HRT and now it looks like I can't tolerate the only safe Progesteron available. But I can not go on like this, I already lost weight (being thin already) and I can not function. I am losing my joy, my poor husband has to take care of many chores/school runs because I am on the toilet all the time or being too weak... It actually feels like being posioned and I think it gets worse with every capsule. As I said lowering the dosis didn't help at all. I would be so so grateful for some supportive words, ideas or hearing similar stories. I read every Utrogestan Forum Message on here already, but what I find in most of the stories are the emotional/mood problems caused by Utrogestan, not the horrible physical suffering from it. And waht realyl shocks me: the vaginal route was supposed to be the more pleasant one, but for me, it turned out to be pure horror. Thank you so much in advance, really looking forward to each response. Lucy

[Peri2022]

Hi Lucy, it sounds like you've had a really awful time, made even worse by the fact that these bad gastric symptoms were totally unexpected. And also - don't apologise for your English - your English is perfect and we don't judge each other on here anyway - it's all support and good vibes (or at least, it should be!).

Women seem to have such different, individual responses to utrogestan, and then the symptoms are all different depending on how you take it too (vaginally, orally or even rectally for some people). I was fine on vaginal utrogestan for months and now it really irritates me down there. I tried rectal which was good for one night and then gave me an awful, drugged-up sleep the next night. I am scared to even try oral as I'm worried about the potential mood effects.

You probably know this already, but there are other forms of progesterone/progestin you can try. Some people get on better with Cyclogest pessaries. Other people prefer a Mirena coil. The frustrating thing is that there's no definite right answer, and the research supporting each option is often contradictory or hard to find.

I don't have anything very wise to add except I'm sorry for what you're going through, and I wish you all the best of luck trying to work it out. This is a great place to get support while you're on your journey.

[Penguin]

Hi Luculka
I don't have any advice as such but just wanted to say I experience similar on utrogestan taken vaginally. Not the loose bowels so much, but definitely bubbling in stomach (including upper abdomen), bloating, wind, and farting. It isn't pleasant as I also have the mood issues too and more recently a kind of depression sets in after the first few days.  I am taking a lower dose this month, 100mg for 12 days, and then seeing someone privately in January to explore options. I may try a mirena coil. Although synthetic, it is a much lower dose than utrogestan.
I don't know what else to suggest. You have my sympathies with the gastric stuff every month, it is hard and I hate utrogestan.

[slowmo]

I have too had awful side effects taking this tablet vaginally, was on it a while but since having an applicator and getting it inserted "higher up", my bowel was literally "dead and asleep", felt so bloated and windy and backed up....no appetite.

I decided to stop progesterone this weekend and already, it's wednesday and my bowels are waking up and behaving a little more normally.

I think I am just sensitive to this progesterone as I take mini pill progesterone which whilst much lower dose, its oral and I take double dose due to endo.

I think this urogesterone can really affect some of us, perhaps in different ways but please know you are not alone.

[Mary G]

I would definitely ditch the Utrogestan and try a different progesterone. 

You could try a progesterone coil, an oral form of progesterone or you could ask for Cyclogest which is a wax vaginal/rectal pessary that can be cut into tolerable doses.

Utrogestan is not well tolerated and it's the most debated problem on here by far.

[Catkin]

I had the same! 
After reading Dr Newsons recommendations (who I really admire) I went on Utrogestan and Estradiol gel. Stayed on it for nearly  2 years, but had to stop due to awful diarrhoea. The doctor swore that Utrogestan doesn’t cause diarrhea, so I just kept putting up with it as I didn’t want to take synthetic progesterone. ….and I believed the doctor when she said she didn’t think there could be any link! I tried it vaginally too, and that still made no difference. After 1.5 years I realised I was having diarrhoea every 3 days, I already ate very healthily, but I did eat sourdough bread so I cut out gluten completely…. still no effect. It was really getting me down and worrying as I went on HRT to try and feel better! I saw a male doc about it (my usual doc was away) and asked him if I could change HRT. He said what is the point, it won’t make any difference, it must be a food allergy, and he put me on a low fodmap diet!  I followed this for 3 months, it is a very strict diet so not fun to follow, still no difference. Finally the diarrhea started to be accompanied by bleeding and I went back to my female doctor and asked again if I could change my HRT. She agreed, but said I would also have to go into hospital for tests (which were all fine). I went on the combi patches (synthetic progesterone) and within **7 days** my tummy was back to normal!  Fast forward 6 months and I have not had a single upset tummy! So, it looks like I was right all along, which is exasperating. I wish I had listened to my own instincts rather than suffering for so long. I think doctors can be a bit blind, sometimes they just trust what the drugs companies tell them rather than listening to their patients!!

The frustrating thing is, is that the patches I am on now are synthetic progesterone. Both Kate Muir and Dr Newson do say that the synthetic form isn’t so good and has more risks. Instead of an upset tummy I am now also getting periods/bleeds all the time, when before they had just about stopped. Not sure what to do:-(  Has anyone found a solution to this? I was on the Utrogestan  2 weeks on and then 2 weeks off. I have wondered if this sent my body on a sort of roller coaster.
I don’t want to go back to the doctor without a solution to suggest, as sadly so many of our gps  don’t seem very well informed on HRT. My female doctor is good in that she is supportive, but clearly she hasn’t been told in her training about the different forms of Progesterone or what Utrogestan can do! :-( 
I am sure I read somewhere where you can take utrogestan once every 3 months, enough to give you a bleed….and wondered if anyone who has trouble with Uterogestan has tried that method/ or been recommended it by Dr Newson?

[Mary G]

Utrogestan both orally and vaginally has caused diarrhoea for plenty of people on here.

I wouldn't worry too much about synthetic progesterone, it's not that risky and it's better at controlling bleeding.  I would look into having a coil fitted and preferably a low dose Jaydess or Myleena - I think the Mirena is too strong for HRT use and it can lessen the positive effects of the oestrogen component.  I've had two Mirena coils and I found I felt best when they were running out of steam so the dose was too high for me - the output dose decreases every year.

Otherwise just stick with an oral synthetic progesterone like Provera or Cerazette which is a very well tolerated progesterone only pill.  There are quite a few synthetic progesterone pills to try.

[Catkin]

Thanks Mary

[joziel]

I think the first thing to do, is to be absolutely sure whether it is the estrogen or the progesterone causing this. You can't take estrogen without progesterone, but you can take progesterone by itself without estrogen. So - see if it happens if you take only the progesterone.

If it does, you need to experiment. I've learnt not to assume anything with HRT(!). It's about trial and error and ticking stuff off. So, try taking it orally. It might not be the case that it causes runny poop that way. I mean, the vagina is very near the rectum. Perhaps you are over-absorbing it locally and it's causing the runny poops. Try taking it orally and see. You can also try it rectally. I've no theory behind why that would work, but I've given up theorising most of the time and just religiously trial everything....

IF you can't take the utrogestan any way without it causing this and IF you are sure it's the utrogestan and not the estrogen, then you can consider a Mirena coil or even a synthetic progestin if you need to. There are other options.

But also.... One final thing to say is that the gut microbiome is VERY HORMONE DEPENDENT. This means that the particular bacterial species a pre-menopausal woman with her natural hormones will have, are very different to those of a post-meno woman without her hormones. If your gut is suddenly switched from being deprived of hormones to being given a plentiful supply of them, this might at first cause some runny poops and gas and bloating and weird gut issues. It doesn't mean these will continue. Hopefully your gut will adjust to the new hormones and the bacteria will change and all will settle down. After all, these are the same hormones you've had yourself from your own body earlier in life....