Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Violetta808]

Hello, I'm new here and newish to HRT. I'm 55 and was 3+ years post meno when I started HRT in October last year.

I was on Everol Conti 50 for three months but have swapped to Everol 50 and utrogestan because of a lot of bleeding that wasn't going away. I've been prescribed 2 x 100mg capsules orally at night. I asked if I could take them vaginally but the medical practitioner isn't keen as it's off licence.

But having read a lot about the pros of the vaginal route, on this site and elsewhere, I made the informed decision to try it anyway, as I could always change to oral if three was no improvement after a few days.

I’d heard on Newson Health/Balance that the oral utrogestan dose should be halved when taken vaginally, so I have been using one 100mg capsule at night, but have now also read the advice from Dr Currie on this forum that the dose should be the same, whatever the route of delivery (ie 200mg in my case).

I’ve only been on it four days but after the first dose the bleeding was immediately and greatly reduced and currently I’m having only the very lightest spotting, so it’s definitely having an effect.

But I’m now wondering about the dose and whether I should double or stick, so to speak. Or should I follow doctor’s orders and start taking it orally?

[Penguin]

You can stick with taking it vaginally, it is licensed for use this way in many countries, just not the UK for some reason. However, both my NHS GP and a private meno GP have confirmed it is fine to use off license in this way.
Regarding dose, if you have been given that dose to stop bleeding then it may be better to stick to that dose and ask about lowering it at your review meeting.
I personally hate utrogestan and get horrible side effects but if I was taking it to stop active bleeding then I'd take the dose prescribed until I could speak to my doctor.

[Violetta808]

Thanks Penguin, that's reassuring. Maybe two tablets tonight then. If the bleeding stops completely that would be the ideal scenario - while it has greatly reduced (from super tampon to daily panty liner) it isn't quite all gone. I have had no side effects from taking utogestran via the vaginal route.

I've never liked the idea of a Mirena coil but am wondering if I should reconsider!

[Violetta808]

Well I went ahead and shovelled in the prescribed dose last night - two 100mg capsules.

At 4 am I was woken with sharp cramping - like a period pain that you feel in your bowel as well as uterus. Got up, walked around a bit until it eased and went back to sleep. Then had some crazy dreams. When I woke I felt woozy, spaced out and slightly removed from myself. It was very disconcerting getting the train in to work.

However by mid morning I felt mostly normal and am fine now. And there is no sign of any bleeding at all today, which is the whole purpose of all this!

I hope the drugged feeling is a temporary thing. I'm even wondering if I was imagining it? 'No side effects', I said... ha!

[Penguin]

Well I went ahead and shovelled in the prescribed dose last night - two 100mg capsules.

At 4 am I was woken with sharp cramping - like a period pain that you feel in your bowel as well as uterus. Got up, walked around a bit until it eased and went back to sleep. Then had some crazy dreams. When I woke I felt woozy, spaced out and slightly removed from myself. It was very disconcerting getting the train in to work.

However by mid morning I felt mostly normal and am fine now. And there is no sign of any bleeding at all today, which is the whole purpose of all this!

I hope the drugged feeling is a temporary thing. I'm even wondering if I was imagining it? 'No side effects', I said... ha!

What time did you take it? I usually take about 8pm bit still feel a bit dopey in the morning. I getild cramps not long after taking it but they go. Good that the bleeding has stopped. Assume you won't need to be on 200mg long term, just until bleeding sorted.

[Nellf]

Hi there.  I can't take it orally, so have to use it vaginally.  On 200mg at night.  I too have mad dreams and wake up shattered.  My gp wont prescribe it for me as its off licence, but I've had 2 private prescriptions at a whopping £130 for 6 months.  I've been bleeding, though, so scan tomorrow for me.  Told my next alternative would be inserting a coil.  I guess if you have no side effects from taking it vaginally then that's great.  Just be prepared for paying for it though

[Violetta808]

Penguin - I took them at at midnight, just before I went to sleep (I'm a bit of a night owl). Should I try putting them in earlier? There's no danger of them falling out, lol. Interesting that you get the cramps and dopey feeling too - it's not just me then.

Nellf - I am on the 100mg capsules, NHS prescription, supposed to take x 2 orally, so it's my chosen method of delivery that is off-licence. Couldn't you do the same as me and not have to pay? (I think the 200mg caps are licenced for women in early pregnancy when there's a danger of miscarriage - though I might not be correct there). But you shouldn't have to be paying for a private prescription. Good luck for your scan. I am waiting for a date for mine.

[Nellf]

My specialist told me not to take the oral capsules vaginally as there was no way of knowing you would get the same dosage.  And my Gp wont prescribe the 200mg vaginal pessaries as they're not licenced for HRT.  It's all a bit of a minefield really.  Can't say I really want a coil, but I'll get the scan out of the way first and then see.  Hope you get a date soon

[Violetta808]

My specialist told me not to take the oral capsules vaginally as there was no way of knowing you would get the same dosage.  And my Gp wont prescribe the 200mg vaginal pessaries as they're not licenced for HRT.  It's all a bit of a minefield really.  Can't say I really want a coil, but I'll get the scan out of the way first and then see.  Hope you get a date soon

Oh dear that’s a Catch 22 situation. So I’m new to HRT and no expert but I thought these exact 100mg caps are licensed to be taken vaginally in other countries, just not here. Hopefully one of the forum experts can advise?

Either way, they seem to be keeping the bleeding at bay for me. I took them earlier last night and am maybe feeling less drugged this morning. The weird dreams, though!!

[Penguin]

My specialist told me not to take the oral capsules vaginally as there was no way of knowing you would get the same dosage.  And my Gp wont prescribe the 200mg vaginal pessaries as they're not licenced for HRT.  It's all a bit of a minefield really.  Can't say I really want a coil, but I'll get the scan out of the way first and then see.  Hope you get a date soon

Oh dear that’s a Catch 22 situation. So I’m new to HRT and no expert but I thought these exact 100mg caps are licensed to be taken vaginally in other countries, just not here. Hopefully one of the forum experts can advise?

Either way, they seem to be keeping the bleeding at bay for me. I took them earlier last night and am maybe feeling less drugged this morning. The weird dreams, though!!

Yes they are, you're correct in that. The UK doesn't license vaginal use but other countries in Europe do. Even so, my UK NHS GP (two actually) but private meno GP all told me that it was fine to do. There's an argument that you actually get better absorption as it goes straight where it's needed rather than via digestive system.

[Violetta808]

Utrogestan update - it took me a few days to get used to the 200mg dose but the drugged feeling went away, thank goodness. All was well, I thought, but then, maybe unwisely, I tried alternating 100mg / 200mg. I immediately got some spotting so went back up to 200mg, which I've been on since, but to my surprise and disappointment it made no difference at all and the spotting turned into a full-on bleed with very uncomfortable cramps. After almost a week it is at last starting to tail off now, thank goodness.

I don't understand the mechanism of it, because when I took my very first dose of utrogestan it immediately stemmed the bleeding. Did I upset the balance by trying 100mg? I only managed two days alternating. Or am I taking too much oestrogen and stimulating my endometrium into a frenzy of random shedding (even though I'm only on the 50 patch)? I wonder if this side effect is actually incredibly common?

[Bandango42]

Violetta808 - I'm another one who doesn't fully understand the mechanism of progesterone!

I'm currently on a 100mg evorel patch and take 200mg a night continuously. I thought the purpose of taking utrogestan was to keep the womb lining thin and therefore when you stop taking it, you bleed. But on a continuous regime you don't have a break and therefore should not bleed, in theory. However, I have a lot of spotting and full bleeds still which I don't fully understand. If the womb lining is being kept thin, why the bleeding??!

So you are not alone in not really understanding what does what 😂

[Ann8666]

I have taken 200mg Utrogestan vaginal at night. I have since changed to oral provera as I found them too fiddly to keep in.

[Violetta808]

Hi Bandango42 and thanks for replying. Sorry you're having to put up with random bleeds too. I find them really exhausting after no periods for nearly four years and there's just... so much... Have you had any investigations or an ultrasound, any advice? I'm currently waiting for a gynae appointment myself. If everything is OK I am seriously thinking about a Mirena because they apparently work the best in this situation.

Hi Ann8666. I didn't have any issues taking the tabs vaginally but ended up swallowing them last week because I though they might get 'washed away'... They make me feel spaced out for a while but it wears off soon enough.

Meanwhile the bleeding has stopped as of yesterday but I'm probably tempting fate by writing that!

[Anonymous1]

I had an appointment with a nurse at a private menopause clinic (My Menopause Centre) yesterday.  They advised that I take the same dose vaginally as I would do orally e.g. Utrogestan 200mg/day so that I don't have to have scans.  I already have significant treatment costs for some other health problems. 

See my post today for what advice they gave me.