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[Anonymous1]

Hi there,

I'm new to the forum and live in the UK.  I recently started on cyclical HRT:  Evorel patches 50mg and Utrogestan orally 100mg x 2/day (Days 15-28). 

Past medical history:  Chronic fatigue, mental health.  I am on treatment for these conditions.  Fatigue and related symptoms started when periods started changing and following chronic stress.

Symptoms include sleep disturbance, low mood, feelings of overwhelm, increased anxiety.  No hot flushes/night sweats.


A recent private test showed that I was low in Oestrogen and Progesterone; consistent with menopause.  Testosterone levels were OK.

Within 2 days of starting the Evorel patches (Oestrogen) I noticed a signficant improvement in my mood.  I felt more like my normal self, happier, calmer and more motivated.  I had no side effects and the product felt natural.

However, as I have now discovered is very common within 24 hours of starting the Utrogestan I experienced unpleasant side effects e.g. Headache, nausea, feeling groggy, flu like, tiredness and low mood.  I felt worse than before I started the HRT.  The product didn't feel natural.

I read on the Balance App that there may be less side effects when Utrogestan is taken vaginally.  Therefore, I started taking the Utrogestan vaginally after just 3 days of taking it orally.  I've just been taking 100mg.  I am still experiencing some side effects e.g. Headache and reduced mood but they are not as bad as when I took it orally. 

I have found it more effort administering Utrogestan vaginally.  My levels of fatigue are worse at bedtime.  I have ordered a suppository applicator to make it easier to insert the tablets and to provide reassurance that they have been inserted higher enough.  I have read on this forum that I should continue to take 200mg/day.
 
I am planning to continue the HRT until the end of this cycle.  I am wondering whether to then stop it so I compare how I feel off it versus how I am when I have to take the Utrogestan and then perhaps re-start or continue in the hope the side effects from the Utrogestan will improve with time.

I only started the HRT a few weeks ago but I can see it is not as straight forward as I thought and can involve quite a bit of trial and error and patience.

I am wondering whether to book an appointment at Newsam Health or wait.

QUESTIONS:
*  Are the side effects from Utrogestan likely to diminish and/or stop if I continue with it?  How long do you think it will take before I notice an improvement in side effects?
*  If you are taking Utrogestan vaginally do you take the full oral dose or not?  If not have you been seen by the Newsam clinic?   Have you told your GP?  Are they happy with that?  I have seen that in some other countries it is licenced to be taken via oral or vagina.
*  Do you think the positive effects of the Esterol (Oestrogen) will increase as time goes on?
*  Do you notice that you feel really good when you are on the Oestrogen and your mood goes down when you are on the Utrogestan / Progesterone?
*  Do you think I could insert the Utrogestan vaginally earlier in the evening when I have more energy or will the tablet fall out if I stand up?

I look forward to hearing other people's experiences.

[Banjo1973]

Hi,

Like you, I love the effects of oestrogen but hate Utrogestan.

At first I took 200mg orally 12 days a month, but couldn't cope at all. A pharmacist friend suggested I take 1 tablet instead but it was still horrible. I then tried 1 tablet vaginally, far better. There seems to be differences of opinions regarding dosage of vaginal utrogestan, however some women choose to take 100mg 12 days a month.

I don't tell my doc everything (but obviously am not advising this)

As utro makes me wired I take it in the morning, it never falls out.

These are my personal experiences, I'm not telling anyone what to do xx

[Minnie Mouse]

Hi, I'm the same - never liked the Utrogestan part of the cycle, always made me feel a bit weird.
It became easier when I went from cyclical to one daily throughout the month - less of a hit - but I believe you have to be a fair way through peri to make that switch.
Despite my negative comments about Utrogestan, my meno GP has never been keen to switch me to another type of progesterone.
My personal opinion would be to continue & tweak rather than stop HRT completely.
"The Change" is full of its own constant change, I've had to tweak HRT many times...

[Penguin]

Hi

First thing I'd ask your doctor is whether you can do days 15-26 rather than 15-28. UK NHS GP prescribed 15-26 for me (same dose as you) and it seems standard  so that would immediately reduce it by 2 days.

To answer your questions, yes I always feel better when on estrogen only (I use the gel) and no, the side effects of the utrogestan don't diminish over time when taking sequentially as your body has to get used to it all over again every month, so doesn't have a chance to adapt. I have only ever taken it vaginally and mostly kept to the 2 x 100mg dose. If you reduce do it under supervision/ with scans, you'll probably have to pay for the scans.

I personally don't think you've given the hrt enough time to work - it took about 3 months for mine to settle, so it is probably too early to stop and make a comparison. The only thing I have found that helps with utrogestan is upping my estrogel on the days I have to take it. For some reason having a better ratio with a higher level of estrogen seems to help my body cope with the utrogesrltan a bit better. But I'm not sure how you could do that with a patch.

I also plot the utrogestan days months ahead in my calendar so i can look ahead when planning things and decide on the right time.

[Emma74]

I was too paranoid to take utrogestan orally as I don't like taking any oral medication. I use vaginally. I was using 100mg at night with no apparent issues.

I told my GP then we went into full blown negotiations. They wanted me to change to a different progesterone but I know I wouldn't take it as it took me over 6 weeks to stick a patch on.

They said OK but I must take 200mg. I alternate each night with 1 or 2 tablets. If I remember I put them in earlier. They don't fall out and are absorbed very quickly. Is a bit of a faff though. Not sure if I have any side effects as I'm still living with symptoms.

[sheila99]

You could ask for a different progestin. As you're on 50mcg you could use evorel sequi. Utro 7s supposed to be the gold standard but I get side effectscwith it but not with the progestin in the evorel combined patch.

[Cassie]

I have been taking 100mg Utrogestan for 12 days per month for many years. It sometimes makes me a bit restless at night but other than that seems to work and brings on a small bleed after stopping it.

[TC4775]

I had utrogestan tablets in November they were ok to take with but in December/beginning of January I went to the doctors as I had side effects which made me come of them
I was having breathing problems and chest pains on the leaflet we had it says if you had them you need to stop taking them immediately and contact your doctor
So I am now taking everol conti Patches

[Anonymous1]

UPDATE

I booked an appointment at a private menopause clinic (Online).  It was expensive but I did find it helpful.  The nurse was very knowleageble and I felt less on my own with it. 

The nurse suggested that I go on Everel 50 for a month to get my Oesterogen levels up and then re-introduce Progesterone continuously as I am not far off 12 months without a period.  Either Utrogestan 200mg/day vaginally or one of the alternative forms e.g. Cyclogest pessaries 100mg/day or go on to Everol Conti patches.  Alternatively, I could try the Mirena coil.  They said that the coil might cause a hormonal surge intially and take time to settle.
They said that there is not really a preferred order to try the different forms of progesterone.  They recommended that I try things for a month if possible.
 
I stopped the HRT on Sunday and feel a lot better than when I was on the Utrogestan e.g. Increased mood.  I guess my oestrogen levels might still be raised from the month on Evorel 50.

I might buy some Cyclogest pessaries from an independent pharmacy and then ask for them on prescription if I tolerate them better than Utrogestan.