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[Abs75]

I’ve just got off the phone with my Dr to discuss moving to a lower dose combined hrt as Evorel sequi made me put on weight. He said I can have estrogen in gel form or a lower dose estrogen only patch but progesterone only comes as a pill, or mirena coil, is that right? Seems odd you can’t get it as a gel or cream. I didn’t want to take anything in a pill form. He’s prescribed me Evorel 25 patches and Progesterone micronised 100mg capsules which I have to take 2 a day. Has anyone had this regime with success or anyone had any issues with it? I’m undecided as to whether to take it or not as I feel ok since stopping the patch a month ago apart from having 2 periods 10 days apart.

[Dotty]

That’s correct….progesterone doesn’t come in gel or cream.  Utrogestan is a micronised progesterone and is not synthetic. I’ve been taking it for 6 years with no problems.

[sheila99]

You can utrogestan vaginally. It's off licence for vaginal use for hrt in the UK but is licensed in the rest of Europe (and for ivf in the uk).

[NightNurse]

I've used vaginal utrogestan for over a year now and am quite happy with it. 100mg capsule at night, every night. I started initially with it orally at bedtime and the upside was a great night's sleep. However, I'm very progesterone sensitive/intolerant so mentally/emotionally I didn't do so well. Then I tried a Mirena for 18 months and gave up on that mainly due to mood changes again. Also, the bleeding never really settled either but that turns out to be the Mirena was incorrectly sited too low in the uterus - stuck behind my section scar rather than at the fundus (top of the uterus). I also tried oral norethisterone - hideous!
Since switching to vaginal utrogestan I've found it's so much better on my mood/mind, no bloating or headaches - and still a little soporific at bedtime. FYI I have 100 Estradot patches. Happy days 

[Abs75]

That’s correct….progesterone doesn’t come in gel or cream.  Utrogestan is a micronised progesterone and is not synthetic. I’ve been taking it for 6 years with no problems.

That’s good to know, thanks Dotty ☺️

[Abs75]

You can utrogestan vaginally. It's off licence for vaginal use for hrt in the UK but is licensed in the rest of Europe (and for ivf in the uk).
Thanks for this Sheila, never heard of that but glad it’s an option if I decide not to take orally.

I've used vaginal utrogestan for over a year now and am quite happy with it. 100mg capsule at night, every night. I started initially with it orally at bedtime and the upside was a great night's sleep. However, I'm very progesterone sensitive/intolerant so mentally/emotionally I didn't do so well. Then I tried a Mirena for 18 months and gave up on that mainly due to mood changes again.
Thanks for the info NightNurse, I had a rather traumatic and painful experience with doctor trying and failing to get Mirena in so will never even try that again! I’ve been told to take the progesterone on days 15 To 26 of Cycle but 2 capsules - seems like a lot of progesterone compared to the 25mg estradiol in the patches?

[sheila99]

The dose you've been given is correct but it's good for up to 100mcg oestrogen.

[NightNurse]

There is helpful info about progesterone on the Balance Menopause website https://www.balance-menopause.com/menopause-library/micronised-progesterone-or-utrogestan-factsheet/

And also about progesterone intolerance https://www.balance-menopause.com/menopause-library/prgesterone-intolerance-factsheet/

Hope this helps

[Abc123]

I had to come off patches so went to oral utrogestan, 200mg. As I've recently tested low in oestrogen, I'm not sure if it was that or the oral progesterone or low B12 (all possible options and all around the same time), but my mood plummeted.

My GP then prescribed me vaginal utrogestan (I get the packs used for IVF). I'd not had a period for 9 months and within 6 weeks of starting utrogestan vaginally I had one and another 30 days later so it's doing the job well for me taking it vaginally. My mood has improved but that could well be B12 related or a combination.

I did find I got a bit sore initially taking it vaginally but I've upped my ovestin usage and it's ok now.

Good luck with the change of regime, it's always daunting!

[AKatieD]

I use Crinone, which is a vaginal gel, as utrogestan makes me feel awful and I was not prepared to go for a coil. I have to pay for it (and hence the consultations) though.

[Abs75]

I was prescribed cyclogest as a progesterone, it's a waxy pessary that can only be taken vaginally or rectally, so it's closer to transdermal in my mind than an oral pill.

I find it odd that Evorel can put norethisterone in a patch to be absorbed transdermally alongside oestrogen, while we are told simultaneousy transdermal progesterone hasn't been trialled or doesn't work and can't be produced as a product 

I was thinking the same thing!

[Mary G]

I use Crinone, which is a vaginal gel, as utrogestan makes me feel awful and I was not prepared to go for a coil. I have to pay for it (and hence the consultations) though.

Katie, what dose of Crinone are you taking and is it 8%?  I had a quick look online and it appears to come in boxes of 15 fixed doses in  sealed syringes.

It looks interesting and I feel like trying it myself - I am happy with my progesterone gel but I like trying new/different products.

It sounds like a viable alternative to the dreaded Utrogestan and less messy than Cyclogest.

[sheila99]

I know you have scans Mary G but for anyone else reading if you don't use a licenced product or use less than the licensed dose it's important to scan regularly to make sure your lining isn't building up. Crinone was discussed recently and it seems the 4% is insufficient but there wasn't data on the 8%. Unless anyone's found anything?

[AKatieD]

Hi Mary G

Yes it is the 8% Crinone, I don't think the other 4% is available any more. Yes, they come in boxes of 15, which is a months supply for me as I use it every other day.

I am not too worried about it not being licensed for HRT, as it is licensed for fertility treatment and so is obviously (to me) safe and probably safer than some of the synthetic alternatives that g.ps are happy to prescribe as it is bioidentical.

As for the dose,  nobody knows what level of progesterone is required for protection against oestrogen (no studies). The crinone dose (90 milligrams every 2 days, or 45mg a day) is higher than a mirena coil (21 micrograms daily) so again I am not concerned that it is inadequate. It is less than utrogestan but via a different route, and perhaps that is why it is tolerable.

[Mary G]

I know you have scans Mary G but for anyone else reading if you don't use a licenced product or use less than the licensed dose it's important to scan regularly to make sure your lining isn't building up. Crinone was discussed recently and it seems the 4% is insufficient but there wasn't data on the 8%. Unless anyone's found anything?

I would actually go further than that and say that ALL post menopause women should have regular transvaginal scans.  They are not just for measuring womb lining and checking womb health, they check the ovaries, bladder and things like rectal tumours can be detected.