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Author Topic: When can I drop to continous utrogestan or should I just ditch HRT completely  (Read 877 times)

Shamo

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Hi all. I am on HRT....2 pumps oestrogel every day, which I find great, plus days 1-12 of month 200mg utrogestan . Currently on day 12, have just taken my 2 utrogestan pills.

Utrogestan just does me no favours....my mood is all over the place....angry, snappy, very low, hate everyone. I'm horrible to be around. Been taking it for nearly 3 years.

I'm almost 52 , periods are every 2-3  months, haven't had one for a couple of months. Last one v light. Have asked gynae about taking continuous utrogestan, and she says to give it until no period fpr a year and therefore post menopausal. Is this correct? As my periods are light and v irregular can I not drop now ? I'm almost at the stage of coming off HRT completely becuse of this, but what happens then to my cycle ? I just can't deal with feeling like this. Any other suggestions otherwise?
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Dotty

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Hi if you stay on sequential Utrogestan then you may never go 12 months without a period as the bleed is due to withdrawing the progesterone.

The advice is that you should go onto continuous progesterone when you’ve been on Sequi for one year or when you are 54 ( I think that’s the recommended age ).

However, you can take continuous progesterone at any age or stage of menopause but you might get unscheduled bleeding.
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K45

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Hi, I was told after about 15 months to try continous but I'm not sure now as even sequential hrt is making me bleed at random times. Think there are people on a 25 day regime in late perimenopause where you stop it for 3 days while bleeding then continue daily for 25 days. The old advice was to stay on sequential until post-menopausal but I believe this is now outdated.
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Seasidegirl

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I'm in month 4 if HRT  I really struggled with 200 progesterone.  Some of the lovely ladies here suggested that actually the symptoms I was getting get when I take the progesterone were actually low oestrogen symptoms.   I've increased from 50 to 75 this month and I'm tolerating the progesterone with no issues. 

I know it feels like it's the progesterone but it may be that your own cycle is dipping at the same time and you need more oestrogen.   It's working for me.
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Shamo

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Thanks Seasidegirl. So, do you just increase the oestrogen when you are taking the utrogestan and then go back to previous dose ?
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bombsh3ll

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There's no medical reason why you can't take continuous progesterone.

It MIGHT result in some irregular bleeding, but so what if your overall quality of life is better.

It would be interesting to know what your gynaecologist thinks would happen if you took it continuously - many clinicians just follow arbitrary and dogmatic guidelines without any real understanding of the physiology or rationale, viewing bleed pattern as the only or most important outcome without regard for overall wellbeing.
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Seasidegirl

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Thanks Seasidegirl. So, do you just increase the oestrogen when you are taking the utrogestan and then go back to previous dose ?

Hi Shamo, I've gone for taking the higher level oestrogen for the whole month.   I started after the progesterone weeks so it's been a whole cycle (I had to abandon the 200 progesterone last month as I was struggling).   

I had a treatment plan from Newson to go to 75 if I was still symptomatic, I didn't think I was symptomatic during the rest of the month but when I thought about it my joint pain and anxiety were starting to reoccur, not enough that I'd really given it much thought but they were there so it made sense to go up and see how it went. 

I'm half way through the progesterone 14 days and I'm fine with it for the first time since month 1.   

I do think it's possible that my oestrogen is still a bit low during this part of my cycle,  I'm due a Newson follow up and I'm going to ask if I can have gel to go with the patches and I'd like to trial adding a bit more for the few days that I think I might still be low, but I am tolerating the 200 progesterone which was becoming a real issue.   

I seen to react quickly to a change of dose and level,  I know the logic is to wait 3 months...
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sheila99

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You could try 100mg for 25 days. The 3 day break allows a bleed if there's been a build up so is useful in late peri. But it may mean you have symptoms all the time instead of for a fortnight. Might be worth trying but I find 100mg as bad as 200mg (can't sleep at night but doped all day). If you're symptom free on oestrogen only it might be better to change the progestogen to something you can tolerate better.
 Your gp is wrong, it's unlikely you'll ever be bleed free for a year as long as you remain on sequi hrt.
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joziel

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Do what Sheila says ^

That's what I do and it works great. You basically take continuous but you stop for 3-5 days to allow a bleed. It stops breakthrough bleeding at other random times but you are basically on continuous.

However you could also try a Mirena coil if you wanted to get rid of the utrogestan totally.... and any bleeding.
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