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[K45]

Hi, this is a quick question for anyone in perimenopause on sequential hrt...how do you mentally manage the withdrawal after stopping the progesterone? I didn't take the progesterone last night and had a terrible night of anxiety and little sleep, today feel utterly wretched. I've been on the 200mg utrogestan and 2 pumps gel 7 months and everything seems ok until I get to the utrogestan withdrawal and it feels like pmt but much worse. I've looked into birth control pills, Mirena out of the question decided hrt is still best option so I'm just wondering if there's anything to just help get through the withdrawal better? Thanks x

[CLKD]

Oh have a 

How long does progesterone stay in the body?  It may that you feel off as you are worried about possible side effects by using less of the product.

Hopefully some1 will be along with proper advice. 

[discogirl]

Hi K45

There is an old thread on here about progesterone withdrawal, here is the link it may help x

https://www.menopausematters.co.uk/forum/index.php?topic=28635.0

[bombsh3ll]

Why not just take 100mg continuously instead of 200mg cyclically?

You MIGHT get some unpredictable bleeding on continuous but is that really worse than what you're experiencing, over and over?!

Progesterone intolerance can be really challenging, but progesterone withdrawal is voluntary.

Alternatively you could switch to a progestin strong enough to switch off your own cycle like 150mcg desogestrel (2 x cerazette pills daily) instead of the progesterone.

[discogirl]

Sorry to cut in on this thread but I wanted some advice, I'm post meno and on continuous hrt, however, I am wanting to try and take hrt sequentially as I seem to be experiencing quite severe anxiety and I want to know if its the utrogestan that's causing this.

My issue is I'm concerned about progesterone withdrawal as K45 has mentioned she is experiencing.

I was on cyclogest rectally however i wasn't absorbing it and last year had a very heavy bleed, I had a biopsy and all was ok. I wondered about taking cyclogest again but vaginally this time to see if that may help ?

I don't want a coil as I know I just wouldn't take to it. I wondered what other ladies thoughts were. Thanks x

[bombsh3ll]

If you were having a therapeutic de-trial of your progesterone for a few weeks with estrogen alone to evaluate symptoms, you would only potentially experience progesterone withdrawal once.

Stopping it might cause some withdrawal bleeding however most women don't suffer any unpleasant symptoms after stopping progesterone.

There are other options besides the IUS and micronised progesterone if neither of these suit you.

These include;

Desogestrel
Drospirenone (slynd)
Norethisterone - oral or in combination patch
Dydrogesterone - oral combination
Medroxyprogesterone acetate - less metabolically favourable but still much better than no HRT if nothing else tolerated.

Tibolone - compound with estrogenic, progestogenic and androgenic properties, often liked by progesterone intolerant women.

[discogirl]

Thanks so much bombsh3ll, thats really informative.

Could I ask would the Tibolone contain a strong enough progesterone to protect my womb lining as it thickened quite considerally last year. thank you x

[K45]

Thanks so much for the hug! Really appreciated:)

quote author=CLKD link=topic=70817.msg958577#msg958577 date=1727008193]
Oh have a 

How long does progesterone stay in the body?  It may that you feel off as you are worried about possible side effects by using less of the product.

Hopefully some1 will be along with proper advice.
[/quote]

[K45]

Thanks discogirl - I'll check this out. Hopefully you won't have the withdrawal too bad if you did try sequential as I am quite reactive to all meds due to having Gilbert's.

Thanks Bombsh3ll for the suggestions - I think I'm at the point where it is likely worth trying 100mg progesterone continuously for the sake of my mental health. I finished my utrogestan on friday so was wondering should I start 100 tomorrow when I can get to a pharmacy or should I wait until I get the withdrawal bleed and then start after this? Thanks.

[bombsh3ll]

I'd just continue right through if you are getting such miserable symptoms every time you come off it.

There's no medical reason continuous progesterone cannot be used right from the start in perimenopause.

Bleed pattern is not the be all and end all, and should not be prioritised above a woman's quality of life when someone struggles with seesawing progesterone levels.

Regarding tibolone, it is generally regarded as providing adequate endometrial protection alone.

However if an individual has previously experienced thickening WITHOUT an explanation (such as not absorbing progesterone very well or using lower than recommended doses due to tolerability issues), then getting a scan periodically on tibolone eg after 6 months would be a good idea.

[sheila99]

K45 you might be better on the 25/28 days routine as this allows a bleed if the lining has built up. As you're peri not meno if you take it continually now it's very likely you will bleed as utro doesn't stop your own cycle.
  My own withdrawal? I heave a sigh of relief that in 2 days time I will no longer be sedated and I can have a normal life again  .

[K45]

Thanks ladies - both very helpful advice & much appreciated. It's definitely like marmite this progesterone malarkey!! Really been an absolute lifesaver these past months having the support from this forum. Hope the next 2 days fly by for you Sheila!