Print

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

[Seasidegirl]

I started HRT (Estradot 75/Utrogestan 200 sequentially) at the end of May.

As I've posted before I've been struggling with the progesterone as after a varying number of days (1 to 8 ) it was making me feel dreadful.

At my private prescriber suggestion I've moved to continuous (I'm 55 but still peri) so that I can take the lower dose (100 and see how that works.

I had the same issues taking the lower dose orally so have moved to vaginal and it's better.  Not fantastic but better.

I'm just starting to bleed,  I'm not concerned by that I know that the peri aspect is likely to give me breakthrough bleeding and this was always a compromise regime to see if I could tolerate the lower progesterone dose.

From what I've read there is little point using the Progesterone vaginally whilst bleeding, I'm thinking I might create what I think was a regime and stop the progesterone for a few days and then restart.

Has anyone tried this approach and have any advice to share? 

[JoannFran]

Hi

I have the same issues with progesterone. I’m not really great on any method of taking it but 100mg vaginally seems to be the lesser of the evils for me. I’m 49 and still peri.
I’ve only just started to try this so haven’t done a full cycle but my meno dr said to take for 25 days and have a 3 day break.
Hopefully someone who has been doing this can give some advice 

[Seasidegirl]

Thanks JoannFran, it's tricky isn't it,  your description is right,  this feels like the lessor  of all evils. 

That's the regime I was thinking of and I'm thinking that if 12 days at 200 is sufficient progesterone then anything at 24 x 100 ought to be sufficient?

I'm intending to pay for a scan at some point anyway as I had a fibroid pre HRT and I wonder what is happening with that,  plus I've had a few months where I haven't managed a full dose if progesterone so I think it makes sense to be cautious.

Have you tried the Marina coil?  I think that's my next option.... but I'm worried that if I react I'll be stuck with it for months!

[discogirl]

Hi

I'm having a similar issue with utro, I restarted hrt in March, Im post meno so taking it continuously, early September I noticed after taking utro orally, increased ear pressure so I had a 3 day break from it and restarted on 100mg vaginally, ear pressure went and anxiety decreased.

I just recently increased to 200mg vaginally and utro seems to have a cumulative effect as anxiety is getting bad again, so maybe taking it 25 out of 28 days helps to reset the receptors

Also regarding mirena coil, for me that would be too much progesterone, however I have read on another thread on here, that there are other coils, the Jaydess coil which is less progesterone I believe, also the kyleena coil.

[JoannFran]

I wasn't managing 12 days on the 200mg either.  I'd usually get to day 9 and couldn't stand it anymore.  I actually didn't take any progesterone at all last month as I needed to try to figure out if that was causing the awful anxiety.  Seems that the anxiety is there regardless but the utro causes low mood, depression and intolerance of my family  

I've tried cyclogest which gives me really really bad cramps.  I had mirena coil years ago and didn't get on with it then.  I've never been great being on any kind of hormonal birth control.  Have wondered if the mirena coil might be an option for me now as I don't remember it causing anxiety or depression before, more of a flat ish kind of mood (i'd take that now over this constant fight or flight I seem to be in).  But I'm the same as you, worried it's not easy to remove if it's not working out!    My meno dr said that taking 100 for 25 days worked out a bit more than 200 for 12 days so if that works for me then all good.  I'm going to trial it for a few months and then I might consider asking for Tibolone.

Hope you get on ok!

[discogirl]

I had an interesting conversation with my gynae today regarding progesterone and endometrium protection. First time id spoken to him as my lovely lady gynae left the trust.

He said hed never heard of using the utro capsules vaginally (even though my gp had!!) and he insisted that to get the level of protection on endo it had to bypass the liver first.

Needless to say I gave him some information and gave him some food for thought.

[Seasidegirl]

I had an interesting conversation with my gynae today regarding progesterone and endometrium protection. First time id spoken to him as my lovely lady gynae left the trust.

He said hed never heard of using the utro capsules vaginally (even though my gp had!!) and he insisted that to get the level of protection on endo it had to bypass the liver first.

Needless to say I gave him some information and gave him some food for thought.

You'd expect him up know that wouldn't you?!   I get that it isn't licenced in this way in the UK but it is a well known option and IIRC is licenced in this way in mainland Europe.  The BMS statement and guidelines also reviews vaginal use I think.

It really does feel that we are on our own with these issues. 

I've only got light spotting of darker,  clottier  blood still so I think I'll use the utrogestan tonight (unless I get more flow), that will mean I've had 15 x 100 which I'm reasonably content with in terms of protection.

My other issue is that whilst I'm on 75mcg oestrogen currently,  I think I need to go up to 100mcg as I'm more symptomatic than I was.   That's going to bring a whole new world of issues with progesterone.   My SHBG is really high though which as I understand it means that much of hormones are bound up but I'm not sure how that works in terms of dose.

I'm waiting for a scan on my thyroid lump and I'm going to pursue an endocrine referral even if I need to pay for it. 

[joziel]

You can for sure take P continuously and then a break for 3-5 days to allow a bleed. If you are in peri and trying to take it continuously without a break, you will get breakthrough bleeding so it's much better to schedule it in this way and avoid that. The old and VERY OFFICIAL continuous regime was to take P for 25 days out of 28, to allow a bleed. When they thought everyone should bleed. (For some reason.) So taking it this way has been officially sanctioned and you are not doing anything weird, it's just that post-menopausal women don't need to bleed so they changed the continuous regime to actually be continuous instead of 25 days out of 28.

Be aware though that cycles can still go wacky - I just started to bleed on day 18 whilst still taking it, having had a 5 day break at the start of the cycle to allow a bleed. So now trying to figure out if this is my period and I should stop it again to allow the bleed, or whether I should take it through the bleed. As I've had several cycles where I bled around day 21-22 I guess day 18 isn't impossible, especially if they get shorter and closer together before going the opposite way.

Anyway - yes, you can have breaks to allow a bleed but there's still some figuring out to be done!

Extra confusingly, my GP switched me to Gepretix recently from Utrogestan and I know some women find they don't absorb it the same. I wish they would stop changing things, it is hard enough trying to sort all this out and stabilise without having to account for changes in brand etc....  I know it's supposed to be exactly the same but the capsules are much harder so it would make sense if we absorbed it differently. How do I know if that is why I bled early this cycle....1!?!?

[bombsh3ll]

It would absorb just as well even if you are bleeding - vaginal progesterone is given as a treatment for women bleeding in early pregnancy - however there's no harm in having a break for a few days until the bleeding stops if you prefer.

What I wanted to say is that there are so many alternative progestogen options, some that are completely bleed free, that it really isn't worth struggling and feeling miserable on micronised progesterone if it doesn't suit you.

I think there has been so much social media evangelism about body identical hormones that the fact some people fare better on the older preparations is being overlooked.

It isn't really individualised care when one single option is being promoted as best for all.

[joziel]

I agree bomb. Even the Mirena coil is demonised by some because it contains a tiny amount of a progestin. It's much better that people use a progestin if they need to, than they give up on all hormones altogether.

[Seasidegirl]

Thanks Bomb and Joziel, this is all a bit of a work in progress to try to find the right solution and I'm really grateful for your input.

 I was hopeful that taking the progesterone vaginally at the lower dose would resolve the issue and its definitely better but I do feel less well than I felt on the oestrogen only days on the sequential regime . 

 Having said that,  I planned to delay starting the progesterone this month to see how I felt without it but I still became really symptomatic on what would have been day 14 of the sequential regime!  (Jittery, elevated heartrate etc).

I've got some thyroid issues going on which I'm attempting to get the GP to deal with,  I'm not completely convinced it's not my thyroid becoming overactive in the middle of my natural cycle as I had similar symptoms at that point pre HRT. 

I'll try this approach fur the next few weeks whilst my thyroid goitre is assessed and see how it goes.   I'm very open to other options, I felt so good at the start that it's frustrating to feel under par.    It just all takes so long,  trying a different approach each month!

[sheila99]

If you haven't tried vaginal on a sequi regime I would do so. I feel just about the same on 100 as 200 and sequi gives me more time off it.

[discogirl]

Hi sheila99

Im back on utro vaginally increased it 200 which really increases my anxiety so my plan is to drop to 100 and if i feel the same to go on a sequi regime x

[sheila99]

Hi sheila99

Im back on utro vaginally increased it 200 which really increases my anxiety so my plan is to drop to 100 and if i feel the same to go on a sequi regime x

I hope you find a solution you can tolerate, fingers crossed you'll feel OK on 100.

[discogirl]

thanks sheila99 x