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[dancinghrt]

I'm have been on cyclical HRT for years, firstly for PMS, then a short break, then for Peri (100mg patches, 200mg Utrogestan vaginally plus topical Oestrogen). I have always complained about the Utrogestran but never managed to get any solution.  I can't tolerate Mirena. I have tried continuous Utrogestran which was even worse and led to an episode of PMDD.

Symptoms on Utrogestran: PMS, tummy ache waking me at night, frequent urination, drowsiness

My latest NHS Menopause consultant has suggested trying the following:

Testrostrone as I have low libido - great, keen to try
Cyclogest -  in reply to me asking to try it, she said unlikely GP will prescribe, little research etc but she will add it as a recommendation
Sequential HRT patches (Evorel Sequi) - she said most women tolerate body identical/Utrogestran better but maybe worth a try. Not sure why I have never been recommended this in past?  I asked if it was as I had sticky blood until very recently but she said no.

Has anyone else with Utrogestran intolerance found Cyclogest or Sequential HRT better? Tips for convincing GP to prescribe Cyclogest as I don't think they will without a fight.

Thanks

[chopsuey]

Hi

It's very difficult when you're progesterone intolerant. I battled on with cyclical vaginal Utrogestan for three years, then saw a new (private) specialist who gave me some Cylogest to try. My main issue with Utro vaginally was that it burned and really irritated my bladder. Unfortunately, the Cyclogest also caused a burning sensation and I stopped it after 5 days. The specialist was very surprised, as in her experience, it is much better tolerated. However there were no guarantees the GP would prescribe it  - I think it depends on the area you live in as well.

I never tried a combined patch, as I was allergic to the the glue when I tried Evorel

In the end, I have ended up with a Mirena, which is something I didn't want but have to say I am finding it OK.

If you put Cyclogest in the search box, you should be able to find posts on other women's experience with it.

[CLKD]

Morning.  I believe that many have problems with the progesterone part of a regime. 

[bombsh3ll]

The reluctance to prescribe cyclogest or crinone is due to the excessive cost vs utrogestan.

However to be honest as the active ingredient micronised progesterone is the same, if you are progesterone intolerant there is probably little to gain by switching, however this is something you could try if you were willing to self fund a short supply, then you would know.

Have you tried or considered an oral synthetic progestin such as desogestrel or slynd? Both are off label as endometrial protection but supported by the BMS based on evidence supporting their efficacy. These should be available on the NHS.

[CLKD]

All HRT options should be available on the NHS 

[dancinghrt]

The reluctance to prescribe cyclogest or crinone is due to the excessive cost vs utrogestan.

However to be honest as the active ingredient micronised progesterone is the same, if you are progesterone intolerant there is probably little to gain by switching, however this is something you could try if you were willing to self fund a short supply, then you would know.

Have you tried or considered an oral synthetic progestin such as desogestrel or slynd? Both are off label as endometrial protection but supported by the BMS based on evidence supporting their efficacy. These should be available on the NHS.

Thank you.  I think that is what the consultant was trying to convey to be but I have read some women get on better with Cyclogest.  How would I buy some to try if I'm seeing NHS medical practitioners do you know?

I will look up those synthetic progestins - have always been scared of synthetic due to my blood clotting condition but apparently I don't have it anymore and just affects pregnancy and more fertile years

[dancinghrt]

Thanks all, can't quite work out how to reply/like comments. All very useful.  I haven;t been able to find much about Cyclogest prescribed on NHS, just abroad

[CLKD]

U shouldn't have to buy anything.  If a regime doesn't work then there is an option of asking for a referral to a dedicated menopause clinic but both NHS and private have waiting lists.

When did U last discuss your clotting issues with a Consultant?

[bombsh3ll]

1) from an online pharmacy service such as the independent pharmacy. They include the prescription.

2) your GP may be willing to issue a private prescription for it. A fee is usually charged for this, and you would also have to pay for the medication at the pharmacy. This is often done where a treatment is medically appropriate but not funded by the NHS (for example my combined pill Zoely as I live in Scotland) and is at their discretion.

3) book a private consultation with a specialist and explain the situation to them, and that you would like to try cyclogest having failed utrogestan. They would probably be happy to prescribe. This is the most expensive option as you would pay for the consult, probably a prescription fee and the cost of buying the medication.

It would be nice if everyone could get their needs met on the NHS but sadly that isn't the reality. Also if you try something privately and it works, you then have a stronger case for subsequently getting it on the NHS, and know that you aren't wasting your precious time and energy fighting for something that turns out to be a dud.

[flo69]

Dancinghrt have you tried tibolone for any length of time?

It is supposed to be first line treatment for any woman who is intolerant to progestins (Google says it's 20% of us).

Sometimes it can cause digestive issues at first, I don't know of any other side effects.

I have high blood pressure which isn't a problem for me to take it.

I go seriously nuts on progesterone, but it's not only for severe cases, it's a standard treatment for any woman who wants it on the NHS.

If a woman says she feels awful with utrogestan etc, then it's supposed to be offered, but often GPs frequently don't know anything about menopause or the treatments they have at their fingertips.

[sheila99]

I am also intolerant to utro but I had no adverse reaction to evorel sequi. It was my first hrt but after nearly a year I developed an allergy to the glue so had to change. Worth a go imo. My gp won't prescribe cyclogest.