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[Abs75]

Hi all, I hope you had a very Merry Christmas! My period was due on Xmas day but thankfully didn’t come on time! Unfortunately it still hasn’t arrived though and I’m wondering how I work out when to take my ultrogestan if it doesn’t show up at all, which has happened occasionally. Should I waist until I have next period and count from there or just start it on the same day as last month? Or 15 days from when my period should have started? I’m on Evorel 25 patch daily with the ultrogestan 200mg capsules from day 15-26 of cycle

[Penguin]

I would start it again when you get to day 15, otherwise you risk your lining building up with unopposed estrogen.

[bombsh3ll]

25mcg is such a low dose that if you are no longer cycling endogenously you may simply not have built up any lining to shed.

If you don't have a regular cycle you could either just use the first of each calendar month to start taking the progesterone for 14 days, or take one 100mg capsule every night, either leaving a 3 day break every month to see if you bleed, or just stopping for a few days if and when you get a bleed.

[Abs75]

I do usually have a very regular cycle, I usually only bleed for 3-4 days but last month I had a 10 day period. That’s happened a couple if times before with regular cycles otherwise.
I went down to 25 mg as was on the 50 mg before and it made me gain weight.

[Abs75]

I would start it again when you get to day 15, otherwise you risk your lining building up with unopposed estrogen.

Yes that’s what I was thinking was probably best.

[joziel]

As bomb says, it's very likely you are not getting enough estrogen from a 25 patch to cause enough build up to have a period. This happened to me when my estrogen was too low.

The down side of that, is that if you are not getting enough estrogen for a bleed, then you are likely also not getting enough for bone protection, cardiovascular benefits, dementia protection and all the other benefits of HRT.

Weight gain (from fat) does not happen rapidly or within weeks. It takes many weeks and months of eating more calories than you are burning to put on ANY fat. Weight gain which occurs more quickly is likely temporary water weight as a result of hormonal changes and will resolve itself. It can also be due to insufficient progesterone, which is a diuretic and counters the water retention.

Simply applying or taking hormones does not mean you have optimal levels because there is a huge variation in what women absorb. Unless you test your hormones and ensure they are therapeutic levels, you really are just guessing.... And it's not possible to test P in the UK if you take it orally, so we have to go by symptoms and trial and error.

[Penguin]

I would start it again when you get to day 15, otherwise you risk your lining building up with unopposed estrogen.

Yes that’s what I was thinking was probably best.

What I'm not sure of is what to do if your period comes while you are in the middle of taking the utrogestan. I used to take mine vaginally so it would have been a problem, but if that happens you can always ask again on here as I've seen it be asked before, I just can't remember what the responses were 🤣

[joziel]

I would stop if it came in the middle of utrogestan. That is Day 1 of the cycle. Otherwise you are fighting your body and will just end up bleeding randomly.

[Abs75]

Joziel it was definitely caused in some way by the Evorel sequi, I’d been the same weight for years, I don’t eat much and exercise most days and when I switched I lost it again. I wonder if my dr would allow me to stay on the ultrogestan with Evorel 50? If the weight gain was down to not enough progesterone rather than too much estrogen then maybe oral P works better for me than through patch?

[bombsh3ll]

If anything it was probably the norethisterone in the combi patch causing weight gain.

It has utility in some cases but I would definitely consider it one of the ugly stepsisters among progestins.

The dose of micronised progesterone you are currently taking is typically considered adequate with a 50mcg patch so you may as well get the benefit of the estrogen.

Hypoestrogenism itself also increases the chance of weight gain.

[Abs75]

Well I decided to go ahead and stick another patch on to try it out before officially changing it with the Dr. Still no period and feeling really miserable. I lost my mother in law in September and just couldn’t stop feeling miserable about it yesterday and pretty much ruined the mood of New Year’s Eve for my family, not sure if that’s down to the extra estrogen or too much Prosecco 😞

[joziel]

It's not likely to make a difference this fast. The fastest I've ever noticed results with increasing estrogen has been about a week, but it can be 2-4 weeks for max effect.

You can go up to 100mcgs with that utrogestan dose so you may need to go higher, but gradually.

[Abs75]

Ok thanks for that, I’ll stick with it for a couple of weeks then and hope for the best.