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[rosebrid]

This is my first post here as have just started my own weird and wonderful regime looking for advice until I have my review in April. I feel inclined to consult with the doctor before that.

I'm 50, and have come off the combined pill which I had been on for 25 years and felt perfectly fine on, except the last few months I had been feeling a bit tired and low on occasions which could be just the combo of peak time work, crap weather and perimenopause anyway. In January I started Desogrestrel and two pumps of Oestrogel which I felt good on, had back some motivation and even energy to do some exercise in the evening which is unusual. Then I started 200mg of Utrogestran in the evening for days 15/26 which is creating a pattern of getting to sleep ok but from around 3am onwards the dreams are so vivid and utterly ridiculous. For the first couple of nights taking it I woke up with them and didn't get back which was miserable. I think now I am sleeping (sort of) but the Lucy in The sky with Diamonds imagery in my head I could well do without, especially when I have to try and get my head clear for work in the morning.

I am wondering if switching to the morning would be better as unfortunately it doesn't appear to be conking me out in the way it seems to do for most, on the other hand I am nervous in case it did. Or whether the dose needs adjusting. I definitely don't want a coil.

Other than the sleep, well dreams, I don't seem to have very much of the problems that can arise that others wrote about - yet- so do I just carry on or can something be done?

I am very healthy, take appropriate supplements which definitely help, all my own stats like blood pressure are all great.

[MadCatLady]

You can certainly experiment with the timing to find what works best for you specifically. There's no requirement to take it at bedtime, they just recommend it because drowsiness is common.

For me, taking it in the mornings led to me feeling faint about 2 hours after taking it. So if you try that, I'd suggest doing it on a day you can stay at home, just in case. But it may work out a good solution for you.

I found utrogestan disturbed my sleep when I first started taking it. For a while it worked well to take it in the early evening, but after 2 months my body seemed to adjust and I am back to taking it at night now. It may be that if you keep going, these weird dreams will eventually stop.

Good luck, I hope you can find what works for you.

[bombsh3ll]

Why take desogestrel and utrogestan when you can just take 2* desogestrel (150mcg) as your endometrial protection.

This is supported by the BMS and is also much more likely to keep you bleed free than cycling micronised progesterone.

[rosebrid]

You can certainly experiment with the timing to find what works best for you specifically. There's no requirement to take it at bedtime, they just recommend it because drowsiness is common.

For me, taking it in the mornings led to me feeling faint about 2 hours after taking it. So if you try that, I'd suggest doing it on a day you can stay at home, just in case. But it may work out a good solution for you.

I found utrogestan disturbed my sleep when I first started taking it. For a while it worked well to take it in the early evening, but after 2 months my body seemed to adjust and I am back to taking it at night now. It may be that if you keep going, these weird dreams will eventually stop.

Good luck, I hope you can find what works for you.

Well the last two nights have been a bit better as in I am sleeping, albeit in a weird sort of hallucinogenic way. The first two nights I wasn't sleeping at all past 3am much which was obviously depressing. I shall see how things go on the last few days.

[rosebrid]

Why take desogestrel and utrogestan when you can just take 2* desogestrel (150mcg) as your endometrial protection.

This is supported by the BMS and is also much more likely to keep you bleed free than cycling micronised progesterone.

That sounds brilliant but it was never suggested as an option. I will certainly raise it. Thank you both.

[joziel]

You can just take the desogestrel probably even at the same 75mcg dose, we just don't have as much research on that - but as it's a powerful progestin it is likely fine.

However you might also decide not to take a synthetic progestin (unless you need it for birth control) and instead switch to the utrogestan only.

If you want to stay with utrogestan, I'd suggest you take it vaginally. When you take it orally it is getting processed by the liver and producing a lot of metabolites and GABA in the brain. (That is what causes the sedative effect and woozy stuff.) If you take it vaginally, not only do you absorb more of it but you also don't get these effects on the brain as it bypasses the liver. It's the exact same gel capsules and you just shove them up as far as you can with a finger before bed.

[rosebrid]

You can just take the desogestrel probably even at the same 75mcg dose, we just don't have as much research on that - but as it's a powerful progestin it is likely fine.

However you might also decide not to take a synthetic progestin (unless you need it for birth control) and instead switch to the utrogestan only.

If you want to stay with utrogestan, I'd suggest you take it vaginally. When you take it orally it is getting processed by the liver and producing a lot of metabolites and GABA in the brain. (That is what causes the sedative effect and woozy stuff.) If you take it vaginally, not only do you absorb more of it but you also don't get these effects on the brain as it bypasses the liver. It's the exact same gel capsules and you just shove them up as far as you can with a finger before bed.

If I did that would it affect sex at all?

Since I posted, I am still getting vivid dreams but I am sleeping sort of at least. I finish my cycle of them tonight. I am curious as to what the next two weeks will be like off them and whether the dreams lessen.

I will be asking this anyway but is 200mg of Utrogestran plus the 75 of desogrestrel an ok dose to take? Or is it a par for the course dosage to take if you still have a womb.
I have read about 100mg every night taken as an alternative.

[joziel]

I'm not too sure why you are taking the desogestrel at all, I know someone else asked above, but doesn't look like you answered?

You should get enough P for endometrial protection from utrogestan. The only reason to take desogestrel as well is for contraception during peri, or because you are having bleeding issues and it's a solution you've found after trying the utrogestan by itself. As you're 50, the chances of pregnancy are miniscule....

With P and sex, you want to wait until you've had sex and then put it in. Just because it can get dislodged during sex and then not get absorbed. You can also use it rectally and then (um, unless you're having anal sex - must not make assumptions  ) it's not going to be affected.

Whilst lots of women take more (I do), the two bog standard doses of utrogestan is either 100mg continuously (or almost continuously - with 3-5 days off to bleed for some women) or 200mg for the last 2 weeks of the cycle. That is the same regardless of whether you take desogestrel on top or not - which raises the question again about why you're taking it and whether you need that.....

[bombsh3ll]

Just to add regarding the desogestrel, particularly if you are using it for bleed control, or even just for contraception but it has you bleed free as a bonus, it makes no sense to take the micronised progesterone cyclically, as this is designed to induce bleeding every time you stop it.

[rosebrid]

Desogrestrel was I think because I was still having a regular bleed on my combined. To be honest, it didn't occur to me to question it.

I shall be raising what has been said, thank you all.

[Katherine]

This is my first post here as have just started my own weird and wonderful regime looking for advice until I have my review in April. I feel inclined to consult with the doctor before that.

I'm 50, and have come off the combined pill which I had been on for 25 years and felt perfectly fine on, except the last few months I had been feeling a bit tired and low on occasions which could be just the combo of peak time work, crap weather and perimenopause anyway. In January I started Desogrestrel and two pumps of Oestrogel which I felt good on, had back some motivation and even energy to do some exercise in the evening which is unusual. Then I started 200mg of Utrogestran in the evening for days 15/26 which is creating a pattern of getting to sleep ok but from around 3am onwards the dreams are so vivid and utterly ridiculous. For the first couple of nights taking it I woke up with them and didn't get back which was miserable. I think now I am sleeping (sort of) but the Lucy in The sky with Diamonds imagery in my head I could well do without, especially when I have to try and get my head clear for work in the morning.

I am wondering if switching to the morning would be better as unfortunately it doesn't appear to be conking me out in the way it seems to do for most, on the other hand I am nervous in case it did. Or whether the dose needs adjusting. I definitely don't want a coil.

Other than the sleep, well dreams, I don't seem to have very much of the problems that can arise that others wrote about - yet- so do I just carry on or can something be done?

I am very healthy, take appropriate supplements which definitely help, all my own stats like blood pressure are all great.

When I first started on utrogestan I found it hard to adjust to, it takes a while to get used to it. However I’m on 100mg continuous, I could never have tolerated 200mg. I take mine before bed and although it doesn’t stop me waking up it makes me sleep deeper and I wake up feeling much more rested than without it. I would highly recommend trying 100mg continuous. I tried it vaginally but didn’t get the sleep benefits so switched back to orally.

[joziel]

rosebrid, that sounds like pretty strange HRT prescribing. I mean, it is normal to have a bleed on the combined pill. It is also normal to have a bleed on HRT until you are post-meno and the way you take the utrogestan accounts for that - you stop to allow it. The goal isn't to prevent all bleeds by dosing you up on progestins. Not unless you have severe problems like endo/adeno or pain or very heavy periods. It wouldn't be the first thing to do, when putting someone on HRT....

The reason this matters is that it's a sign your prescriber doesn't know much about HRT and prescribing it and you probably can't rely on them in other ways for accurate info. You might want to seek out another doctor.

[rosebrid]

rosebrid, that sounds like pretty strange HRT prescribing. I mean, it is normal to have a bleed on the combined pill. It is also normal to have a bleed on HRT until you are post-meno and the way you take the utrogestan accounts for that - you stop to allow it. The goal isn't to prevent all bleeds by dosing you up on progestins. Not unless you have severe problems like endo/adeno or pain or very heavy periods. It wouldn't be the first thing to do, when putting someone on HRT....

The reason this matters is that it's a sign your prescriber doesn't know much about HRT and prescribing it and you probably can't rely on them in other ways for accurate info. You might want to seek out another doctor.

Many thanks to both you and Katherine above.

I was prescribed by the 'menopause expert' doctor in my surgery which the doctor I saw had to refer to and get the prescription from.

You have given me much food for thought and I shall try and get a consultation in if only a phone one as soon as I can.