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Author Topic: Timing of Utrogestan  (Read 1534 times)

fabatfifty

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Timing of Utrogestan
« on: June 15, 2025, 04:34:26 PM »

Hello all,

I know this question has come up before but I would welcome some advice.
I am almost 50 and have been taking HRT for 9 months. 2 pumps of oestrogen and 14 days of 2xUtrogestan. All tolerated well and helped me to feel much better. However, I am getting breakthrough bleeding with the Utrogestan that is annoying. I had been taking it for 2 weeks starting on the 15th of the month. I suspect my own cycle had been too strong though and so I was ending up with a proper period (although not as heavy as a natural period had been) and then further bleeding- not as heavy but annoying nonetheless- when I stopped the utrogestan.

I was expecting to start my 'proper' period a few days ago but now it hasn't happened! Should I just start taking the utrogestan tonight for the next 14 days or should I try to get things back in sync by waiting for a 'proper' period and starting the utrogestan 14 days later (all will I still end up chasing?) I have no idea what to do!

I'd much rather take the utrogestan continuously but the menopause nurse tells me this is dangerous when I am still having periods. But how willI ever know when my periods have stopped if I get a withdrawal bleed.

Many many thanks for any insight!

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sheila99

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Re: Timing of Utrogestan
« Reply #1 on: June 15, 2025, 06:36:33 PM »

Medical advice is to carry on with the hrt cycle regardless but I found it much better to alter the hrt cycle to keep it in sync with my own. If you still have a cycle of your own going on conti too soon doesn't stop the bleeding though a mirena or synthetic oral progestogens might. You might consider the 25/28 regime which can be useful in late peri as it allows a bleed if there's been a build up.
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bombsh3ll

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Re: Timing of Utrogestan
« Reply #2 on: June 15, 2025, 09:56:18 PM »

I would love to know what catastrophic fate that nurse thinks will befall you if you take progesterone continuously.

I have been on a combined pill continuously for 15 years so am interested to find out if I am about to grow a second head or begin speaking in tongues!

They are simply mindlessly following a flow chart (excuse the pun) which generally recommends sequential to those still menstruating and continuous to those postmenopausal.

This dogma is based on the belief that sequential progesterone results in a regular bleed pattern, and that continuous is more likely to result in a less regular bleed pattern.

As you have discovered this is often not the case - trying to time cyclical HRT in perimenopause is rather like trying to time the stock market.

Whilst using the progesterone continuously MAY also be associated with a less regular bleed pattern, this is not medically harmful in any way except if it results in inappropriate referral for investigation, which is avoidable in the hands of a skilled clinician who is capable of differentiating explained vs unexplained/concerning bleeding.

You can also try a hybrid regime where you have a break to bleed for 3-5 days per month as suggested by Sheila.

To further reassure you, continuous progesterone is typically recommended from the start in perimenopausal individuals with conditions aggravated by hormonal cyclicity such as migraine or endometriosis.

« Last Edit: June 16, 2025, 06:40:46 AM by bombsh3ll »
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fabatfifty

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Re: Timing of Utrogestan
« Reply #3 on: June 21, 2025, 04:12:50 PM »

Many thanks to you both for your comments. I am finding the lack of knowledge/willingness to meet the needs of each individual woman before them frustrating in the NHS! It very much seems to be luck to find a knowledgeable NHS clinician. I appreciate there are many demands on the NHS but one can't help wonder that there would be significantly more funding and experience if the menopause happened to men!!!
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fabatfifty

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Re: Timing of Utrogestan
« Reply #4 on: June 21, 2025, 04:14:35 PM »

Also meant to say- I think I will try 25/28 and see how I get on with that.
If I lots of breakthrough/irregular bleeding I will go back to see about an alternative progesterone. Other than this issue, I have found the HRT to be hugely helpful and I am keen to take it for the cardio protective benefits too.
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