Print

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

[Debyould75]

Morning

I've been taking Urogestan continuously for about 6 months, and it has meant no breakthrough bleeding which is bliss.  However, when I asked for more from my GP, they started saying that I need to take it 12 days on, 12 days off as I'm peri.  So I reduced my progestorone does, got immediate hot flushes and other symptoms back and today I've got a breakthrough bleed.  I'm a month away from no periods in a year so very close to menopause.  I'm 50 and stopped my periods 5 years ago.  I only ever bleed when I take Urogestan.  So can I go back to taking Urogestan continuously.  I don't seem to get any answers from my GP, so I've been self managing.  Can anyone help?

[joziel]

You can take utrogestan however you want to take it, continuously or continuously with a short break to allow a bleed, or sequentially (day 16-26). If you take it sequentially, you should be taking double the continuous dose. So instead of taking at least 100mg daily for continuous, you would be taking 200mg daily from day 16-26.

As for not bleeding for a year and all that, forget all that. If you are on HRT, you can't claim to be menopausal because you haven't bled for a year. It can easily be because the utrogestan is having a strong effect on you, or you are underdosed on estrogen... Forget about 'knowing' when you are menopausal, it isn't important. Take what you need to take to manage your symptoms and test your blood to be sure you are over 300pmol (preferably 400pmol) of estrogen to ensure you are absorbing enough for the health benefits. Who cares when you are officially menopausal...

[bombsh3ll]

As joziel said, as long as you are taking enough progesterone to protect your endometrium, then how you take it is a personal choice.

Some prescribers with a poor understanding of the physiology will stick rigidly to guidelines recommending sequential in those still menstruating and continuous once postmenopausal.

However this is not due to any safety concerns, it is based on outdated and erroneous beliefs that a) women "ought to have" regular bleeds and b) that sequential micronised progesterone will reliably achieve this.

Since the dose of progesterone prescribed for sequential use is typically double the dose if used continuously, the overall number of capsules taken is the same, and it is in your gift to take it either way without needing to change your prescription with the GP.

[Debyould75]

You can take utrogestan however you want to take it, continuously or continuously with a short break to allow a bleed, or sequentially (day 16-26). If you take it sequentially, you should be taking double the continuous dose. So instead of taking at least 100mg daily for continuous, you would be taking 200mg daily from day 16-26.

As for not bleeding for a year and all that, forget all that. If you are on HRT, you can't claim to be menopausal because you haven't bled for a year. It can easily be because the utrogestan is having a strong effect on you, or you are underdosed on estrogen... Forget about 'knowing' when you are menopausal, it isn't important. Take what you need to take to manage your symptoms and test your blood to be sure you are over 300pmol (preferably 400pmol) of estrogen to ensure you are absorbing enough for the health benefits. Who cares when you are officially menopausal...

Thank you, I feel listened to and have some proper advice.  How do I get a blood test though, can I request one through my GP, or there are some companies like Thriva who do it privately. 

[joziel]

If you are taking oral progesterone, you can't test progesterone levels via the tests available in the UK. (UK tests will record all the metabolites of progesterone as progesterone proper and come back falsely high.) You can only test progesterone if you use it vaginally or rectally in the UK. (Personally I switched how i take it to be able to test and get an accurate result but recognise not everyone is going to want to do that!)

You can request bloods for estrogen via your GP yes. They don't have to agree unless you are still symptomatic and are on the highest licensed dose, because you should be treated on symptoms alone until that point. You don't say what estrogen you are taking in your post, but unless you are on 100mcg patch or 4 pumps of gel, they might not agree to test - but they should agree to you trialling an increase if you tell them you have symptoms. You should treat symptoms and not blood levels until you are at the max licensed dose, when you should then check bloods for absorption....

[sheila99]

Using utro 25/28 can be useful in late peri as it allows a bleed if there's been a build up. Once you know you're not going to bleed anyway you can just take it every day. My GP won't test oestrogen levels but worth asking as yours might. Randox does them as well as others, Google will come up with some. Hot flushes are durle to insufficient oestrogen not because of the progesterone.

[Debyould75]

This makes sense as I went down to 1 pump of Eostrogel. I've gone back to 2 now and am taking Urogestan 100mg a day. Had a 5 day bleed, mainly brown and quite heavy. Really want to take 200mg progesterone but then I run low quickly.

[joziel]

It's worth saying that too low estrogen can cause bleeding as well. People always assume that bleeding is about high estrogen and/or insufficient progesterone, but if you don't take enough estrogen it can't maintain the endometrial lining which keeps breaking down and shedding lightly and randomly. You need to take enough estrogen and balance with enough progesterone as well.