Print

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

[LucyLu]

I've been taking utrogestan vaginally (conti, 200mg for 12 days halfway through cycle) for over 6 months now due to awful mood effects of oral administration. I've reliably had a bleed around 2 days after stopping each month. However, I took it orally this month due to worries about its effectiveness when used vaginally, and haven't had a bleed.
Does anyone know if this means it's working better or worse at preventing the womb lining thinking?

[sheila99]

It might be telling you that your own cycle has decided you'll bleed at a later date when it decides it's time. Or that there hasn't been much build up this month so nothing to shed. They say used vaginally more gets to where it's needed vaginally but one month isn't going to tell you much. Utro is licensed in the EU for both oral and vaginal use, it's only the UK that says oral only for hrt though fine vaginally for ivf so I think it's more of a licencing issue than a medical one. If you're using gepretex rather than utro I'm not sure.

[bombsh3ll]

From what I understand progesterone is more effective at controlling the endometrium when used vaginally as it is absorbed unadulterated into the bloodstream, and also in proximity to the target tissue.

When taken orally most is converted to other metabolites in the liver (hence you feel groggy) due to the first pass effect.

This is the same principle for estrogen, and you will notice that the oral doses are MUCH bigger (milligrams) than transdermal doses (micrograms). Whilst some of this is due to the era in which they entered the market, it is largely because most of what we take orally is lost before it gets into the circulation, vs something that goes directly into the circulation.

Certainly in the world of infertility and miscarriage prevention where the stakes are much higher, micronised progesterone is ONLY used vaginally (occasionally rectally if bleeding heavily) but oral use is not considered reliable enough.

It is not a cause for concern if you don't have a withdrawal bleed.

[LucyLu]

Thank you for both of your helpful replies. It does make sense that it'd be more effective when absorbed directly into the bloodstream near the target area and when it hasn't had to be metabolised. The withdrawal bleed has now arrived, much later and much lighter, which I'm now assuming means it's been less effective at inducing shedding. I'm just going to go back to taking it vaginally as last month the impact on my mood was awful...so much sadness and sobbing!
If it works for the Europeans it'll work for me