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[Pamela1509debbie]

Hi all I'm new here and, praying someone with knowledge can help me. I've been on HRT, the estrogen patch daily and 12 days of added progesterone as still have uterus, however it's become apparent as much as I benefit from the patches I'm intolerant to the progesterone, Utrogestan brand made me even worse, I cry continuously and literally feel suicidal, I was told off label to 'help this' to use the capsules vaginally but that caused ab overactive bladder and itching. I then started to pop the capsule (NOT a pessary) just inside my retum. I don't want to dare risk changing to another brand ie: the pessaries beginning with C, (forgot the name sorry 🤦🏼‍♀️) due to horrific experiences on other brands and suicial ideation. I'm getting mixed messages now, one minute I'm told, or read on reputable sites Gepretix CAPSULES CAN be used rectally and deliver progesterone TO uterus area better. Then I see conflicting advice that anything rectally needs to be a pessary only - why?.🤷🏼‍♀️ Going to my Doctors is useless, not one of them has a clue and I'm scared I'm doing the wrong thing and unsure how it dissolves into the body. Can anyone please advise im driving myself insane and getting distraught with worry and can't afford to go private?.

[bombsh3ll]

Yes you absolutely can use micronised progesterone capsules rectally. The gut is the gut and many medications can be given this way, albeit not most people's preference.

Dr Louise Newson supports this.

If you are happy with this then fine but you should also know that there are multiple other oral progestins apart from micronised progesterone, and also tibolone.

There is also the mirena IUS.

So please don't feel like micronised progesterone and shoving something up your bum every day long term, are your only options.

[lizzy76]

I have been using cyclogest rectally for a while and have found it to be much better for mood than utrogestan. It might be worth giving cyclogest a go. I couldn't tolerate the utogestan at all. The cyclogest is waxy and soft whereas the utrogestan is in a hard shell so maybe that's the difference.

This link seems to suggest it's ok (if I'm understanding it correctly): https://www.drlouisenewson.co.uk/knowledge/progesterone-intolerance.

"Some women actually feel better when they use higher doses of progesterone as suppositories. The dose depends on the clinical situation and your healthcare professional will be able to advise you. While Utrogestan is not licensed to take in this way, it is safe to do so and there is evidence to support its use this way [5]."

As bombsh3ll says there are lots of different progesterones to try that might not affect you in the same way. Two other options I have been recently offered by my NHS GP are dydrogesterone and slynd which are both supposed to be better for women who can't tolerate progesterone.

Good luck!

[Pamela1509debbie]

Thank you so much for your replies, can I ask you @lizzy76 when you also say you didn't get on with Utrogestan was this also really affecting you mentally like myself or was it more physically if you don't mind me asking, sorry I just feel like some freak and Doctors are making me feel I'm a challenge, I'm awkward and made to feel 'no one else' is this mentally disturbed by it why am I so difficult and it's making me feel rock bottom?

[Hurdity]

Cyclogest is designed for rectal or vagonal use, whereas Utrogestan and Gepretix are designed for oral or vaginal use. Gepretix and Utrogestan are almost identical and have the same dose of progesterone is a very similar capsule so likely you will have similar effects from either.

Bombshell - there haven't been any trials as far as I know on using Utrogestan or Gepretix rectally? Yes all sorts of medicines are used this way but designed for this purpose. Whether or not Louise Newson supports this doesn't mean it's OK for anyone just to try. It may well be OK but without any data one can't be sure - but please put me right if it has been properly trialled recently?

Pamela1509debbie - I do understand your woes with prog and sympathise but it would be preferable if you are going to try this only to do so under supervision ie regular scans - to check it is working. If you've found reputable sites which say it can be used rectally then please can you post links?

As bombshell says there are other options;  as above Cyclogest even though not licensed for HRT, is licensed for fertility and prescribed off licence for HRT by many GPs and menopause specialists.

Very frustrating for docs to make you feel like that - progesterone intolerance is widely recognised by menopause specialists!

All the best with it all anyway.

Hurdity x

PS 

[bombsh3ll]

Progesterone has been used for decades within the treatment of infertility and threatened miscarriage. It is used vaginally or rectally (but not orally in this context as first pass absorption means most of it is converted to other metabolites). It can also be injected intramuscularly however this is not suitable for long term use eg within MHT.

The data for its absorption into the rich blood supply of both the rectum vagina come primarily from this field and can be looked up on pubmed and related sites.

Funnily enough there is a lot more research done when it comes to women's perceived role as baby factories than goes into treating menopause!

Dr Newson and others have extensive clinical experience with its use and whilst they may not have published a paper, they have scanned hundreds if not thousands of women using vaginal and rectal progesterone and found their linings well controlled.

So if using it rectally works for you, whether you choose the capsules or the waxy cyclogest pessaries (both just melt easily with the heat of your body - I used both types vaginally for IVF) I would say go for it, and you can always book a private scan every year or so for reassurance about your lining.

I actually think an annual pelvic scan should be part of routine well woman screening anyway like mammography and smear tests, and I have one due to a family history of ovarian cancer, and for me its money well spent.

[lizzy76]

Thank you so much for your replies, can I ask you @lizzy76 when you also say you didn't get on with Utrogestan was this also really affecting you mentally like myself or was it more physically if you don't mind me asking, sorry I just feel like some freak and Doctors are making me feel I'm a challenge, I'm awkward and made to feel 'no one else' is this mentally disturbed by it why am I so difficult and it's making me feel rock bottom?

Hello,
Yes, the utrogestan really made me feel very low. Like bad PMS. I tried it orally and vaginally and though it was slightly better vaginally I had to stop taking it. The cyclogest was better mood wise but caused drowsiness and I had to get it on a private prescription. Am now trying dydrogesterone which seems better but it's only been a few days so not getting excited. I think it's very common for utrogestan to affect mood so you're not alone! Good luck!

[sheila99]

You might find the problem you have with vaginal use is the start of va. It was for me, other symptoms of it developed later. So it's possible with topical oestrogen you may be able to use it this way. I used it rectally for approx 6 months because of this and actually found my bleed was heavier so I suspect for me it was more effective. Obviously this is only my experience and I'd also advise scans if you use it this way. You may well find a different progestogen doesn't have an adverse effect for you so imo would be worth trying. (My problem was fatigue which I don't get with either norethisterone or a mirena).