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[Caroline77]

Hi Ladies, please can I have some advice. On the recommendation of a specialist I am taking 25 days of 100 Utrogestan Vaginally with a 5 day break to bleed, because I was still getting regular periods before starting but suffer from PMDD so couldn't tolerate the start stop of taking it for only half the month. I am also on two pumps of Oestrogel. I have been bleeding normally in the 5 day break.

My question is I have been on this regime for a couple of months and the past few days I have started spotting that has become a heavy bleed today but it is only day 15 of my Prog. My question is should I power on with my tablets as usual, should I try upping anything to counteract the bleed or should I just stop the prog for a few days let myself bleed and start on day one again....

So confused. Not sure what to do.  Can anyone advise?

[Daisy1]

Following as I'd like to move to continuous progesterone as I also have PMDD and I can't cope with the stopping and starting. How do you feel for the 5 days you're off? I've just stopped utrogestan yesterday and I feel exhausted and unwell like I have flu.

[bombsh3ll]

In my opinion quality of life should never be sacrificed for bleed pattern.

Your overall wellbeing surely outweighs the inconvenience of having to carry some sanitary towels or tampons.

Chasing a particular bleed pattern on any HRT regime or none is is not always successful anyway.

I would just take the dose of progesterone that you tolerate, every day consistently. The PMDD brain much prefers a hormonal monorail than a rollercoaster.

I would also make sure you are taking the maximum estrogen dose that you can without having to increase the progesterone, which additionally helps support mood and tolerability of the progesterone, and consider adding testosterone which can be truly game changing in this context.

(You would have to say it is for libido to get on the NHS)

[sheila99]

Advice is to carry on with the hrt cycle regardless. But if you have a pretty regular cycle yourself and the two cycles become out of step personally I'd alter the hrt cycle to fit my own. 25 days on 5 off is a bit odd unless you have a natural 30 day cycle, it's normally 25/28 as a 28 day cycle is more usual. You only need the drop to induce the bleed.

[bombsh3ll]

There's just no medical reason to induce a bleed.

Bleeding is a side effect of having ovarian hormones, not the goal of treatment.

With PMDD, particularly if severe, the overriding objective is the patient's wellbeing and quality of life.

This group of women are generally dealing with far bigger problems than the state of their knickers.

[common-lime]

The good thing about utrogestan is that you can kind of take it however works for you - there won't be enough of a difference between taking it 28 vs 25 days to draw anyone's attention in terms of repeat prescriptions. I'm only 41, still have regular periods and use it vaginally every day because I was getting migraines and mood swings cycling. I have had the odd day's break when I've worried that I'm not bleeding "enough", but honestly I think that's just my health anxiety. My periods still turn up every 18-28 days (normal for me), they're just lighter. And I don't get migraines or horrendous mood swings any longer.