Menopause Matters Forum
Menopause Discussion => Alternative Therapies => Topic started by: skkb on October 26, 2015, 08:06:01 AM
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Has anyone tried this and does it work? Feeling desperate
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I've been using serenity for years, my GP is aware I use it, and yes I do think it has definitely helped me. It's worth a try x
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Thanks Lisa, do you buy it on the internet or in store? How much would you apply daily?
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Aaaaagh skkb! (Sorry - but we've had this one lots of time - no offence :) ). What would you want it for? It does not have enough progesterone cream in it to oppose oestrogen in HRT and in itself there is little evidence that it will do anything for menopausal symptoms. Studies have been mixed ie there are no consistent results. This is what Dr Currie says about it (in brief)
PROGESTERONE CREAM "Natural" progesterone cream is available on private prescription in varying strengths. Studies have shown inconsistent results on effect on menopausal symptoms. Claims for a protective effect on bones have not been confirmed. Women who take systemic estrogen for menopausal symptoms must also take progestogen to protect the womb lining from being stimulated by the estrogen. Progesterone cream is not suitable for giving protection to the womb lining and should not be relied on for this purpose.
Please don't be taken in by the powerful marketing blurb.
Lisajp - I'm pleased you feel it has helped you and of course important for us all to feel better - but no amount of individual testimonies can tell anyone else whether it is likely to be effective - the results possible being largely placebo, or that changes observed would occur anyway - or perhaps it may help a very few - depending on symptoms? This is why we have trials - at least so that women can look objectively and see whether there is a chance of it working.
Hurdity x
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I tried this cream some time ago. Sorry but didn't work for me. I was willing to try it though & it may be worth a try.
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I tried it too after all the other red clover, black cohosh etc etc hadnt worked and thought from the blurb that it would be my salvation - :P but afraid it didnt help any of my symptoms
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Soon this kind of post will be in the dedicated alternatives section. ::)
Honeyb
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Thanks to a very helpful MM member, I am just about to try some! I was just about to start it last month but my period came before I had the chance. I was put in touch with a doctor who is a hormone specialist and I had telephone consultation during which he ran through some basic questions and prescribed it.
I was going to start a separate thread on this but you beat me to it! Because I am severely intolerant to artificial progesterone and Utrogestan, I am going to try using this cream as an alternative and as part of my HRT regime. The doctor agreed that it would be OK for me to use it for 7 days each month instead of the Utrogestan. He thinks that I react badly to the 100mg Utrogestan because it is too strong for me and I don't need to take it in such high doses. He thinks the fact that I have regular periods with or without taking progesterone means I do not needs as much progesterone as some women and can't see any reason why it should not work. I just hope I can tolerate it and it doesn't bring on the silent migraines.
Will keep you posted.
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Let us know how you get on.
It's really interesting to hear how others manage symptoms
Be prepared for some negative responses to this, but stick to what you have decided and don't be put off.
When we get our alternatives thread then this can hopefully be discussed and not get any negative comments.
Honeybun
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Mary G - I am not clear what your doc hopes to achieve by prescribing the progesterone cream? The thing is, the cream in the thread title is a much hyped commercial brand - which as pointed out below is not recommended by experts for use in protecting the womb lining, because it is so weak - not sure if this is what you are going to be using?
There is nothing wrong with a progesterone cream per se for this purpose, if it is produced at the right concentration to be absorbed and give serum levels of progesterone sufficient to thin the lining - it's just that this commercial brand does not as far as I know do this (and as per the info on this site). I can understand and sympathise with your problem and if only utrogestan was produced at lower doses!
Are you still having regular periods even without any HRT? If this is the case then why do you need it at all - although the additional oestrogen may make the lining thicken. I really can't see what it would do to protect the womb if it's the commercial brand - unless there is a prescrption only stronger version available. :-\
Will you be having regular scans to check that it is not overthickening, despite the bleeding you are experiencing?
( ??? Negative comments??)
Hurdity x
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Hurdity, I am rather an odd case. I am 9 years post menopause and taking 3 pumps of oestrogen gel every day which gives me periods without the use of progesterone. It is very unusual I know, and no doctor has ever been able to explain it. If I don't use the gel or any HRT, I don't get periods at all but the oestrogen gel seems to bring them on. I have regular scans and the lining is all normal. I tried to go for the longer cycle of HRT but never got beyond 5 weeks before having a period WITHOUT taking any progesterone. It seems that I shed naturally for some reason. The reason I want to take progesterone is (a) to make sure the lining is well and truly shed and (b) without it, I get a period that lasts for two weeks but with the same volume of blood.
It's all a bit of a mystery but apparently some women shed naturally and without progesterone once the lining builds up, nobody knows why. Because of my severe intolerance to progesterone (my body is clearly telling me it doesn't like this stuff) I thought it might be worth a try with the natural progesterone cream that I can take is much lower doses. I will let you know how it if works and whether or not I can tolerate it. If not, the next step is a hysterectomy.
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Hi there mary
I felt really concerned when I read this. This is not by the way the same as Serenity- I assume? This is prescribed by a gynaecologist?
Normally, bleeding outside of a controlled cycle (using progestogens) in someone 9 years post meno would be investigated fully - it could be down to hyperplasia.
Are you sure you are post meno for a start?
Have you had a scan recently?
What is the measurement of the lining?
A hysteroscopy?
Have you tried the Mirena with the gel
Three pumps is more than the normal dose, so are you sure you need that much? Could you be using too much and it's making the lining build up too much?
Sorry for all the questions!!!
You're not having periods, you're having breakthrough bleeding.
You won't have periods if you are 9 years post meno (does that make you about 60 or did you have an early meno?)
The reason that someone post meno would bleed as you are when using oestrogen is because the lining is growing too thick under the influence of oestrogen.
If this continues, my understanding is that hyperplasia could develop, or exist already.
Are you being treated by a gynaecologist and is the one prescribing the progesterone for you now the same one who's giving you the gel?
If you have only had a phone consultation does your dr intend to see you in person to discuss this?
Sorry for all the questions but I use gel and I feel very worried for you if you're having 2 weeks of bleeding, 9 years post meno, if you don't use any progestogens.
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Duchess, yes, I do have regular ultrasound scans and and gynaecologist prescribes the oestrogen gel. This is not breakthrough bleeding, it's the real thing and very regular like a periods, I don't bleed between periods, don't have fybroids of any other underlying problems, all checked thoroughly and no build up in the lining.
It is a mystery and no doctor seems to know why I get periods naturally although one said I must have good womb receptors. I do take progesterone (Utrogestan) which brings on a period which last about 6 days. It tried to go for a longer cycle but can't make it that long, I always start a period without the progesterone which, as I said, is the same volume of blood but lasts for two weeks instead of the usual 6 days then stops completely until the next time. I never bleed between periods.
I am 54 and had an early menopause and never have any bleeding if I don't take HRT. The gynaecologist does not prescribe natural progesterone cream but said why not give it a try - I went to another doctor to get it. I am severely intolerant to all types of artificial progesterone including Utrogestan and the Mirena coil, they give me silent migraines which consist of disturbed vision without headache.
Leading expert Professor Studd originally prescribed three pumps of oestrogen gel plus 7 days of Urogestan 100mg per month, it is his bog standard prescription for all women who are progesterone intolerant. I am trying to substitute the Utrogestan with the natural progesterone cream and this new doctor said it is worth a try. If all else fails, I will have to have a hysterectomy, this is last chance saloon.
I did have an "off the record" conversation with the gynaecologist (not Professor Studd) who said that once size does not fit all but they are not supposed to say so. All women do not need a large amount of progesterone while on HRT but doctors have to tow the party line. Some (like me) can shed the lining by using much less whereas some women may need much more (some women cannot provoke a period by taking 200mg of Utrogestan for 7 days and that is a much bigger problem than mine), it depends on the individual but they will never say this on record.
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Mary- I'd got my wires crossed,
You ARE using utrogestan?! When you wrote this-
"I am 9 years post menopause and taking 3 pumps of oestrogen gel every day which gives me periods without the use of progesterone" I thought you meant that you were having bleeds even when not using progesterone which is why I said it was breakthrough bleeding. Apologies!
Yes, if you are on a regular regime of 6 days Utrogestan you will get a regular bleed as you are mimicking a cycle. Maybe the 3 pumps of gel are giving you too much build up and that is why you are getting a bleed if you try to go for a longer cycle.
How would you feel about reducing your gel- the normal dose is 2 pumps and some women use 1 or 1.5 pumps. If you did maybe tried this - dropping back to 2 pumps for a few weeks- then 1 pump - and seeing if your symptoms got any worse, you might be able to go onto a longer cycle- maybe every 8 weeks.
You might find - don't know if you have experimented- that 200mgs of Utro doesn't give you a migraine. I get a migraine on 100mgs because the level falls too much and that starts the migraine.
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Sorry Duchess, I know it's confusing! Yes, I do use Utrogestan (which I am going to try and replace with the natural progesterone cream) but have tried to go for the long (3 month) cycle HRT several times and not made it - I get a period bang on time without using the Utrogestan while trying to go for the longer cycle. Last time, I tried scale it back and go for a six week cycle and yet again, I didn't make it and got a period again which, as I said, was the same volume of blood but because of the low progesterone levels, lasted 14 days instead of the usual 6 days - believe me, it was the real deal and not breakthrough bleeding! That is what I meant when I said that I get periods without using any progesterone.
I tried two pumps of oestrogen gel but didn't feel very good so I reverted to 3 pumps, which is what Professor Studd recommends, and felt completely normal again.
Even one 100mg capsule of Utrogestan sets off a migraine so I would not want to risk 200mg. I once tried Norethisterone 2.5mg and had 5 silent migraine attacks in one day, 4 the next and the 1 the following day, this is the dreadful effect it has on me and I simply cannot function while taking this stuff. The Utrogestan does not affect me as badly, probably because it is bio identical, but nonetheless, I want to find an alternative hence the trial run on Serinity.
Interestingly, I never had any migraines while I was still producing adequate quantities of my own progesterone.
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Hi again
Is it possible that your drs are not explaining clearly what's been happening?
As far as I know- and someone may pop along to put me right!- bleeding without using Utrogestan post menopause is not considered a period- it's breakthrough bleeding.
Again, my understanding is that the breakdown of the endometrium which results in a bleed can only happen either with progesterone / synthetic progestogens OR breakthrough bleeding. My understanding is that when we use progesterone / progestogen, it has an effect on the endometrium: it changes the lining from a proliferative phase into a secretory phase where it 'halts' the build up of the lining. When progesterone is no longer being produced (as in a natural cycle or an HRT cycle mimicking this) then the endometrium breaks down and there is a bleed.
I agree with what you have said that your endometrium must be very sensitive to the effects of oestrogen, which is why it's even more important that you find something to offset it.
Has your dr suggested you use Utrogestan vaginally? This is not licensed as such in the UK but many women on here (from my reading) are doing this. If you are seeing a consultant privately (which I assume you are to have regular scans and treatment that is not mainstream) have they suggested this?
Up thread you implied that you were using another sort of progesterone cream that was being prescribed by a dr. Presumably this is in a higher concentration than Serenity because, as someone has already posted, the amount of active ingredient in Serenity does not give endometrial protection.
It might seem a bit illogical to say try 200mgs b of Utrogestan - I can only say what works for me and what doesn't! I get migraines on 100mgs and on 200mgs I don't feel I'm taking anything. If you had no symptoms during your own natural cycles when progesterone would be much higher, it might be worth a try?
I hope you get on okay and find something that helps!
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Hi again MaryG - you found the thread! Interestingly this discussion now belongs more in the "All Things Menopause" section ::). Hey Ho!
As TheDuchess explains the bleeding is still breakthrough bleeding - oestrogen breakthrough bleeding - if you have no progesterone. if there is a lot of it (blood)then this would be of some concern. Sorry I can't remember if you've had any scans or biopsies.
Prof Studd's standard prescription is for monthly use and the 7 day course of utrogestan is the minimum he would recommend - and only under supervision with regular scans. For another doctor to contemplate less than this I would suggest is not advisable but I can understand your dilemma!. As I said right at the beginning and also re-iterated by TheDuchess you will not get enough progesterone from the proprietary (commercial) prog cream to oppose the oesrtrogen and especially with such a high dose of oestrogen.
There are private companies that produce higher dose prog creams I understand but the doses are very variable because not licensed. Also even if they were stonger, they are still transdermal and therefore could have systemic effects since they go into the bloodstream before going to the uterus ( even though avoiding the liver). As Duchess suggested and as I have used for several years - vaginal Utrogestan (also not licensed in UK but recommended by privtae gynaes and some NHS docs) - will go stright to the uterus with far fewer systemic effects and personally I would try this before using the cream.
I also would ask for a scan if you haven't had one already.
Wishing you well :)
Hurdity x
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skkb? ??? Sorry we've taken over your thread!
Back to your original post - wondering what you would want to use it for at this point?
Hurdity x
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Hurdity, yes I do have regular untrasound scans and I had one recently after this happened and all is OK and the gynaecologist, not Studd, said that I don't have any build up or fybroids or anything else. I also told Dr. Currie about it when I wrote to her telling her about my severe progesterone intolerance.
I have used the Utrogestan vaginally but even one 100mg capsule gives me a migraine the next day.
I think the next step has to be a hysterectomy, then I don't have to worry about taking any more progesterone. I'll go and have another scan next week anyway.
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Hi Mary G - good that you're having scans and the gyane said there is no build-up - as a matter of interest what was the thickness of your lining last time it was measured? What did Dr Currie advise in your consultation?
Going back to the cream - is it the commercial S brand as in the title of this thread or is it actually a higher dose cream? I know in US and in Oz too there are private practitioners who produce higher dose creams but in this case they would still be likely to give side effects I would have thought - because they need to be strong enough to oppose the oestrogen.Even so I would be concerned about using this for any length of time because it really won't provide enough progesterone to protect your womb in the same way as Utrogestan.
Personally I would try at least to continue with 100 mg Utrogestan used vaginally once a month if you can as per Prof Studd's guidance rather than risk any endometrial build-up. I can't imagine a reputable private gynae recommending the use of prog cream in this way ( at least not the commercial ones).
As well as the info on this site about not using it this way there is also this:
Caution for Women on Hormone Replacement Therapy
Some women who use combined HRT (oestrogen + progesterone) substitute progesterone creams for the progestogen component of their HRT. This can increase the risk of cancer in the uterine lining (endometrium), because not enough progesterone is absorbed through the skin from these creams. A study published in The Lancet found that progesterone creams applied to the skin don't increase the amount of progesterone levels in the blood to any significant degree and do not protect the endometrium.
http://www.heartspring.net/progesterone_cream.html
I'm not trying to be a killjoy but wouldn't want other women reading this to think it's OK to use this prog cream (as an alternative to the other progestogens) to protect the womb from oestrogen as part of HRT. Sounds like you might be a candidate for a hysterectomy although I'm sure the decision could not be taken lightly due to other health problems further down the line.
Good luck anyway :)
Hurdity x
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I don't see any harm in trying this! Your doctor has agreed and it seems you are being well looked after. I used compounded progesterone cream which was prescribed and mixed by a specialist pharmacy (I'm in canada). I found this to have far less negative effects than utrogestan but you have to apply twice daily to keep a steady dose!
Again people trying different things are basically told they are wrong! I have already read this morning that there is no need for progesterone after menopause (except of course to cause a bleed) - this is just wrong! In light of he continual negative and quite frankly unhelpful responses by some members, I will be leaving the forum. I have had lots of help over the years, but I think this is just plain irritating ....
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Such a shame.
Honeyb
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Thanks Hurdity, I have taken your sensible advice and I am now taking 100mg of Utrogestan for 7 days. I will be in touch!
Suzi, sorry to hear you are leaving and to the other ladies, sorry if I have spoilt this particular thread. I thought a discussion about this cream was a good idea because it is used with HRT regimes in the USA and, thanks to your information, Canada. I am always open to new ideas.
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Sorry you felt you had to go Suzyq. I certainly tried the cream, but was post hysterectomy. I was prepared to try it, thinking it might help. It didn't, but everyone is different.
Take care.
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Sorry if I have missed something, but why would you ignore a consultants advice and follow thoughts on a forum.
We have had this discussion before.....we can offer our own experiences but should NEVER offer medical or prescribing advice.
To be honest I would follow the experts opinion rather than be swayed from what he said.
After all the only doctor on this site is Dr Currie and if you wanted a professional second opinion then for a small charge you can email her.
Honeyb
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Honeybun, assuming you mean my decision to go with the vaginal Utrogestan, I suppose I was a bit scared off and I had to make a snap decision last night because that is when I was scheduled to start the progesterone cycle for 7 days and I feel I want to buy more time before trying the progesterone cream. I have emailed my gynae. and told her what I am doing and said that I will go for another scan after my next period which, because I am taking the Utrogestan for 7 days, will be the normal 6 day job. I want to start with a clean slate and then think again.
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The issue is you were set on your course of treatment from a consultant before you posted.
Again, I mean no offence but you have been swayed by other forum members into trying something else.
None of us are qualified to tell you what you should do......No matter what some may think.
I really believe we get into very uncertain territory when a member is dissuaded from a course of treatment on a forum.
I really don't think Dr Currie would be in favour of that at all.
Of course the decision is very much yours......but a consultant with heaven knows how many years experience......or a chat on a forum from people with no medical experience what so ever.
:-\
Honeyb
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Thanks Honeybun, I take your point. Perhaps I shouldn't have chickened out but I panicked and wanted to buy some time so thought I would stick with the Utrogestan as usual for this month and then think again. I certainly won't be trying for the long cycle again though, it clearly will not work for me. I'm not giving up completely on the Serenity idea because as I said before, it is used in the USA and Canada so it can't be that bad! That said, many doctors over here are not keen on it but as with most things medical, opinions are divided. I'll have another womb scan after the next period and then give it a go.
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I know I'm certainly going to offend some here ....but hey ho.
Listen to the consultant and not a bunch of amateurs on a forum who have no medical experience at all.
Take your time.....take advice from the expert and make an informed decision.
I wish you luck whichever way you choose and let us know how you get on.
Honeyb
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Thanks, I'll keep you posted.
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Oh dear - honeybun - do you really have to resort to insulting posts all the time? It's getting rather tiresome and Grangravy - you couldn't resist giving another dig. If you read what I say in the thread below (above?) you will see it's not personal opinion at all - the gist of what I am saying is current thinking. Also - why would Mary G or I or TheDuchess start another thread? The discussion developed out of the thread title and is relevant not just to Mary G but anyone else contemplating such a regime.
What is the point of these comments? Neither of you have offered any useful advice on this thread so why are you trying to cause an argument? I certainly don't want an argument but I am being forced to respond because of the comments being made.
Please read the thread properly in its entirety and what has been said before making such comments as "a bunch of amateurs" which I know is meant to be insulting.
Of course we are all amateurs in the medical context, but some members have biology degrees and even science doctorates - not that these are pre-requisites to being a very well informed amateur, nor having read an enormous amount around the subject, and many women are actually able to advise other women on here - not to replace medical opinion but to interpret it, or entreat women to return to their doctors when an incorrect prescription has been given - as happens regularly.
Without wanting to reproduce the entire thread - the crux of it is that Mary G said she had been prescribed Serenity progesterone cream to protect the endometrium from oestrogenic stimulation with a fairly high dose (3 pumps of gel). Very early on in the thread I quoted from Dr Currie on this site that this was not medically advised and did so again later on from another source. Endometrial protection with appropriate doses of a progestogen is the cornerstone of HRT, and Dr Currie would agree!
Mary G and I (and TheDuchess) have been having a friendly discussion about her treatment and by her own admission she was not following the advice of "the expert", a recognised private gynae Prof Studd (the consultant whom you said she should listen to honeybun) whose minimum progestogen prescription is 7 days per 28 days oestrogen - and this is for those who are progesterone intolerant, and is far less than is licensed.
We do not know the second gynae who Mary G has consulted - but I was not giving my own opinion - but echoing Dr Currie and Prof Studd's opinion and Dr C's words, which is the current medical practice.
If you are not following or not interested in the precise details of this discussion - fair enough - but please don't use it (or the fact of another member leaving however regrettable that is) as an excuse to heap insults on those who are spending time reading and interpreting current thinking and trying to help another member with the best of intentions.
Mary G - you know I wish you well!
Hurdity x
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I was not trying to be insulting but I stand by my view which is......apart from Dr Currie none of us are qualified doctors and therefore should not try and dissuade a member from following the advice given to her by a consultant.
It would seem that some think they can say what they like but dislike anyone disagreeing.
It's now up to Mary whether she takes a doctor's advice or not.
Maybe Dr Currie would agree with you but she is qualified, and :-\
I won't comment again.
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I agree Honeybun xxx love lindyloo
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Once again, sorry if I am the cause of this. All views and advice are welcome and we cannot expect to agree on everything all the time. Lively debate is healthy and must always remain open!
PS: Sorry if this is a bit Fawlty Towers-esk, but there are actually three doctors involved! I consulted a separate doctor who prescribed the progesterone cream and my regular gynaecologist (not Professor Studd), is aware of this. Thought I had better clear that up.
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Going back to the cream - is it the commercial S brand as in the title of this thread or is it actually a higher dose cream? I know in US and in Oz too there are private practitioners who produce higher dose creams but in this case they would still be likely to give side effects I would have thought - because they need to be strong enough to oppose the oestrogen. Even so I would be concerned about using this for any length of time because it really won't provide enough progesterone to protect your womb in the same way as Utrogestan.
I don't certainly don't want to add to any ill feeling on this thread, but I just thought I would weigh in on Hurdity's comments about the higher dose compounded creams in Australia, and other countries like Canada and USA. These tend to be call "bioidentical", so that is why I have often said I wish that term wasn't used on BB, which is an international site and not just a UK site, as it can cause a lot of confusion, because some women may think you are referring to compounded hormones. Bioidentical isn't a scientific term anyway, hence it's use as a marketing term in some countries.
Anyway, yes certainly these higher dosed progesterone creams are available from a small number of dubious doctors on prescription, and usually at a very high cost. They are quite controversial because not many main-stream doctors will prescribe them (for a lot of legitimate reasons), and they are certainly not recommended to be used to oppose estrogen. These are a couple of excerpts from respected menopause/medical sites. You will also clearly see that the term "bioidentical" is used for these products, and that is where the confusion comes in when regulated HRT is referred to as “bioidentical†on MM.
Incidentally I will readily admit to being an amateur, but even amateurs have an opinion.
http://www.menopause.org.au/for-women/information-sheets/34-bioidentical-hormones-for-menopausal-symptoms
Progesterone is very rapidly degraded in the human gut, liver and circulation so it has been difficult using oral therapy to maintain a level of progesterone sufficient to inhibit hyperplasia or prevent cancer in the endometrium. Progesterone can be absorbed through the skin but the amount circulating after a measured amount of progesterone cream has been applied to the skin, is insufficient to have any effect on the endometrial cells. There is some evidence that progesterone can be absorbed through the vaginal epithelium and through the buccal mucous membrane, but at present there are no reliable studies available to confirm that the amount absorbed from this source has a protective effect on the endometrium.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219716/
Women with intact uteri are prescribed estrogen with a progestogen to oppose estrogen-induced endometrial hyperplasia and cancer. Bioidentical hormone proponents sometimes recommend topical progesterone cream instead of oral progestin for this purpose. However, it is unclear whether topical progesterone can effectively mitigate estrogen-induced endometrial stimulation. Three studies have examined the ability of progesterone to oppose estrogenic stimulation. The longest study, which lasted for 48 weeks, found that transdermal cream containing 40 mg of progesterone could not effectively oppose estradiol-induced endometrial stimulation.42 A 12-week study of a cream containing up to 64 mg of progesterone found similar effects.43 The only study that found that progesterone cream (1.5% or 4%, dosed by body weight) effectively opposed estrogen lasted only 28 days, too short a time to assess estrogenic effects.