Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Peroxideblader on September 03, 2017, 11:01:27 AM
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Hello sorry for the headline it sounded awful but I'm seeing gp Wednesday to try oestrogel utrogestan next period and the NHS dose for peri is 200mg days 15 to 26 but seeing as I had very bad sude effects on femoston on just the oestrogen I'm thinking the progesterone will be bad too so I'm trying to eliminate the side effects and you all seem to suggest not taking it orally . However as I have an overactive bladder for over 30 years the vaginal route is risking it as I know it's higher than my urethra but weeing every hour through the night will push the pill down and maybe out so I wondered if anyone has taken it anally and how they found it success wise. Sorry to discuss bums on a Sunday lol ..
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I wouldn't have thought that it would be a problem - reading on the fertility forums it is ok to use them vaginally or rectally. My problem would be wanting to have a bowel movement straight after - just the thought of knowing I couldn't go for an hour and a half-ish would be enough to make me want to!
Taz x
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I know what you mean but sadly my bowel stopped working as it should 34 years ago so I have to use glycerin suppositories to go to the loo anyway and only in the morning so I'd take mine at night. Thank you
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I can't see any reason not to do it that way and if you do it last thing at night, you are not likely to need a bowel movement until the next day.
If you are progesterone intolerant, I would think twice about taking 200mg Utrogestan for 12 days each month because you might have side effects and I doubt you will need that high a dose anyway. This is only my personal opinion from my own experience (I take less than half that amount) and yes, I know it is against the NHS guidelines but I think the progesterone part of HRT is being way over-prescribed for most women and has been designed as a catch all for the worse case scenario because the NHS don't offer regular ultrasound scans. This is a much debated subject on here.
Obviously for those who love it or don't have any side effects it is not a problem but if you are progesterone intolerant or even just experience low mood it can be a deal breaker - side effects from progesterone are the main reason for women ditching HRT.
I would halve the dose to 100mg if I were you.
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My husband suggested the other night I should do this .
Can't see there being any difference between vaginal and anal , as like you vaginally irritates my bladder and orally makes me so weak and watery for a couple of hours almost zonked out which I don't like.
See my gynae next month and will discuss with her.
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My consultant said it was fine to use it that way. :)
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Thanks everyone I'll try it this way I think..
Mary g I totally agree I'd read and read on here about doses and when I saw my gp she'd never heard of the utrogestan so basically prescribed what I asked for which was 100mg utrogestan days 15-26 which seems to be enough for one pump of oestrogel I'll be taking. This is what private menopause clinics advise to cut down on the utrogestan side effects. Unfortunateky when I said on this forum that was the regime I was using I was told to only use the nhs guidelines of the higher dose unless I go to a private meno doctor myself . So now I'm stuck. I'm seeing the doctor Wednesday as she has to check my blood pressure and weight before she prescribes it but it was at 100mg dose...it's so confusing but like you said if I get bad effects on the utrogestan and the oestrogen like in femoston thats it for me with hrt so I don't want a bad experience
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Peroxideglader, the problem is the NHS is very rigid with a 'one size fits all' policy but they are supposed to be guidelines, not gospel. If you can't take that amount of progesterone, you can't just magically flick a switch and make yourself able to because of the NHS guidelines which, in my opinion, are OTT on progesterone doses anyway for many women. The whole thing needs to be far more flexible.
If you have a problem with progesterone, the only thing you can do is reduce the dose and then have a scan in a few months to see if you are getting adequate thinning and clearance, there is no other option. It's pointless to slavishly take too much of it, suffer when you don't need to and then end up ditching it altogether when there are other options. If I took the NHS stated dose of progesterone, I would get overthinning of the womb which would cause all sort of problems - I would have a permanent migraine too.
Obviously everyone is different and there is no guarantee you will need as little progesterone as me, you might need more, but the best thing to do is to find out how much you need and stick to it.
I hope that helps.
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I seem to think that the idea behind using Utro vaginally is that it gets to the area that it is intended for much easier, heavens knows where it would end up taken anally.... :-\ Surely it must be most uncomfortable, I would want to pop it out just thinking about it....I think the vaginal walls are somehow more muscular and perhaps absorption is also better per vagina... :-\
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Lots take medication this way,it's quite usual on the continent especially.
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Just had a quick google re pregnancy and equally effective wether vaginal or rectal , rectal can cause wind and constipation ( suffer wind anyway 🙄 ) .
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I seem to think that the idea behind using Utro vaginally is that it gets to the area that it is intended for much easier, heavens knows where it would end up taken anally.... :-\ Surely it must be most uncomfortable, I would want to pop it out just thinking about it....I think the vaginal walls are somehow more muscular and perhaps absorption is also better per vagina... :-\
The rectum should be much tighter than the vagina because you have the anal sphincter which keeps everything closed. Also absorption is much better through the walls of the rectum due to the increased blood and lymph supply and painkillers are often administered in this way if you want fast relief from pain. My son had an operation when he was four and I had to sign the consent form for rectal administration of drugs. He thought it was hilarious when he "farted blue stuff" the next morning!
Taz x
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Ha ha I bet your son loved having a laugh at the time. I agree lots of pain meds are taken this way and I don't find it any different front or back just the weeing that would push it out. I think if you've never has to use your bun for meds it must seem awful and sorry if I asked the question but it could mean I could suffer less sude effects this way than taking it orally.
And regarding the done I agree the nhs has a one size fits all and I don't know why I'm worried about taking less on hrt when over the last 10 years nearly everything I've taken I've never had their full dose ice always ended up either halving or doubling depending on the results. I can only try but when you mention getting a scan done 2 months after I start is that something nhs will do ?
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You could ask your gp to refer you for a scan,of course it's up to them if they do. I've read on here that you can get one done relatively cheap from Mothercare I think it was. In 6 months I think would be fine.
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Thanks for all your advice I'll use it anally when I do start next time I'll give it a try
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Hi Peroxideblader - you don't have to go to a private menopause doctor in order for your prescription for utrogestan to be varied from the licensed dose. However as has been said it does need to be done under medical supervision - to check that the dose is sufficient to protect the uterus.
Re anal use - I'm not sure whether any research has been done on this with Utrogestan? The other type of progesterone used for fertility and which I was prescribed for HRT before Utrogestan was available is Cyclogest (for fertility) and these were designed for rectal or vaginal use.
The key thing is whether the coating of the Utrogestan capsules will dissolve quickly in the rectum as it does in the vagina - in order to release sufficient quantities of progesterone into the system to protect the uterus.
My gut feeling ( ::)) is that you would get more from anal use than with oral use as less would be lost through digestion - but that assumes the above - ie the coating dissolves and sufficient prog diffuses through the gut wall? I also think it might be quite difficult pushing those little round 100 mg Utro balls up there as they are so small :o. Provided your doc is OK with this and will agree to scan you after say 6 months as dazned says, and a year to check your uterus lining - then no reason not to give it a try?
You could ask Dr Currie if you want via £25 consultation?
Hurdity x
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Whilst we shouldn't need to go privately as shown many times here and probably repeated across the UK, many GPs aren't up to speed or not interested in enough in womens' health over-all to be supportive. In the 8-10 mins slots allowed by the UK Government it really is difficult to get symptoms discussed, though I am extremely lucky in that my GP, nor his Staff, ever rushes me and when I'm confused, I make an appt. to go over points missed.
It is known that medication delivered via the anus is absorbed much quicker than by mouth. The tissues there are thin so uptake is almost instant.
The question has been asked; answered; absorbed and now the lady can make her decision?
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I was advised by my gyne Meno specialist that it was fine to use it anally. I would have thought that he was basing his answer on some sort of medical findings alongside his own experience in his field. Any research can be viewed/skewd different ways by different doctors depending on where they are coming from .
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...... as well as whether they are after a Research Grant ;-)
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Good post CLKD.
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I'm not sure if this gives any answers or even how scientific it is. Scroll down to "rectal route of administration" I appreciate that it is concerned with PCOS and not menopause but think the result must be similar http://www.redorbit.com/news/health/264835/different_routes_of_progesterone_administration_and_polycystic_ovary_syndrome_a/
Taz x
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:thankyou: Mary G and Taz - every day is a learning curve ;-)
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Thanks everyone and I agree going anally is not well documented but if it's that or orally I'd rather try it as vaginally is no good for me. As I've said I've had pain meds that way and it worked great. Guess I'll just have to try.
As for the Dr currie email route how can she diagnose prescribe or discuss my regime via email and what info would I need 8f I did try as I am going down the 100mg utrogestan route with only using one pump of oestrigen any higher would be too much but I'd rather have medical back up too. Has anyone successfully emailed Dr currie and how precise or helpful was the outcome
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I think others have had some success with that option.Only thing would concern me is that you have to get your own gp onboard with what she says and they don't have to I guess. :-\
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My own gp had never even heard of utrogestan so when she prescribed it she asked what dose I'd read was best so i said 100mg 11 days a month less sude effects so thats what she prescribed she said she'll go off my opinion. Which is great for me but worrying that I dictated the dose that's why I asked about Dr currie
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Hi Peroxideblader
It sounds like if your doc is listening to your idea of the right dose ( quite worrying in itself as the information is all out there if she only looked for it) then surely she would take even more notice of Dr Currie's response?
If you wanted to consult her then best to give as much information as you can but briefly eg your age, what your periods have been doing (re cycle length), symptoms, any medication you're on, what your doc has prescribed you and your concerns - (eg side effects from oral use, and bladder problems from vaginal use) and then ask your question.
I e-mailed Dr Currie about coming off HRT before having a hysteroscopy due to unscheduled bleeding/spotting and her reply was really helpful, and my doc complied - although I went to a different doc with the reply than the first one who had told me to stop HRT.
I also earlier found some info on rectal use of progesterone but didn't post it as it wasn't specifically about Utrogestan but you might find it interesting:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217976/
Again it is in connection with fertility and in vitro fertilisation - and compares progesterone pessaries (the Cyclogest ones I mentioned) used rectally and vaginally, as well as utrogestan used vaginally.
You could also maybe ask Dr Currie whether she would recommend Cyclogest pessaries but you might find your doc unwilling to prescribe this (even if Dr Currie suggests it) as it is not licensed for HRT - although my local GP prescribed this for me for 4 years as I mentioned, until I changed to utrogestan.
Interesting link Taz also - but as you say it is concerned with PCOS. What I got from it was how variable absorption is from rectal use (this would be Cyclogest pessaries, not utrogestan) - but this is the case with any HRT both oestrogen and progesterone - that there is great inter-individual variability!
Let us know what you decide Peroxideblader, and how you get on :)
Hurdity x
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Thanks everyone. And hurdity thanks for the informative post too. I might email Dr currie I'm not sure yet as I've pretty much got what I want hrt wise and what seems the best dose. I might try it and if I come across more issues I'll have to maybe try her as my gp hadn't a clue..I don't see one particular doctor you get who you're given and I've seen them all over the years and they're all totally unknowledgeable or ignorant on menopsuse..hence why my main source of information and support is on here..thank heaven for MM
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My concern with using it vaginally or anally is the dyes in the gels. I'm wondering if it's not untoward to be exposing sensitive tissues to the coloring in the capsules repeatedly like this? I doubt it's anything that's been studied.
The capsules are meant to be broken down in the digestive process with the strong acids in the stomach and other enzymes and what not. But when we use it in the vagina, the capsule is slowly melting via body heat, and staying in contact with the vaginal tissue there for an extended time - hence the discolored secretions the next morning. The 200mg capsules I get in the U.S. are a sort of brownish/red color. The 100mg ones are yellow or pink, depending on the manufacturer. It's just a thought.
I'm so hoping this is not something to be concerned about.
Anyone have any thoughts? :o
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In the UK they're not coloured - the 100 mg are pretty much white - or maybe very pale cream. The 200 mg ones were too - maybe they were cream but no colouring to my knowledge. How weird that they are brightly coloured in US! I quite agree I wouldn't want my vagina to be bathed in dyes - especially as I avoid all artificial colouring from food ( but I do dye my hair - there are limits ;D ).
Hurdity x
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Mine are pure white I cannot imagine why they would have dye in them.... :o
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So many pills/capsules here in the U.S. do indeed have some color to them. :( Tablets as well. Hurdity, they are not 'bright' colored at all, but do have a shade to them.
I don't know what the coloring is and it may be completely harmless. Unless it's a perfectly clear, see-through, translucent capsule, I'd assume some colorant is involved.
You can check with the specific generic manufacturer of your brands and see all the ingredients. That's what I'm going to do right now. This may be an end to me and natural Progesterone.
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Well, I just checked and both the 100 and 200mg gels have fd&c coloring in them. At least the brands I'm on here in the US. Just the gelcap itself - not the medication inside.
I may just break open the capsule, squeeze out the contents and smear it up there somehow!
I just can't keep using it orally as it is too hard to tolerate for the 10-day stretch. Good Lord! Can anything be manufactured in a safe way?!! LOL!
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Cassie, I agree that I can't see why they'd color the capsules. 😞 And Hurdity, I'm with you there about the hair coloring! 😊
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;D
Not sure squeezing the contents out will ensure enough prog gets to where it's needed though :-\. Personally I'd still rather dye my vag slightly than ingest the stuff though....not sure I'd want to use the coloured ones rectally either though :o
Hurdity x
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Having a good giggle at the thought of pooping rainbows.... ;D
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I thought of that too, Hurdity and appreciate your concern. I'm using 200mg and have to think at least 1/2 is getting there. I'd even use it longer if need be. I am also on a very LOW dose of estradiol - the patch is 0.0375 which is second only to the patch that's indicated only for bone density maintenance (0.025 patch).
I think I'm not even building a lining. The past 4 cycles that I've used the 10-day 200mg Progesterone (orally) I haven't even had any bleed. Just a tiny bit of brownish spotting that doesn't even need a liner. So I feel comfortable doing it this way.
I nipped off the very end of the capsule and could see the white medicine inside. I am pretty flexible (LOL) and was able to get it up into the vagina and push it against the the cervix to squeeze out the contents. I pulled the empty capsule out. Hopefully at least half (100mg) stayed. I'll see how this goes. I could go to a combipatch that has natural estradiol and a synthetic progestagen but really prefer not to go that route. Although I know many do fine with using the synthetic gestagens.
Thanks for listening! You're always helpful! :)