Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Cee on October 18, 2018, 01:23:33 PM
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Hi all
I am 54 and menopausal, not had a period for about 2 years+. I have been on elleste and while I was fine on the oestrogen part, I was having a bad time on the progesterone. So my doc prescribed utrogestan 100mg and Elleste solo 1mg. She told me to take one of each every day. But I am very confused as when I picked it up from the chemist, the label on the utrogestan box says 'one to be taken daily on days 1-25 of cycle' I am not even sure what my 'cycle' is anymore. I am waiting for some advice from the doctor but don't now if I am doing this correctly.
Also the leaflet says not to take utrogestan on an empty stomach - so I took it at night - does this really matter? I would rather just take it in the morning with my breakfast as usual. When I took it last night I could not wake up at all this morning, can it really make you that drowsy? If so, taking it in the morning would be no good for me and work. Thanks for any advice.
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So Cee, when I was put on a continuous cycle of Utrogestan, I was told to start whatever I was changing to on the 1st of the month and then to count the days from there. It is not based on "your cycle" as you don't have one anymore.
In terms of taking the utrogestan - if you take it orally, it is usually recommended to be taken at night as it can have a "sedative" effect on some women, so that is why you had trouble waking. If you take it around 9pm that may help. What time did you take it last night? However, some women on here have a real problem with progesterone altogether and they may insert it vaginally. Some Dr's do not know it can be taken this way but hundreds of women on this forum do it and up to date consultants recommend that it can be taken this way. That is how I take it.
It stops any stomach problems that taking progesterone orally may create and also there is no dilution as it doesn't go through the stomach and be processed by the liver. It is "delivered to site" so to speak!
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Hi Cee.
Yeah it really does make you that tired, that's why most women take it at night time, or they use it vaginally, apparently they don't get any side effects from it that way. But I didn't want to use it that way, so I stopped it. Went back on femoston,.
Your doctor must think you're post meno, because he/she told you to take everyday.
The Utrogestan does say to take 1-25 day cycle, but it's ok to take every day as well.
As long as you can tolerate progesterone everyday, I can, and some women can, but others can't. My understanding was you took the Utrogestan on an empty stomach.
So as long as you don't eat anything for two hours, so, I would have my main meal at about 6pm, then take the Utrogestan two hours or so later. Then 1/2 hour later the tiredness would kick in, with a little bit of dizziness too, but that only lasted for about an hour so.
Hope this helps....good luck..
Jd xx
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Thanks all, so I took the utrogestan at night and the oestrogen in the morning. Not sure that's right but at least I'm not tired at work. Also the oestrogen takes away most of my joint pain. Anyhow, 3 days in and now I have a bleed. Is this to be expected? Just not worry and carry on? Many thanks for any advice
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Many thanks for your speedy response sister. I will do a search here also.
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Hi again, I did a search and accepted thst I may have a bleed. However I'm on my 4th week and have now bled for a week ( not spotting ) then no bleed for a week and now I bleeding again, like a period. Just carry on and wait for this to settle down?
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Hi Cee - Yep - I would carry on and wait to settle - your body is re-adjusting. Irregular bleeding can be a feature of a new or changed regime especially on a continuous cycle as you have been prescribed, it is more likely. Settling can take 3 months or sometimes more.
The utrogestan at night and the oestrogen in the morning is the usual way to go and its good to hear the tiredness at work has been sorted.
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Thank you
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Hi Cee
Your bleeding pattern is similar to mine, although I was still doing a sequi regime - ie 200mg Utrogestan for 12 -14 days a month, literally within four days of taking it I would bleed, then I would finish the 12 days, and within a week would have another bleed 😐
I found this with norethisterone too. And on Femoston 2/10, would start bleeding within the first couple of days on the progesterone part 😐😐
Speak to your doc about trialling it vaginally, many ladies on here do this, (you'll only need to use 100mg as well I believe) and have great success with it. As for me, I've decided to trial a Mirena with patches, just really would like no bleeds now xx
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Hi all
I need some advice again please. As the bleeding continued, they did a ultrasound scan and said my womb lining had increased. I am having a hystercopy next week and now they are talking about inserting Mirena for 4 years, if I want. I am anxious about this as I don't like the idea of something inside me, also it seems that I will be on a progesterone that is like the synthetic ones and of which in the past, I have had reacted badly to. I feel so fed up with bleeding, going to the doctors all the time and now to have something put inside my womb. I don't know what is best for me even though I have read the threads on here about Mirella. I cannot make up my mind. I feel like just stopping all the HRT and just going natural. It's not as if on the HRT, I feel that much better anyhow (apart from stopping hot flushes). Just to clarify I am using Elesete solo 1mg and Utrogestan daily.
Thanks sisters for any advice.
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Hi bleeding can be expected for 6 months when starting any new hrt regime. So the advice would be to wait 6 months to see if it settles x
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Thank you but they seem to be saying that I cannot continue on the current HRT that I am using and that the next step is the Mirena inside me. This is due to the build up of my womb lining. I have tried various progesterone over the last two years, femostan, patches, etc. I was quite happy on the Urtogestan.
If anyone else has some advice I would be grateful. I honestly feel that the doctors don't really know.
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If you are getting on with the utrogestan, is it possible to just reduce the amount of estrogen you are using to see if that helps reduce the uterine lining? Sorry, I don't know much about all this but it seems like that would be an option to me...
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Cee - you can carry on with whatever hrt regime you wish as long as you make a good case for what you want to do. As Bluebutterfly says both utrogestan and oestrogen are flexible when used separately. Less oestrogen ensures that the lining doesnt build up in the first place. If things are working to an extent then it really only tweaking the system that you are currently using rather than going the whole hog and throwing everything out.
You need to be asking what you can do to ensure you get a good bleed to remove the lining and if as Birdy says if you were not good with synthetic progesterone before, having it permanently "on tap" so to speak in a Mirina may well not do your head much good.
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Thanks Ladybt28 and Bluebutterfly, it is good advice. I will ask when they are doing the hystercopy what I can do do ensure I get a good bleed.
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hi Cee,
reducing the oestrogen may help, with the lining build up and break through bleeding . why not try a trandermal patch? start with the lowest dose 25mcg and see if that helps control the flushes. I started with a 50mcg patch but found that it caused occassional break through bleeding so I gradually reduced the patch size by carefully snipping ( measured) bits off. Am now down to 37.mcg patch ( changed twice weekly) and all is well , for now!
I use urtogestan 100mg every night vaginally , no probs with that either used this way.
hope this info is helpful.
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Thank you Traceylr, that's also good advice. I love this forum, women looking out for each other.
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Hi Cee
As has been said - it is your choice which and whether HRT you decide to use/start/stop.
When I had a hysteroscopy due to unescheduled spotting the gynae also tried to persuade me to have a Mirena fitted at the same time - which I declined.
Also as has been said you are supposed to give a new HRT 6 months to settle - although if an increased lining (thickness) has already been identified is responsible for your ongoing bleeding prior to 6 months having elapsed then you will need to sort out a regime to make sure it stays thin.
In terms of stopping bleeding and reducing the womb lining - you have several options, some of which have been outlined: increase oestrogen, decrease progesterone, change the delivery method of progesterone.
As Traceylr says and as advised when you first posted - when used vaginally, progesterone is more effective - in keeping the endometrium (womb lining) thin. This could be the first option - used daily or Days 1-25 so that if it does build up you could potentially bleed/shed after you stop for 3 days per cycle. So that's one option. You can also try taking the utrogestan with food ie at the same time as your evening meal. This increases bio-availability so theoretically should enable greater absorption of the progesterone dose you are taking.
The other suggestion which not sure if it's been made - is to change from taking it continuously to having a cycle. Eventually this should shed the thickened lining but in a predictable manner. You would double the progesterone dose (to 200 mg) and take it for 12 days per cycle (possibly 14 to start with?) - ideally vaginally. OK you would have a monthly bleed but hopefully your worries about the lining would evaporate along with your lining!
It's also been suggested that you reduce oestrogen - this may stop the womb build up but not necessarily deal with your flushes. Also the lowest doses do not give the same protection against osteoporosis. It's a good suggestion to change to transdermal HRT at some point but as you are still young - if you are happy with the tablets then at this point no need to change I would have thought.
To ensure you get a good bleed? Not sure if you mean as a one-off or regularly. If your lining is very thick then a course of progestogen might be advised eg norethisterone - for two weeks or so to "strip" the current lining and then you can start again on whatever regime you decide - eg by tweaking the one you are on. Otherwise then changing to a cycle with a larger dose (or longer duration) of progesterone would enable thinning too.
Not sure if this has been mentioned but bleeding can also be caused by fibroids or polyps but I guess these might have shown up on your scan?
Hope these additional suggestions are helpful and let us know how you get on.
Hurdity x
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Thanks for all the advice, I'll let you know how I get on
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Hi sisters
I went for the camera in the womb scan and it was good news. My womb lining is fine and they did not do a biopsy. So I'm having a chat with doctor this week but I was told by the hospital that if I wanted I could continue on the utrogestan and elleste. Thanks all x