Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Blue Kingfisher on April 28, 2019, 06:55:21 AM
-
Ok, trying to keep some perspective on this but struggling.
I'm only on day 2 of taking Utrogestan 100mg oral capsule at night inserted vaginally. I've had 2 doses. Had to go to bed at 8:30 last night & have just forced myself out of bed at 7:30am. Feel like I'm in a complete coma & just want to sleep!
I don't understand why I can tolerate the Utrogestan 200mg pessary a lot better than the 100mg oral Utrogestan (again taken vaginally) when the progesterone is supposed to be double the amount ??
Wondering if I should go back to the 200mg pessary or stick it out with the 100mg progesterone tablets for longer. If I'm experiencing over whelming progesterone symptoms now on the tablets after two doses......I'm wondering if this is likely to improve with time or get worse with the progesterone building up in my body?
Ive been moved from 7 days on the pg 200mg pessary régieme onto continuous HRT with the 100mg tablets (used vaginally) but I'm already beginning to wonder if I should at least go back to the pessary. I'm feeling so bad I'm considering starting the 200mg pessaires tonight & then worrying about how long I should take this for when I feel l can function! Is it even worth asking the gyne if cutting the pessary in half for continuous HRT is an option?
Now I know why people say they feel they can't drive etc when having this progesterone coma!! I do NOT feel human!! :'(
-
Hi Blue Kingfisher,
if the other regime suited you better you can always go back to it. Why dd you change, if it was working well? You haven't been on the new regime very long and it might settle in time? But that is no consolation when you feel so crap. I wouldn't cut the pessary in half as you may not get enough in the dose. I hope you feel better soon. Someone may come along who has been in the same position soon.
Peppermintyx
-
Hi Pepperminty & thank you so much for replying. I felt good for half of my cycle on the 7 days 200mg Utrogestan pessary routine with 5 pumps of oestrogel but terrible with crashing fatigue from day 5 of my cycle through to day 15 of my cycle. I say ‘cycle' having no idea if I still bleed naturally as only 50 years old but been on HRT for about two years. I count day one of my cycle on the day i start bleeding (was always 3 days after stopping the progesterone).
Having looked around at other posts it looks like an option could be to take the 100mg tablet vaginally every other day & consider increasing my oestrogel back to 5 pumps daily (gyne suggested I start by reducing the oestrogen dose to 4 pumps). I absorb oestrogel badly which I why I have been on 5 pumps daily.
Not sure whether to try:
A) sticking with 100mg daily & increasing oestrogel back to 5 pumps
B) taking the pg every other day & staying on 4 pumps oestrogel
C) taking the pg every other day & increasing oestrogel back to 5 pumps
D) going back to 200mg pessary & 5 oestrogel pumps immediately & then reviewing
My concern with taking pg every other day is will it just confuse my body even further & I won't know if I'm coming or going? This morning I tried option A) 5 pumps oestrogel as opposed to 4 & I ‘think' this is slightly more comfortable but it's early days & I could crash & be back in bed within half an hour for all I know so I will just have to see how the day pans out. One things for sure though, I feel under extreme pressure to get this sorted. I don't feel well enough to work & if I lost my job it would be financially disastrous & affect my whole family. I couldn't work last week due to hormones, trying to fix this now with this continuous régieme & terrified I'm going in the wrong direction. :'(
-
You said it yourself "Confuse my body further". The body doesn't get where it is suddenly so it stands to reason that any HRT will need to be absorbed to improve symptoms. Which may take a while.
Maybe keeping a diary would be helpful to chart feelings and any progress? This fatigue needs to be investigated, unless it is absolutely related to the HRT. Thyroid function, low VitD levels can cause associated tiredness. Make sure that you keep well hydrated. And be kind to yourself :foryou:
-
Thank you CLKD, I think you are right of course. I'm not being rational at all. I will try taking the 100mg pg earlier tonight say 6pm in the hope that the side effects have worn off a bit more & I can go to work! I just don't understand why I feel ok on the 200mg pg pessary & not the 100mg tablet taken vaginally. But like you say, I didn't get here overnight so I can't expect to be in a better place overnight. Will keep persevering to try to get to a more comfortable place xx
-
The 100mg is an oral tablet. It's spherical. The gyne (I'm under the Studd clinic) was very specific that I should use the oral 100mg oral tablet vaginally. He said they find it works better for patients. I think I'd rather try a 100mg pessary though as I do ok when on the 200mg version. Perhaps the oral version are absorbing too well for me despite it being half my usual pessary dose??
-
Stella Jane, are you saying you can get pg 100mg in pessary form? If so this might be the answer for me. I feel so much better on the 200mg pessary than the 100mg oral tablet taken vaginally! But that was just taking pg for 7 days so for a continuous routine which has been suggested I try...the 100mg pessary might be better.....
I HAVE to try the 200mg pessary tonight, I can't even explain how BAD I feel!
-
Hiya ladies. I didnt know there was a pessary.
I had trouble with thec100mg oral pill falling out when I used it vaginally, probably because i wee so much during the night.
I've had to stop it altogether now after 5 months continous oral without even the 3 day breaks. Its built up so much in my system its intolerable.
I'm intending to restart on a 14 day cycle which will mean 200mg doses. I had assumed that meant taking 2x100 pills. Do ladies insert 2 of the 100 pills vaginally. Do you know if the "pessaries" are different to the "pill" and whether they are NHS available please.? They might not "fall out" as easily and I dont fancy taking 200mg orally.
X
-
How much do your own hormones interfere with the HRT though?
-
In my case they dont interfere at all as I've lost my ovaries. You would think that makes things simpler wouldnt you? Apparently not so :(
-
I think that hormones are also produced from somewhere else when ovaries are gone :-\. Wouldn't it be nice to have see-through bodies so that we can actually watch what is happening ;D ..... it would solve so many issues ::)
-
It sure would. Adrenals and fat cells produce small amounts but I guess its individual as to how much. I've often wondered if the reason some ladies fair better on no or low hrt after ovary removal is because their adrenals are functioning better than others.
Stellajane thanks. Dont worry I can easily confuse myself all on my own!!
Shame the pessary isnt available. I wouldve liked to try it. When I put the pill in vaginally I found it on the toilet floor completely whole the next day. Just glad the cat didnt eat it!!!
-
Hi BlueKingfisher,
as you also changed the dose of estrogen, it may be difficult to know whether it is a combnation or that alone. It is horrible worrying about your job. Can you work from home if you need to? Most good employers should be supportive whilst you are adjusting medication.
It can take a while getting it right. If you feel that trying regime at the moment is too stressful, perhaps go back to what you know, although not perfect, and re group mentally. Can you explain to your employer that you are having to adjust you medication and this may cause a few issues, so you may need a bit of support? Do you have an occupational health department ?
Trouble is you don't know what works and what doesn't until you try and then it can be variable until your body adjusts. Also tell your family that you need a bit of support too.
Crap isn't it!
Anyway, once you find what works, please update on your progress.
PMX
-
I've been on the 200mg progesterone pessary for HRT for approx 2 years. Was prescribed this under the Studd clinic. I feel good whilst on the 200mg pessary but terrible on the 100mg pg oral tablet used vaginally. They've put me on the 100mg pg continuous routine as I felt terrible on days 5-15 of my menstrual cycle so we are trialling if I need a continuous dose of pg. I might indeed need more pg but I can't tolerate this oral tablet version at all! Back to the 200mg pessary for me tonight & will take it from there. I'm still not clear if you can get a 100mg pg ‘pessary' does anyone know?
I think the way the pessary dissolves or absorbs is much more tolerable for my body.
-
Having looked around, it looks like there is either 100mg progesterone oral tablets (these are spherical) which you can also use vaginally OR 200mg vaginal pessaries which come with vaginal applicators. The 100mg tablets (taken vaginally) feel disastrous for me, I feel like I'm loosing my mind! I had no idea that the 200mg pessaries weren't normally prescribed for HRT.....! The side effects are significantly less for me.
-
This is the third thread this eve I have posted this same info - think we need a sticky post as it is understandably so confusing!
Stellajane has said all of this already in her post, but in view of your last couple of posts I will say again as you won't have seen them!
Until a year or two ago you could get:
1 100 mg utrogestan capsules (they're not tablets but little round balls of micronised progesterone) - licensed for oral use in UK as part of HRT.
2 200 mg utrogestan capsules - oval shaped, licensed for oral use as part of HRT (normally cyclical use)
3 200 mg utrogestan capsules - exactly the same as the above number 2, but with applicators and a different leaflet, licensed to be used for fertility.
Option 2 was withdrawn a year or two back leaving the 200 mg version as only produced for fertility and the 100 mg only produced for HRT.
The French medicines info gives only these two but they are both described as for oral or vaginal use, and the prescribing info gives how to use them for fertility and for HRT (well it does for the 200 mg ones). Not sure if you would want to insert 3 x 100 mg or more little balls for fertility :o !!!
It could be that you are absorbing more systemically from the 100 mg ones although difficult to imgaine that 1 x 100 mg would give you more than 1 x 200mg. The different surface area (say for 2 x 100 mg compared to 1 x 200 mg) and possibly slightly different thickness ( if there is one) of the outer capsule shell - could be one explanation for the difference?
The most important function of the progesterone is to protect the endometrium so you need to use whichever does this best for you. Unfortunately a byproduct of vaginal use is greater systemic absoprtion too giving the side effects. It does mean that a lower vaginal dose can sometimes be used compared to an oral dose but if you are on a high dose of oestrogen then it needs to be adequate to keep the uterus lining thin. However as you say you must be ab le to function and work so a compromise might be needed.
Some women can get their doc to prescribe the 200 mg fertility ones for HRT - because they should know they are exactly the same....
Hope this doesn't sound too garbled BlueKingfisher! As CLKD says you need to give each option some time - for example you might actually settle down with the 100 mg continuous use - sometimes it's worse for me at the start and then I sort of get used to it, and sometimes it just hits me straight away - the prog surge!!
Incidentally there are pessaries/suppositories for fertility not licensed for HRT called Cyclogest and you might want to ask about these although Utrogestan seems to be more favoured. They are taken at twice the utro dose ( although you don't get twice the dose). They are waxy pessaries so the stuff takes longer to ooze up through the cervix. I used these for 4 years before starting Utrogestan.
Hope this helps :)
Hurdity x
-
Thank you Hurdity and everyone else who has used up their personal time to help me! I am hugely grateful. I've no idea why the 100mg micronised progesterone pills make me feel so ill & the 200mg vaginal pessaires make me feel good. I can only think it makes sense to go back to the 200mg pessaires from tonight, give it a few days to settle & then consider my options such as increasing the amount of time I'm on them (I was only on them for 7 days a month).
I will see how I get on tonight but I can still feel the progesterone surging around my body from the micronised version so it will take a few days to run the side effects of this down. I will let you know how I get on as I hope this experiment might help some other women who really struggle with the micronised version.
Thank you again, I can never thank you all enough for the selfless help you have given me, even thinking of occupational health etc at work which I will ask about as soon as I'm well enough to be back in the office.
Xxx
-
Just to add - all of the capsules 100 mg or 200 mg, both of which can be used orally or vaginally - contain micronised progesterone - it is exactly the same stuff in them just different dose!
I hope you are feeling better today :)
Hurdity x
-
Hi,
sometimes a small shift in what we are doing HRT / medication wise and indeed other ways which can have a monumental effect on our body/ mind and throw things out of skilter and it sems to take ages to get back to the previous norm.
PMX