Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Tracey E on June 12, 2019, 07:07:52 AM
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Hi everyone I am considering starting this regime as I appear to be severely intolerant to progesterone. :( I've tried continuous, every other day and twice weekly without much success.
So I need some advice, when starting this regime do you take Utrogestan orally or vaginally?
And sharing any experiences, be it good or bad would be gratefully appreciated. :) Thanks. X
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This should only be done under medical supervision as it can lead to excessive thickening of the womb lining and endometrial hyperplasia and potentially womb cancer. Therefore regular scans are needed.
I am sure your specialist doc will advise but as this is a greatly reduced regime I would say 200 mg orally or 100 mg or 200 mg vaginally. 200 mg would give you better protection.
Also depends on your oestrogen dose - what are you using? In other words more oestrogen requires more prog as it is dose dependent.
I do it slightly differently from you for the same reasons (although not severly intolerant I don't get on well with progesterone - foggy head and fatigue when I'm taking it, sometimes migraine)- so rather than do a reduced duration I lengthen my cycle so take the prog every 5-7 weeks. This only works really for post-menopausal women and low-medium doses of oestrogen. My doc is fine with this!
Good luck and do let us know how you get on....
Hurdity x
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This should only be done under medical supervision as it can lead to excessive thickening of the womb lining and endometrial hyperplasia and potentially womb cancer. Therefore regular scans are needed.
I am sure your specialist doc will advise but as this is a greatly reduced regime I would say 200 mg orally or 100 mg or 200 mg vaginally. 200 mg would give you better protection.
Also depends on your oestrogen dose - what are you using? In other words more oestrogen requires more prog as it is dose dependent.
I do it slightly differently from you for the same reasons (although not severly intolerant I don't get on well with progesterone - foggy head and fatigue when I'm taking it, sometimes migraine)- so rather than do a reduced duration I lengthen my cycle so take the prog every 5-7 weeks. This only works really for post-menopausal women and low-medium doses of oestrogen. My doc is fine with this!
Good luck and do let us know how you get on....
Hurdity x
Hi Hurdity, I'm on 1 pump of Estrogel. Intially thought Utrogestan vaginally would be better absorbed.
I would be interested to know your regime amounts and durations etc.
I will be getting a scan after 3 months to make sure all is well too. :) X
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Just found this on Prof Studd's websute site. No idea if this is for peri or post though.
The best method of taking bioidentical hormones would in my view be Oestrogel 2-3 measures daily with the possible addition of transdermal testosterone gel and then Utrogestan 100 mgs daily for the first 7 days of each calendar month. This would bring about a regular scanty bleed on about the 10th day of each calendar month. You will find more details of this treatment for menopausal symptoms, hormone responsive depression and osteoporosis in this web site but please remember that it is not a recent American discovery. That would be too much to bear!
August 2012
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Yes he recommends an unlicensed regime, much less than is considered advisable. Fine for his patients as he will check the womb lining and order scans if necessary, and women are paying for this service, but not good to self medicate and hope for the best - best done through a doctor.
Yes Utrogestan vaginally is better absorbed (to the uterus) for the same dose compared with oral intake.
To be a bit more precise about my regime - it is 62.5 mcg patch changed every 3 days and was 200 mg utrogestan taken vaginally every 6-8 weeks - well that's what it has been. I did have some random spotting so having a scan to check all is OK (though GP). I am now experimenting with 100 mg vaginally for 11-12 days every 5 - 6 weeks because I hate the prog and also because I had a blood test (GP ordered) - the first for ages - and my estradiol level was incredibly low for someone on medium HRT and hoping it's a one-off anomaly otherwise it's not protecting me against osteoporosis very well - but that's why I am reducing the prog dose a bit. After the scan I'll see what the situation is and discuss with the doc where to go from here re dosage....the blood tests was done 3.5 days after patch change so was due to put a new one on - but still shouldn't have been as low as it was (85 pmol/l).
Hurdity x
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Hurdity do you think you have an issue with the absorbtion of the patch?
Hopefully I will be okay on the 7 days Utrogestan, it either that trying every to take it every other day. I'm so intolerant to most progesterones, either way I will have a scan to make sure all is well. X
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Hurdity. I read in a trial which I cant remember now that the highest levels recorded were day 2 of the patch. Are you getting tested again? Maybe do it on day 2.
My gynae who suggested I go to 7 days saidxi will need regular scans but it's up to my doc to order them. Do you think yearly is enough?
Also be interested to know your thoughts on if we can take anything from progesterone blood results. They always test mine but never mention them. And I cant interpret them as the rangea on my form are are pre meno and that's obviously irrelevant post. If you're taking it conti post meno shouldnt it remain relatively stable.
But it seem there is no info out there on what the optimum P blood level is to protect the womb post meno . Nor on what the balance of P to E should be on conti post meno. In terms of blood serum. Maybe I'm wrong but I think more scientific research is needed to establish this. It all seemsi lke guesswork. After all there are lots of reasons for taking E but there is only 1 reason we are all taking P. A yardstick or range of optimum levels to protect womb needs establishing It feels like we are guinea pigs.
Hope scan goes well and you get back on track with E levels.
Xx
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Would be interested to know if anyone else has success or otherwise with a 7 day regime of Utrogestan???
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Tracey E - hi.
How were you feeling on alternate days Utro? What was not good for you with this way? What_how were.tou feeling.
Side.effects? Hope you dont mind me asking that. Im.peri and on 2 pumps estro and 100mg Utro.vaginally on alternate days...and been having my own thoughts so would love.to hear.from.someone on a similar regime x
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Ladies I saw my doc today and she said if I'm going to go on 7 days I need a scan 6 monthly and I need to take 200mg. But studs regime is 100.
Tracey. Are you going to do the studd way of 100?
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Tracey E - hi.
How were you feeling on alternate days Utro? What was not good for you with this way? What_how were.tou feeling.
Side.effects? Hope you dont mind me asking that. Im.peri and on 2 pumps estro and 100mg Utro.vaginally on alternate days...and been having my own thoughts so would love.to hear.from.someone on a similar regime x
Hi Julie, I was only on every other day for a week, still very exhausted on it with muscle pain. Couldn't take it orally as it caused gastric problems, vaginally every day
was way too strong for me. :(
Now I've just started the 7 day Utrogestan regime, I am post menopause though not Peri.
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Ladies I saw my doc today and she said if I'm going to go on 7 days I need a scan 6 monthly and I need to take 200mg. But studs regime is 100.
Tracey. Are you going to do the studd way of 100?
Hi TC, yes I am. I can't tolerate too much progesterone. I will get a scan after a few months just to check all is ok. :)
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Hope you get on well with it. Fingers crossed for you.
I've just had a two week break so I'm gonna have to make my mind up soon how to restart. I can just about manage on 10 days but then between 10 and 12 things get wobbly and after 12 its hell. My only reservation about 7 days is I'm on 200 parch but my blood levels are low and even though I stopped utrogestan for a whole month recently I still didnt get a bleed and still havent.so I guess there isnt enough build up.
Hope it works out well for you x
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Hurdity do you think you have an issue with the absorbtion of the patch?
Hopefully I will be okay on the 7 days Utrogestan, it either that trying every to take it every other day. I'm so intolerant to most progesterones, either way I will have a scan to make sure all is well. X
Let us know how you get on with this!
Hurdity. I read in a trial which I cant remember now that the highest levels recorded were day 2 of the patch. Are you getting tested again? Maybe do it on day 2.
My gynae who suggested I go to 7 days saidxi will need regular scans but it's up to my doc to order them. Do you think yearly is enough?
Also be interested to know your thoughts on if we can take anything from progesterone blood results. They always test mine but never mention them. And I cant interpret them as the rangea on my form are are pre meno and that's obviously irrelevant post. If you're taking it conti post meno shouldnt it remain relatively stable.
But it seem there is no info out there on what the optimum P blood level is to protect the womb post meno . Nor on what the balance of P to E should be on conti post meno. In terms of blood serum. Maybe I'm wrong but I think more scientific research is needed to establish this. It all seemsi lke guesswork. After all there are lots of reasons for taking E but there is only 1 reason we are all taking P. A yardstick or range of optimum levels to protect womb needs establishing It feels like we are guinea pigs.
Hope scan goes well and you get back on track with E levels.
Xx
Thanks for comments Tracey E and Tc - it is strange yes! I don't want to switch the convo onto me at this point so I started another thread...
re the prog level - there is no absolute prog level needed to protect the womb because there is individual variation in how serum levels translate into acting on progesterone receptors and prevent overgrowth. The only was to do this is through trial and error when you use separate oestrogen and progesterone - starting with the licensed progesterone dose and increasing or decreasing depending on your oestrogen dose and how your body responds and knowing that it is dose dependent (more prog needed for higher doses of oestrogen).
There is some general research like there is for oestrogen doses classed as low, medium and high. You will see that some of the combination HRT products for example have different doses of progesterone for the different oestrogen doses and different prog doses for conti or sequi preparations ( but not always - but I think this is cost-saving eg Evorel conti is same dose norethisterone as Evorel sequi when they just use the conti patch for the sequi part, when in fact it could be less possibly for some women!). Thes prog doses have been arrived at through trials of different dose regimes of oestrogen and prog - but always the endpoint measured is endometrial thickness (and bleeding) and any abnormalities, as this is what is crucial - irrespective of serum levels.
The yardstick is the licensed dose and assumed to be for medium doses of oestrogen. Hopefully enlightened docs and especially menopause specialists can invidivualise the dose. We do have to be our own guineapigs to some extent - well some of us/ Ree,ber the vast majority of women on HRT won't go anywhere near forums like this and are happily taking the proprietary brands. Just tricky when you don't fit the norm or encounter problems or want to do something a bit different!
Yes you're right - levels should be constant post-meno so they don't actually need to measure prog when they do the test - this is normally to test whether a women is ovulating and not on HRT otherwise it's meaningless - although serum levels have been measrued for the various products as these are given in the Product Info on the web.
Hurdity x
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Thanks hurdity.
Dont worry about switching convo to yourself. You are always helping others. X
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Just a quick update, first month on Prof. Studd's regime. During the Utrogestan 7 day cycle I had a very slight scant bleed from day 10 to day 13. No other bleeds during the month. Still felt a bit pooey on the last few days of the Utrogestan cycle but tolerable.
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Hi Tracey E.
And how you feeling now? Im still in alternate days....4th bleed just stopping....felt pooooo last week so was thinking my own cycle perhaps kicked in.
I may start a cycle of 100mg from 15 - 26 days BUT dont know when would need to start!! Its the 15th today.....? I was thinking to just continue alternate days until the end of the month......then have from.1st august to 15th on just 2 pumps.estrogel and then on the eve of 15th start a cycle of.100mg for 12 days vag. Does a cycle have to be matched up with my own...as i dont know now where my own is !! I thi k the bleed i had last week was my period as i felt awful. I was realy hoping alternate days work.for me but these bleeds..i dont kniw if im.coming or going.....and after 12 weeks now on hrt dont feel as good as i think i maybe can.....i also feel.gutted ive 'lost' my natural.period cycle as.was also so in tune....now feel lost.
Ive posted a few times but no-ones coming to answer.......x
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Hi Tracey E.
And how you feeling now? Im still in alternate days....4th bleed just stopping....felt pooooo last week so was thinking my own cycle perhaps kicked in.
I may start a cycle of 100mg from 15 - 26 days BUT dont know when would need to start!! Its the 15th today.....? I was thinking to just continue alternate days until the end of the month......then have from.1st august to 15th on just 2 pumps.estrogel and then on the eve of 15th start a cycle of.100mg for 12 days vag. Does a cycle have to be matched up with my own...as i dont know now where my own is !! I thi k the bleed i had last week was my period as i felt awful. I was realy hoping alternate days work.for me but these bleeds..i dont kniw if im.coming or going.....and after 12 weeks now on hrt dont feel as good as i think i maybe can.....i also feel.gutted ive 'lost' my natural.period cycle as.was also so in tune....now feel lost.
Ive posted a few times but no-ones coming to answer.......x
Hi, I'm still not liking the Utrogestan, makes my legs ache in the morning. I tried alternate days but like you I kept having bleeds.
I'm not really offer with the Peri regime, but I would of thought your period would just drop into place 3 days after you finish your 12 days of Utrogestan. Tbh it's such a palaver I rang to get Mirena coil fitted tiday but they can't fit me until October. :( Staff shortages apparently not good enough really.
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Hiya again Tracey!
Yes..a palaver. Im.so confused also. My doc originally prescribed me days 1- 25 utro..which i tjen stsrted to tske vah and on alternate days.on advise of a top meno.doc. ..they both knew i was peri
.so i really do think there are some changes now to.prescribing....and alternate days utro is ok for those in peri. I was ok..apart from feeljng really rubbish last week hence me questioning if i maybe needed.more.gel......then wondered if would be better suited.to a cycle.. ..then like you.....i was just earlier.considering the coil.!!!!
Why didnt you feel great on the alternate regine, symptom.wise...did you feel tired moody etc. I dont know for the life of me if im.benefiting from hrt or not!
October for an appt for coil....omg thats so bad and yes - not good enough !! Surely must be another way?
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The reason alternate day utrogestan is not suitable for early peri-menopause is precisely because bleeding will be unpredictable.
Jmargaret - if you are early peri ie periods were still farily regular when you started HRT then cyclical is likely to be better although you will still get the highs and lows of progesterone (I presume that is the reasoning behind the alternate day ie semi- continuous - ie to minimise the progesterone crash and withdrawal that gives rise to such awful pms in many women?).
To tie HRT and the progesterone in with your cycle depends what your cycle was and if regular-ish. If 28 days then count the first day of your proper bleed (the one that felt like a period) as Day and then start the utro on Day 15 or thereabouts and take for 12 days x 200 mg.
Hope this works for you :)
Hurdity x
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Okay so I'm back in my 7 day regime, thinking of adding testosterone to the mix to try and get libido back. What gel do I need to ask for at the doctors and how much is the usual dose?
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Testogel sachets are the easiest to use. One sachet to last 10-14 days.
JP x
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Tostran is another alternative. 1 pump every other day. I have used both Testogel and Tostarn. I was told to use a sachet of Testogel over 7 days. x
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Testogel sachets are the easiest to use. One sachet to last 10-14 days.
JP x
Tostran is another alternative. 1 pump every other day. I have used both Testogel and Tostarn. I was told to use a sachet of Testogel over 7 days. x
Thank you Joan and Dotty I'll take a look. Does it work?
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Something works for me but not sure if it's the HRT (Oestrogel) or the testosterone or a combination of both x
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To be a bit more precise about my regime - it is 62.5 mcg patch changed every 3 days and was 200 mg utrogestan taken vaginally every 6-8 weeks - well that's what it has been. I did have some random spotting so having a scan to check all is OK (though GP). I am now experimenting with 100 mg vaginally for 11-12 days every 5 - 6 weeks because I hate the prog and also because I had a blood test (GP ordered) - the first for ages - and my estradiol level was incredibly low for someone on medium HRT and hoping it's a one-off anomaly otherwise it's not protecting me against osteoporosis very well - but that's why I am reducing the prog dose a bit. After the scan I'll see what the situation is and discuss with the doc where to go from here re dosage....the blood tests was done 3.5 days after patch change so was due to put a new one on - but still shouldn't have been as low as it was (85 pmol/l).
Hurdity x
Hi Hurdity, how did you get on with the scan and did you manage to balance your Estrogen to a good level? X