Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Bungo on September 10, 2022, 09:08:51 AM
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GP prescribed utrogestan 100mg for 28 days a month. I hadn't even realized and was taking every night. Only realised because don't have enough utrogestan for the final month(I got 6 months supply together). Need to go back to GP for a new 6 monthly prescription. I really really want to take every night as Im prone to insomnia and don't want to risk not sleeping those nights. Why did she prescribe 28 days anyway?Is that what
its licenced for? Most people here take every night with no break?
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Yes you take it every night. x
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Where are you in your meno journey? It can be prescribed that way so you can bleed if there's been a build up so is useful in late peri/early meno. If you're further into meno most people take it every day.
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Am 52 years, very late perimenopausal. Fsh over 70 each time and LH over 30.. I've had a light period on month 2 and 3 and very occasional spotting but that's settling and anyway didn't bother me. So my body did what it will do, regardless of not having had the 3 day break. So I can't see what can't continue taking nightly with no break.
I no longer have spikes in oestrogen ,.these stopped 2 years ago . Have had peri symptoms since I was 45 years
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You could speak to your gp but I think she's right in the way she prescribed it. The problem is that you don't know if your lining is building up unless you have a scan to check. IMO it isn't worth the risk though of course it's up to you and your gp.
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You could speak to your gp but I think she's right in the way she prescribed it. The problem is that you don't know if your lining is building up unless you have a scan to check. IMO it isn't worth the risk though of course it's up to you and your gp.
But doesn't newson recommend that even peri women move to continuous after 6 months or a year? I didn't bleed for 10 years on cerazette ( I stopped that in May) and that was ok so can't see how this is different..I'll have to pay to see a menopause specialist if GP won't prescribe without a break . Fingers crossed. I had a scan in Feb and had some small fibroids so was going to ask for a scan early next year anyway to ensure hrt isnt causing the fibroids to grow. So maybe that will reassure her enough to allow me continue taking nightly..The lining would hardly grow that quickly in 4 months?
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There are areas where newson and the nhs disagree. She starts people on high doses of oestrogen and gives them T straight away, the nhs gives you a lower dose and increases only if necessary. They don't prescribe T until oestrogen levels are optimum. Newson says you can halve the dose if utrogeston if used vaginally, the manufacturer disagrees. Not sure who's done more testing but I suspect it's the manufacturer. Her patients are private so probably having regular scans anyway. BCPs work differently from hrt as they don't allow the lining to build up so it doesn't follow there will be no build up on hrt. There must have been some as you've had 2 bleeds plus spotting unless it was caused by the fibroids. Moving to conti after a year may be OK for some women but for others it's too soon. Perhaps she's being cautious because you don't know what your periods would be doing if you hadn't been on the pill. Hopefully the scan will show no thickening and she'll agree.
Have you tried stopping utro for 3 days? It may not be as bad as you fear. Insomnia was one of my worst symptoms but it was due to oestrogen deficiency and went after 3 months on hrt. Is yours is too you may find you no longer need utro to help you sleep.
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That's interesting re newson. .I'm just too chicken to stop using the utrogestan even for a night..I've had months of insomnia triggered by just 2 nights of poor sleep. I thought even post menopausal women could have bleeding until the settle on continuous? My GP is clueless to be honest. Is utrogestan continuous regime meant to be 28 days, wondering where she plucked that no of days from. She's on maternity leave now so I don't know what her locum will give me. I know I should try without for a few days but I'm so scared.Insomnia is suggestible so I know just thinking it will cause insomnia means it will. I was almost suicidal 3 years ago when couldn't sleep for months, even sleeping tablets couldn't cure the insomnia I was so far gone..I'd prefer go for ultrasound every 6 months
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Hi you can use Utrogestan continuously whether you are in peri or post menopause. The only downside is that if you are in peri then you may get irregular bleeding.
The guidance is to start continuous HRT when you have been on HRT for a year….you are right on that.
The old guidance for post menopausal use of Oestrogen was to take it for 25 days out of 28. The up to date guidance is to take it every night in post menopause. x
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https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf
This document might help you x
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Thanks Dotty. I'll show that article to locum GP. I'm getting myself all worked up now that I'll be made change to sequential or not allowed also have Vagifem etc . I'm settling into the current regime and loath to change it until need to. And hopefully won't ever need to!
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There’s no reason why you can’t take it continuously. Good luck x
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So it's just the unscheduled bleeding that's a problem and the inconvenience of same, as opposed to any actual risks to womb?
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And just to clarify, continuous technically is 28 days a month but most women take the 31 days with no break..I think my GP was going with the technical/licenced continuous regime and that's why only gave for 28 days.
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Continuous used to be to take 25 days out of 28 so a 3 day break, but up to date guidance is to take it every day.
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https://www.newsonhealth.co.uk/wp-content/uploads/2021/07/Micronised-Progesterone-or-Utrogestan-March-22-update.pdf
Dr Newson’s guide
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The PIL for utrogeston says 25 days in each 28 day cycle
Continuous used to be to take 25 days out of 28 so a 3 day break, but up to date guidance is to take it every day.
Not according to the PIL, that says 25 days out of 28. Newson says every day for those who are menopausal (1 year without a bleed) but Bungo may still be peri. Have you found any studies that show peri women taking it every day have no build up? Or is it unknown so still possibly a risk? Perhaps I'm wrong but I expect Besins to have tested their own product thoroughly to get it licenced so should know more about than newson.
The BMS says that after a year you can 'attempt' to go on conti - that isn't the same as saying you can. It goes on to say some will have to stay on sequi for longer.
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Hmmm ..I wonder what the reason for 28 is. I mean if anything, having a 3 day break is going to cause even more lining build up as unopposed oestrogen .
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Hi Bungo,
As I understand from the PIL and other threads, with utrogestan everyone is treated as though they are on a 28 day cycle of medication, whether peri or post-menopausal. Rather than monthly. Perhaps my misunderstanding... please will someone with empirical knowledge correct if so.
So if you are post-meno (and have no negative reaction to micronised progesterone) - prescribed for 25 days from 28 at 100mg (assuming estrogen less than 100) ie 3 day break. I can't speak for anyone else but this has not resulted in a withdrawal bleed for me, although it could do if the womb lining had built up and needed shedding.
One can choose to take it continuously ie no break in each 28 day block if post-meno.
Cheers, Chucklesista x
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Does anyone know answer to Sheilas question "Have you found any studies that show peri women taking it every day have no build up? Or is it unknown so still possibly a risk".
I thought taking it each day prevents buildup and the only reason to not was in case of irregular/unpredictable bleeds.
I'm in Ireland and know from a support group that some peri women with egendometriosis are prescribed continuously. I'm dreading seeing the locum doctor now
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Hi Bungo bleeding can happen on continuous use of Utrogestan even if post menopausal….the advice then is to take 200mg of Utrogestan daily to stop the bleeding and prevent build up of the lining.
I can’t answer your question and I don’t think anyone without medical training can. All I would advise you to do is to read the advice from the British Menopause Society. xxx