Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Hrtnewbie46 on December 19, 2022, 10:59:01 AM
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Hi all :) I’m 46 and have just fought to start on hrt after what I think is a few years of symptoms - nothing major and I coped but got the lightbulb moment a couple of months ago - armed myself with research and went along to the docs - I got oestrogen patch and utragestan 200mg to take 11 days of the month - so I’m two months in - the hair loss has reduced dramatically - my aches and pains and vaginal dryness is so much better as well as joint pain - my issue now is the side effects of the utragestan- my boobs are twice their size and quite painful for two weeks of the month - in fact from the time I start the progesterone I feel lousy - I have read from all the Knowledge on here that I can now use this vaginally ? I took it orally last night - can I just go right in and start vaginally tonight ? And would that be continued at 200mg ? Thanks 😊
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Yes you can use it vaginally. The manufacturer states 12 days x 200mg regardless of delivery method though Newson thinks you halve it if used vaginally. It may not solve the problem though, I take it vaginally and have the same problem. I have always reacted this way to progesterone, the only thing that improves it is when I don't produce any progesterone of my own.
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Ah well I’m hoping it does x thank so much for reply xxx
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BMS advise x2 per 12 days a month and same if vaginally.
I found these two documents useful. The Liverpool one is how I took it but many find it easier to use a calendar month. (I think in weeks!)
https://www.liverpoolwomens.nhs.uk/media/3548/taking-utrogestan-patient-information-leaflet.pdf
Second mentions using vaginally same dose. A few really can’t tolerate it so may do half under supervision. You anpparently absorb more locally to the womb, vaginally.
https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf
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Thank you :) I’m a bit worried as I went ahead and used 200 vaginally and now I’ve not had a bleed - last month I bled
On day 28 (2 days after stopping utragestan) now I’m on day 4 and no bleed 🙈 is this normal or have I messed it up
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Hi HRTNewbie
:welcomemm:
Perhaps tell us a little about where you are in menopause - what your cycle and periods were doing in the months leading up to starting hRT. Have you skipped periods, and is your cycle length getting longer, or shorter or variable unpredictably?
If you haven't built up any womb lining and if you are not ovulating, as well as if you are on a low dose of oestrogen, then you may not bleed each month.
You definitely haven't messed it up because if you are using the utrogestan at the right dose for the right amount of time you are using it correctly.
Hurdity x
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Thank you for the reply
So I’m 46 - periods had started to get a bit irregular just before I got the hrt - I had started to suffer with anxiety hair loss and other relative feelings and if I’m honest I would say I’ve been having issues since I was 40. I’ve just completed my second month of hrt - I know it’s early days and I’m willing to stick at it
I feel better for the oestrogen patch but I don’t enjoy the utragestan phase - I take this for 11 days each month
I have very painful boobs back and stomach ache like I’ve never had before but this month so far no bleed
Half way through this month utragestan I switched to vaginally to try and lesson the feelings - the first month I slept better ( but this didn’t last long - I’m a none sleeper 🙄) I’m on 50mg of oestrogen patch estradiol and 200mg of utragestan for day 11-26 (I find this ultra confusing ) I have an app that tells me to take it on day 17 each month so I think this is correct 🙈
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Hi. BMS and manufacturer recommend taking Utrogestan for at least 12 days, but many women find easier to take 2 weeks on/ 2 weeks off. Try this couple of more months, and your bleeding should form a pattern.
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Thank you for reply
Is none bleed Normal for you? I’m a bit worried that I haven’t had one
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You don't need to worry if you haven't had a bleed because you were taking the right amount of utrogestan though as said it should be 12 days per month - the one day wouldn't make that much difference though.
The actual days are supposed to be days 15-26 inclusive, of 200 mg utrogestan where day 1 is the first day of your bleed when you start. Thereafter you don't change the cycle to count the days from when you bleed but just carry on with the 28 day cycle regardless (though later some tweaking might be necessary to sync with your cycle).
Not sure what the app is but if by day 17 it means the 17th of each calendar month - then this is a different way of doing it - for those later in menopause who don't have their own cycle. This means slightly less is taken because it is only 12 cycles per year rather than 13, and means each cycle varies slightly in length depending on which calendar month it is. Personally I preferred to take it 4 weekly so that the progesterone withdrawal and start of bleed was the same each month - I could time it eg for weekends and not when I was working as I got migraines.
Try not to worry!
Hurdity x
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Thanks ! So what I mean by day 17 is this (I think!)
I take it from day 15 to 26 - I have done this for two months
So on day 26 I stop - then I count two days to day 28 - then start on day 15 -= 17 days ? Is this right ? The app tracks and tells me day 17 and it works out I’m 17 days off and 11 days on
I have found it really confusing - even more now I haven’t had a period
My doctor didn’t help with this either !
So day 26 for me this month was 22nd December - to try and get a more regular cycle - when would
You recommend I start taking it again ?
Thanks - and thank you for replies I’m
So grateful !
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I realise I have said day 11
I mean I do take from
15 to 26 xx
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Continue taking Utrogestan as normal, but for 12 days (not 11).
See how you go in the next 2 cycles. If still no bleeding, you may be ready for continuous regime.
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Hi HRTnewbie,
I am on a similar HRT to you. I am increasing slowly from Evorel 50 to 75 and I take utrogestan on days 15-26 inclusive.
I have a bag in my bathroom and keep my HRT in it for the month. I take my patches for two weeks out of the box (4 patches), I change them every Wednesday and Saturday. Once I have used those 4, I take the next 4 from the box and also take out 24 utrogestan. I then keep these in the utrogestan box on my pillow. That way I remember to take them every night until they are gone. After I finish them, I have a couple of days until my next patch change when I start again, it is therefore a 4 week cycle but within that cycle I take utrogestan for 12 days.
Before I started HRT, my periods occurred every three months, this continued while I was on a very low dose, when I increased to 50 patches I had them monthly for a few months then back to three monthly. As long as you are taking the utrogestan and not having unscheduled bleeding this is ok. My bleeds when ido have them arrive before the end of the utrogestan phase, this too is ok as long as it is regular.
I had abdominal pain for about 5 months after starting HRT, again after having covid, and again after increasing my dose to 50, hence I am taking it slow with this next increase. I also got pain when messing with my utrogestan to try and make my periods and the utrogestan match up, so my advice is to give it a proper go, it does take a while for things to settle, it’s not a quick fix, get your head around a four weekly plan and figure out a way to remind yourself where you are in your cycle. Two months in is a very short time to be changing things around.
Hope this helps.
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Thank
You ! That is helpful
Xx
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Hi after one more sense check before I continue on please
So I did have a period 8 days after my last progesterone pill (vaginally)
I’ve spoken to my doctor and a pharmacist - both of which have never heard of inserting it vaginally - so I’m a couple of days off my next round - I am not sure whether to do vaginally or not - I think I feel better on it but how do you know that it’s working ? If they don’t ever check your levels ? Sorry I’m boring myself but I’m just a little nervous of being off license 🙈
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It's licenced for vaginal use in the rest of Europe just not in the UK. The 200mg utrogeston capsule (the same apart from the dose) are licensed for vaginal but not oral use in the UK and only for ivf not hrt. I think this is a bureaucratic problem not a medical one. Lots of us on here use it vaginally, it's supposed to be more effective this way as more gets to where it's needed.
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Thank you ! I’m doing it then !