Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: shoppingqueen on January 22, 2023, 06:14:53 PM
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Hello ladies
I have been trialling Provera but it isn’t suiting and I absolutely can’t tolerate utrogestan. I’ve tried several times. I’ve also had issues with a coil so don’t want to go back to this.
Would my GP prescribe Cyclogest do you think or is it mainly done through a specialist? Also, is it actually different to Utro or just the same repackaged?
Any thoughts be gratefully received, as always
SQ x
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Hi there,
Not sure about your area but GP in Scotland not allowed to prescribe without instruction from consultant.
I get Cyclogest on nhs but have to pay privately for meno consultant every 3 months to approve prescription for GP.
Utro made me crazy and Provera gave me migraines. Cyclogest is the only one I can tolerate, been on it for quite a few months now.
E x
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Thanks E
That’s really helpful. I have a private Endo for thyroid and I know he would prescribe HRT etc as I get Testogel via him so I’ll ask. I’m the same with utro. It changes me. I hate it. And provera is the same- the headaches and migraines even on 2.5.
Thanks for helping xx
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It might be worth speaking to your gp. I think it's only licenced for ivf not hrt but I think some people have got it (may need a specialist but you have nothing to lose by asking)
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Thanks Shelia99!
I’ve got to try as honestly I can’t NOT have HRT, but really can’t cope with what I’ve tried. I did well on Femoston 2/10 3 years ago but I do know it won’t be enough estrogen for me. I’ve even thought of trying thst and doubling of doing a 2/10 and 1/5, but I’d have to source one via private prescription and I’m also loathed to go to left field. Xx
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shoppingqueen, you should be able to get hold of Cyclogest because it's a pretty bog standard, inexpensive form of progesterone. As you probably know, it's a wax vaginal pessary that you can cut into tolerable doses. I think I paid less than €10.00 for it.
Failing that, you said you did well with Femoston but it didn't contain enough oestrogen so you could take that and top up with Oestrogel or a patch.
I used Angeliq oral HRT in the past but I also found it didn't contain enough oestrogen and was top heavy in progesterone so I topped up with a 50mg oestrogen patch and it worked well. I had regular uterine scans and my womb lining was well below the 5mm danger line.
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Hello Shoppingqueen
I use Cyclogest and it is prescribed privately from Newson Health Menopause Clinic. I was told that it is usually used for IVF.
I get on very well with it, I cut the pessaries into the desired dose and use it alternate nights.
I hope this is helpful and take care.
K.
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shoppingqueen, you should be able to get hold of Cyclogest because it's a pretty bog standard, inexpensive form of progesterone. As you probably know, it's a wax vaginal pessary that you can cut into tolerable doses. I think I paid less than €10.00 for it.
Failing that, you said you did well with Femoston but it didn't contain enough oestrogen so you could take that and top up with Oestrogel or a patch.
I used Angeliq oral HRT in the past but I also found it didn't contain enough oestrogen and was top heavy in progesterone so I topped up with a 50mg oestrogen patch and it worked well. I had regular uterine scans and my womb lining was well below the 5mm danger line.
Thanks so much MaryG. It would be an option to go back to the Femoston and top up. In my later months on it I did add a pump of gel. I think your idea of my getting regular TV scans will be my best option. So plan one is to try the Cyclogest and if this doesn’t suit it’ll be back to the tablet and top ups. It really helps to hear there may be other ways! Thank you xx
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Hello Shoppingqueen
I use Cyclogest and it is prescribed privately from Newson Health Menopause Clinic. I was told that it is usually used for IVF.
I get on very well with it, I cut the pessaries into the desired dose and use it alternate nights.
I hope this is helpful and take care.
K.
Thank you Kathleen this is very encouraging so I need to see if my GP or the private Endo will do a script for me 🤞 I’d like to try it first before switching back to tablets and a top up via patch or gel so o now have a plan. Thank you so much xx
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Hoping to ask if anyone knows if cyclogest is likely to have less systemic effect if taken vaginally or rectally?
My understanding is that both ways bypass the liver but just hoping to understand via which route less would get into the general bloodstream? Thank you!
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Hello Toughtimes and welcome to the forum.
I use Cyclogest and as you know it is a progesterone pessary. I understand that it is to be used vaginally and I have never heard of it being used rectally. I think the delivery method is about getting the drug to the uterus rather than just into the blood stream. Perhaps look at the Patient Information Leaflet if you have one.
As you may know the pessary is mainly used for fertility treatment and again I assume that it needs to be near the uterus for that purpose. I could be wrong of course and hopefully other ladies will be along soon to advise you.
Wishing you well and take care.
K.
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Thank you - yes either way of taking is fine but as I have limited scientific knowledge and keen to minimise progesterone side effects, was wondering if vaginal has less side effects as gets more directly to uterus ie less gets into overall blood stream than if use rectally.
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Hoping to ask if anyone knows if cyclogest is likely to have less systemic effect if taken vaginally or rectally?
My understanding is that both ways bypass the liver but just hoping to understand via which route less would get into the general bloodstream? Thank you!
Hi TT,
I use it rectally as I found it too messy vaginally. I also had cramps using it vaginally but I think both methods are equally effective. I never noticed one being stronger in effect than the other.
This has certainly suited me better than any other oral prog.
Ex
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Hi ladies
So an update. My private Endo has agreed to supply the prescription and the associated chemist has received- Cyclogest is on its way.
I was given a choice of 400 or 200 pessaries so went for 200. Could I ask Evie and Kathleen what dose you take and how much estrogen you are taking. I’m on 3 pumps of gel so wondering what you are dosing at?
Thank you as ever for help and thoughts xx
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Hi shopping queen, this wasn't a question to me but hope you don't mind if I answer anyway! I am at Nick Panay's clinic and prescribed 200mg x 12 days per month. Best of luck with the cyclogest!
Hi TT
Thank you for helping! I did insert 100 rectally last night- slept like a baby so not sure if it helped? All ok this morning so fingers crossed! I’ll do a week at 100 to adjust then go to 200 for a week. I’m sure 200 should be enough shouldn’t it as looking at the BMS sheet it states same dosage for utro and cyclogest. Thank you for your good wishes! Kept me posted as to how things go for you. Let’s hope all good xx
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Sorry TT
I meant to ask what you use dosage wise for your estrogen? Hope you don’t mind me asking xx
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Of course estradot 75. I am finding the cyclogest makes me quite drowsy during the daytime - does anyone have any tips to overcome this? Am taking it early eve.
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Thanks TT that’s reassuring that N Panay has said 200 cyclogest 12 days with the 75 patch so likely I’ll be around the right ball park with my 3 pumps. I’m planning on doing this for 3 months and then getting an ultrasound to check the lining at that point.
Hope someone can help with the day time tiredness. I think I’ll follow you and take mine early eve as well to see if this helps. I’m not complaining about my long deep sleep last night as I often experience insomnia, but I do have to get organised for work!
Hopefully someone will come in with some suggestions to help the sleepy daytime 🤞 thank you so much for help xx
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Hi shopping queen
I'm a bit late to this thread but I took Cyclogest for about 4 years from approx 2007 - 2011. This was prescribed by the NHS GP (who had a special interest in gynaecology) before utrogestan was generally available or known about - in fact I told her about utrogestan in late 2011!
It is designed for both rectal and vaginal use and comes in 200 mg or 400 mg capsules.
As far as I know there is very limited research on its use in HRT. When I first took it I wrote to the manufacturer - I think it was Ferring at the time but might be mistaken, and they sent me some information but unfortunately I didn't save it and the e-mail is on my old computer.
Therefore I would suggest, unless there has been more research, that the dosage is guesswork, or trial and error based on the equivalent amount of Utrogestan.
I was prescribed 400 mg for 11 days per 28 day cycle. I used to get a regular withdrawal migraine so always timed it for the weekend so I would be able to work...
As with any progestogen used vaginally vs other methods, theoretically less should be needed compared with other methods ( rectal, oral) for protection of the uterus since the first "hit" is the womb, rather than being transported through the bloodstream ( via the upper digestive system in the case of utrogestan, via the rectum in the case of cyclogest).
In terms of systemic absorption - I had a google and found this study:
https://pubmed.ncbi.nlm.nih.gov/22714063/
Although it was looking at the use of cyclogest in fertility and so the conditions are different, involving embryo transfer - nevertheless systemic levels were compared between vaginal and rectal administration:
"147 patients who underwent intra-cytoplasmic sperm injection cycle were randomized on the day of the embryo transfer (ET) by a computer-generated randomization program to receive 400 mg of Cyclogest either vaginally or rectally twice daily for up to 8 weeks."
"There were no significant differences in serum P concentration 6 days after ET, "(ET - embryo transfer)
When I took it, I used to put one (x 200 mg) up the front and one up the back! I really did not like the rectal route and the effect in the morning....(details would be TMI!).
I would imagine it is not advisable to cut the capsule unless under medical supervision and proper regular monitoring of the uterus lining - perhpas when very low oestrogen doses are used? It depends how the progesterone is distributed through the capsule itself.
Progesterone is a sedative so the tiredness is a necessary evil, because higher doses need to be taken daily in order that sufficient gets to the uterus - it breaks down quickly in the blood.
I hope this helps and all the best with it!
Hurdity x
PS Just to add that Cyclogest is available on NHS but will be off-licence for HRT, so a specialist private prescription may be needed initially though a £30 e-mail consultation to Dr Currie asking her specifically about this - might do the trick (cheaper than a private consultant!).
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Hi shopping queen
I'm a bit late to this thread but I took Cyclogest for about 4 years from approx 2007 - 2011. This was prescribed by the NHS GP (who had a special interest in gynaecology) before utrogestan was generally available or known about - in fact I told her about utrogestan in late 2011!
It is designed for both rectal and vaginal use and comes in 200 mg or 400 mg capsules.
As far as I know there is very limited research on its use in HRT. When I first took it I wrote to the manufacturer - I think it was Ferring at the time but might be mistaken, and they sent me some information but unfortunately I didn't save it and the e-mail is on my old computer.
Therefore I would suggest, unless there has been more research, that the dosage is guesswork, or trial and error based on the equivalent amount of Utrogestan.
I was prescribed 400 mg for 11 days per 28 day cycle. I used to get a regular withdrawal migraine so always timed it for the weekend so I would be able to work...
As with any progestogen used vaginally vs other methods, theoretically less should be needed compared with other methods ( rectal, oral) for protection of the uterus since the first "hit" is the womb, rather than being transported through the bloodstream ( via the upper digestive system in the case of utrogestan, via the rectum in the case of cyclogest).
In terms of systemic absorption - I had a google and found this study:
https://pubmed.ncbi.nlm.nih.gov/22714063/
Although it was looking at the use of cyclogest in fertility and so the conditions are different, involving embryo transfer - nevertheless systemic levels were compared between vaginal and rectal administration:
"147 patients who underwent intra-cytoplasmic sperm injection cycle were randomized on the day of the embryo transfer (ET) by a computer-generated randomization program to receive 400 mg of Cyclogest either vaginally or rectally twice daily for up to 8 weeks."
"There were no significant differences in serum P concentration 6 days after ET, "(ET - embryo transfer)
When I took it, I used to put one (x 200 mg) up the front and one up the back! I really did not like the rectal route and the effect in the morning....(details would be TMI!).
I would imagine it is not advisable to cut the capsule unless under medical supervision and proper regular monitoring of the uterus lining - perhpas when very low oestrogen doses are used? It depends how the progesterone is distributed through the capsule itself.
Progesterone is a sedative so the tiredness is a necessary evil, because higher doses need to be taken daily in order that sufficient gets to the uterus - it breaks down quickly in the blood.
I hope this helps and all the best with it!
Hurdity x
PS Just to add that Cyclogest is available on NHS but will be off-licence for HRT, so a specialist private prescription may be needed initially though a £30 e-mail consultation to Dr Currie asking her specifically about this - might do the trick (cheaper than a private consultant!).
Thank you Hurdity for the detailed reply and link. I did just read your response in the other thread so thank you for both and your time on this, as always. I’m comforted that you were able to do so much time on it before going to utro. The tiredness is an issue, isn’t it? I just wish we had more choice.
I guess this is the problem with going with something not usually prescribed. My Endo referred to the BMS info as being the same as utro, so I’ll get in touch with Dr Currie to see what she says. I’m keen not to take any risks and hoping this will suit me better then the other options. I can but try!
Thanks again Hurdity xx