Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: violetbat on July 16, 2023, 06:38:46 PM
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Sorry for the clumsy title!
I have been taking utrogestan vaganally for a few years now. I could not tolerate it orally at all. Vaginally it is a tad better but I still get awful pain and bloating during the days I take it, to the point where it would become unbearable, BUT would get a regular and predictable withdrawal bleed AFTER the course was finished- always. Unless I forgot a day and then without fail I would bleed a couple of days later.
When taking it orally I would usually bleed BEFORE the course was finished- which made me think that the absorption was more erratic- hence the triggering of a bleed.
Recently on here there were discussions about taking it rectally and that might make the side effects less.
These last couple of months I have been taking it both rectally and vaginally and I have bleed before the course has finished both times- about a week in, which is what used to happen when I took it orally.
This makes me think that, again, taking it rectally does not have the same constant absorption rate as vaginally and that the vaginal route is the most constant/best absorbed method.
I might be talking out of my arse though!
Would appreciate thoughts and experiences on the different methods and absorption rates/ effectiveness of a consistent level of absorption. I shouldn't make a difference but it clearly does with me. For others it might not matter.
thanks :)
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Interesting question. I would assume Newson is right when she says more is absorbed vaginally. This is the first cycle I've used it rectally and I think it's stronger. I get sore boobs with progesterone and pain is greater now than with either oral or vaginal. I have a few more days til the bleed is due so I'll let you know what happens. I don't think I'm very susceptible to daily fluctuations so can't comment, I never bleed early except when my own hormones are involved. Another thing that makes me think more is absorbed is that there's no mess which I had thought was the casing, now I think it might just be utro that hasn't been absorbed.
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Interesting question. I would assume Newson is right when she says more is absorbed vaginally. This is the first cycle I've used it rectally and I think it's stronger. I get sore boobs with progesterone and pain is greater now than with either oral or vaginal. I have a few more days til the bleed is due so I'll let you know what happens. I don't think I'm very susceptible to daily fluctuations so can't comment, I never bleed early except when my own hormones are involved. Another thing that makes me think more is absorbed is that there's no mess which I had thought was the casing, now I think it might just be utro that hasn't been absorbed.
Hi Sheila99
I'm following this thread with interest.
As you know I've had trouble with progesterone, and I did trial taking utro rectally (I now take cyclogest, using it rectally)
So can I just clarify, you've been using the utro rectally and at first you thought that you using it rectally the absorption was stronger, but now you think that you just weren't absorbing the utro rectally?
Sorry if I've read that wrong xxx
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Thanks for replying!
Maybe I am simply more susceptible to hormone fluctuations? I don’t know. I would prefer to keep using it rectally .
I am super stressed at the moment- house purchase that is dragging on and on. Am now covered in spots so my hormones are deffo out of whack. :(
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Interesting question. I would assume Newson is right when she says more is absorbed vaginally. This is the first cycle I've used it rectally and I think it's stronger. I get sore boobs with progesterone and pain is greater now than with either oral or vaginal. I have a few more days til the bleed is due so I'll let you know what happens. I don't think I'm very susceptible to daily fluctuations so can't comment, I never bleed early except when my own hormones are involved. Another thing that makes me think more is absorbed is that there's no mess which I had thought was the casing, now I think it might just be utro that hasn't been absorbed.
Hi Sheila99
I'm following this thread with interest.
As you know I've had trouble with progesterone, and I did trial taking utro rectally (I now take cyclogest, using it rectally)
So can I just clarify, you've been using the utro rectally and at first you thought that you using it rectally the absorption was stronger, but now you think that you just weren't absorbing the utro rectally?
Sorry if I've read that wrong xxx
I understand her to mean that it might be more than just the casing that is expelled whilst using it vaginally? Therefore rectally it stays in longer?
I always have a Howe movement first thing so I would expel whatever was left up there anyway!
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Hi violetbat
I see, thanks so much for explaining that xx
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That's interesting violetbat, I hadn't thought of it from that angle.
When I take oral progesterone (tried provera then utrogestan) then I'll start my period about 7-10 days into the 12 days.
When I took vaginal utrogestan my period waited until 4-5 days after finishing the 12 days and the side effects were a fraction of the oral side effects.
I only tried vaginally last month, maybe this pattern will continue?
I've finally got approval from the HRT clinic to use it vaginally for now, only because I'm coming in for a scan next month, but I'll take it vaginally until I'm told not to, it seems to absorb more and work better so it makes no sense to go back to taking it orally.
I had some irritation though, maybe rectally is an option to avoid that?
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I still think it's stronger rectally than vaginally. When I use it vaginally white bits come out from 4 am onwards which I had assumed was casing but now think may be the product itself. Not certain though. I had some irritation vaginally too but so far no reaction anally (day 10).
Does anyone know if you can mix delivery methods in one cycle? I wasn't sure if I could switch after vaginal irritation so carried on.
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I still think it's stronger rectally than vaginally. When I use it vaginally white bits come out from 4 am onwards which I had assumed was casing but now think may be the product itself. Not certain though. I had some irritation vaginally too but so far no reaction anally (day 10).
Does anyone know if you can mix delivery methods in one cycle? I wasn't sure if I could switch after vaginal irritation so carried on.
I mixed it this last cycle and the one before come to think of it. Mostly because a few times I got into bed and switched the light off, then remembered I hadn’t taken it and couldn’t be bothered to go and get the lube so just used them the front way.
This is what has made me think that absorption rates are a bit different.
If I manage a whole cycle rectally and still bleed early I will have a better idea of the absorption consistency for each way.
I get horrible womb ache using progesterone . The mirena was a nightmare. Oddly I am ok on norithisterone but my gp won’t prescribe it.🤷🏻♀️
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I was fine with norethisterone in evorel patches too but get fatigue and sleep disruption with utrogeston. When I developed an allergic reaction to the glue in the patch my gp wouldn't prescribe it either.
Has mixing delivery methods been a factor in your early bleeding? I wondered if changing from vaginal to oral might trigger it (I use 200mg both ways).
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I was fine with norethisterone in evorel patches too but get fatigue and sleep disruption with utrogeston. When I developed an allergic reaction to the glue in the patch my gp wouldn't prescribe it either.
Has mixing delivery methods been a factor in your early bleeding? I wondered if changing from vaginal to oral might trigger it (I use 200mg both ways).
Yes- the patch glue can sometimes irritate me. I can just about tolerate everol- but there was another large patch that made me want to tear my skin off. Wish I could get the tiny estradot. These large patches are very very unsexy indeed.
I deffo get early bleeds if I mix oral and vaginal methods- every time.
When I had the mirena in a couple of years ago- the bleeding was getting so heavy that I was also taking 6 northistrone a day just to stop it. Apart from being covered in spots I didn't feel too bad. They agreed it should be removed due to the pain and bleeding, but the threads had disappeared so a gynae had to fish it out with a hook thing- right up my cervix without any anaesthetic. I will never have one again.
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OUCH!! I don't blame you >:( :poke2:
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So I may have been talking through my backside again :-\. 11days of rectal 200mg utro and I'm bleeding. So it may not be stronger this way, it might be that my own progesterone has been added. I really don't know what's going on :(.
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Hi Sheila99
I'm so sorry you've started bleeding.
Have you considered cyclogest, I take 100mg rectally or you can take it vaginally xxx
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I have started my P 8 days early so only half way through utrogestan, I am also taking vaginally 100mg for 12 nights. I was able to persevere until day 9 but my P was too heavy.
What do you do in this instance. I have been counting 15 days after first day of P to start the tabs. I was fine for the first 3 months and now totally confused if I start from the first day of early period.
Although its not as heavy as usual I have had quite severe discomfort for the whole period which is unusual for me. I usually get knocked to the floor for a couple of days then ok again. I only used 100mg as Louise Newsons lady said on youtube and that's where I was sent by the GP surgery. I will increase to 200mg if that would make a difference, only on 50mg evorel
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Hi Sheila99
I'm so sorry you've started bleeding.
Have you considered cyclogest, I take 100mg rectally or you can take it vaginally xxx
Do you find it better than utro? I can ask my gp but they're very reluctant to prescribe anything unlicensed, I have a battle every time I need more Tostran. Bleeding is actually a good thing, last time there was hardly anything and as I'm on 100 patch I worry about the lining building up. I keep wondering if a mirena may be the answer but a bit reluctant to try.
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Hi Sheila99
I'm so sorry you've started bleeding.
Have you considered cyclogest, I take 100mg rectally or you can take it vaginally xxx
Do you find it better than utro? I can ask my gp but they're very reluctant to prescribe anything unlicensed, I have a battle every time I need more Tostran. Bleeding is actually a good thing, last time there was hardly anything and as I'm on 100 patch I worry about the lining building up. I keep wondering if a mirena may be the answer but a bit reluctant to try.
That’s interesting Sheila. Perhaps rectally doesn’t give consistent absorption rates? Orally doesn’t either it seems. Even though I bled on day 7 this month and it was a decent amount on the first 1.5 days it stopped pretty quickly. I will go back to the vaginally route. I hate the bloats and pains so much though. Sometimes the pain gets so bad that I have to stop the course early because it affects my well-being.
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Sorry it's so difficult for you. I'm going to try rectally again next time. I get fatigue and disrupted sleep either way but rectally there's no mess so for me it's an improvement.
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Hi Sheila99
I'm so sorry you've started bleeding.
Have you considered cyclogest, I take 100mg rectally or you can take it vaginally xxx
Do you find it better than utro? I can ask my gp but they're very reluctant to prescribe anything unlicensed, I have a battle every time I need more Tostran. Bleeding is actually a good thing, last time there was hardly anything and as I'm on 100 patch I worry about the lining building up. I keep wondering if a mirena may be the answer but a bit reluctant to try.
hi sheila99
yes i find it better than utro my moods on utro were horrific. i dont know why im better on cyclogest as theyre both micronised progesterone.
since it can be used rectally i use it in the mornings and i just cut the 200mg pessary in half and use 100mg.
personally my moods couldnt handle a mirena but you might be different.
as if meno isnt hard enough without having a battle everytime you need more hrt.
are with a meno clinic as they might be more likely to prescribe off licence stuff.
i really hope you get sorted xxx
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Hello ladies,
I'm reading this thread with interest.
When I first started taking utrogestan 14 out of 28 days orally I synced it with my period so the bleed was a few days after day 14 of Utrogestan Over the months my bleed/period gradually crept forward so it has been starting on say on day 7 of utrogestan. I assumed this was because it was my natural period breaking through and that I was still in perimenopause. Are you saying that it's possible it isn't my natural period and that it's an early withdrawal bleed because the Utrogestan isn't being absorbed?
Apologies if I sound dense. I thought I'd got on top of all this but this may add a new dimension to where I am in the whole menopause process.
Thank you in advance x
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Hello ladies,
I'm reading this thread with interest.
When I first started taking utrogestan 14 out of 28 days orally I synced it with my period so the bleed was a few days after day 14 of Utrogestan Over the months my bleed/period gradually crept forward so it has been starting on say on day 7 of utrogestan. I assumed this was because it was my natural period breaking through and that I was still in perimenopause. Are you saying that it's possible it isn't my natural period and that it's an early withdrawal bleed because the Utrogestan isn't being absorbed?
Apologies if I sound dense. I thought I'd got on top of all this but this may add a new dimension to where I am in the whole menopause process.
Thank you in advance x
Hi Dotty
It’s a good question. What I think might be happening is that the absorption is somewhat inconsistent. So if the level drops a bit because the absorption rate lowers for a day or 2 it will signal to the body to bleed. This is of course what would happen when we were younger and having periods.
I have found so far that taking vaginally pretty always gives me a bleed after I have stopped the course. When I took it orally I usually bled before the course was finished. The jury is still out rectally.
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I've never heard this theory before. When I asked the medics they implied that as long as I was having a bleed it wasn't cause for concern when the bleed actually happened on this regime. Although I understand that some women don't bleed at all on sequi and that is fine too - maybe because the lining doesn't build up enough to shed.
I will ask my GP the next time I have a review.
Thanks x
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Got me thinkimg now so just another question relating to this. Based on this theory that oral utrogestan isnt absorbed effectively, for those women on a conti regime taking 100g utogestan orally on a daily basis, wouldn't there be more cases of bleeding (when conti is not supposed to cause any bleed)?
I would have thought there are papers/studies on the different absorption rates and if so why is utrogestan not licenced in UK for vaginal/rectal use if it is more effective?
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Got me thinkimg now so just another question relating to this. Based on this theory that oral utrogestan isnt absorbed effectively, for those women on a conti regime taking 100g utogestan orally on a daily basis, wouldn't there be more cases of bleeding (when conti is not supposed to cause any bleed)?
I would have thought there are papers/studies on the different absorption rates and if so why is utrogestan not licenced in UK for vaginal/rectal use if it is more effective?
Dotty
I think a lot of women bleed irregularly on conti.
I think you are absorbing enough to protect the womb, just not consistent amounts, hence the erratic bleeding when levels drop/ rise/ drop.
Someone did explain somewhere on here regarding the updating on the licensing. My GP told me to use it vaginally. I am sure I am not built differently to French women.
My guess is that HRT isn’t financially viable to invest research into. My pharmacist told me that big pharma don’t make money from making and selling HRT so can’t be arsed to invest in research etc.
GPS seem to know very little either.
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Got me thinkimg now so just another question relating to this. Based on this theory that oral utrogestan isnt absorbed effectively, for those women on a conti regime taking 100g utogestan orally on a daily basis, wouldn't there be more cases of bleeding (when conti is not supposed to cause any bleed)?
The bleeding on utrogestan happens during the first six months ideally, then your body should keep the same lining if nothing changes and not bleed, but everything changes all the time until we are well past having natural periods, so the natural fluctuations of early postmenopause can trigger breakthrough bleeding after that as well and often this is investigated with a scan.
Anyway the women who bleed with continuous utrogestan are taken off utrogestan and given something else instead, that keeps the numbers down of those who continue to use it and bleed in an unplanned way. I've been switched about a few times, I've not been allowed anything that gives unplanned bleeding after six months, it's all prescription only so it's not really a choice, we're not allowed it if it doesn't work.
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Got me thinkimg now so just another question relating to this. Based on this theory that oral utrogestan isnt absorbed effectively, for those women on a conti regime taking 100g utogestan orally on a daily basis, wouldn't there be more cases of bleeding (when conti is not supposed to cause any bleed)?
I would have thought there are papers/studies on the different absorption rates and if so why is utrogestan not licenced in UK for vaginal/rectal use if it is more effective?
Utrogestan orally every day definitely isn’t enough for me and made spotting turn into bleeding. Vaginal is more effective (for me) to control bleeding but it’s far too strong for me to take every day (too many side effects) and every other day isn’t enough either. I’m not the first one to say it, but it’s a real shame utrogestan doesn’t come in a form that is easier to adjust, this ‘all or nothing’ dosing simply won’t work for some women.