Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Peri2022 on November 18, 2023, 11:08:48 AM
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Hello ladies. I’ve been on HRT for nearly a year now. I’ve always taken my utrogestan vaginally because I’ve struggled with progesterone in the past and didn’t want to take it orally in case it exacerbated the anxiety/depression I was trying to treat!
Anyway it’s always been ok (apart from the horrible white debris the next morning) but for the past 2 months I have awful itching and burning during my utrogestan weeks. It starts within hours of inserting the first 2 tablets. I don’t think it’s vaginal atrophy as I don’t have these symptoms the rest of the month. Is it possible I’ve become sensitised/mildly allergic to the utro?
I can’t have a Mirena (previously had failed insertion, funny tilted womb) so I feel like I’m all out of options! I’m on the waiting list for a hysterectomy but that will take years.
Any suggestions or anyone in a similar boat? Thank you.
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It mayB that the vagina/vulval area is too dry to absorb the utrogestan = stinging on insertion?
Why not try some VA treatment to lubricate on the nights that U don't use the utrogestan?
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Hi CLKD, that’s an interesting thought. It stings more after a few hours though than it does immediately on insertion. It may be that I need something to moisturise that area though…wondering whether to ask my GP but I reckon her guess is as good as mine!
So frustrating that there aren’t better options out there…maybe by the time my children hit meno???
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Have a lookC at the 'yes' and 'sylc' websites, some find both/either products can ease symptoms. U may even get freebies ;-).
Or KY jelly 10 mins B4 insertion?
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Hi Peri2022,
I too am se sensitive to Utro. It makes me wired and hot... the opposite of a sedative effect. It also makes me constipated. I also take it vaginally but after 5 days I get very sore. I read somewhere you could take it rectally. Desperate times!!!
Who knows if it's working that way though.
There is cyclogest which is designed as a pessary. I will ask if my doc will prescribe that, some people say it has less adverse effects. But who knows.
I will keep you posted as my body (and mind) loves estrogen but hates progesterone.
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Thanks to you both. CLKD, I already have some YES freebies so I may try that. Also going to try an antihistamine along with my utro tonight so we’ll see if that helps.
Banjo, I am thinking about trying it rectally! There are a few good threads about that on here. Side effects of constipation and flatulence but maybe that’s better than a burning vagina!
Oh to be a man >:
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It started to make me uncomfortable vaginally so I've used it rectally for the last 3 cycles. I've found it stronger (I get sore boobs with prog) but I think it may be absorbed faster as well as I've bled before the 12 days. One time I was a few hours late so 2 unexplained. I bled every time and it's been a good bleed. Using vaginally I only bled about 1in 3 but 3 cycles may not be long enough to tell (v late peri/meno). The bonus is that there's no mess.
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Rectal medication works almost instantly as the tissue is thin and it enters the blood stream very quickly. Hence some emergency medications are inserted into the rectum i.e. for someone suffering seizures.
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Hi Peri2022
You say you don't get VA symptoms the rest of the month but are you using any topical vaginal oestrogen at all? It may well be that your V tissues are thin and are sensitive to the Utro even though fine at other times?
Also - is the burning and itching on the inside or mainly around the labia and entrance to the vagina?
I always get itching and irritation when I use Utro - every single month. Labia and around the entrance. I use a variety of things to relieve it and/or provide a barrier. I do use local oestrogen nornall but in turn I either apply: E45 cream as moisturiser to external areas, and entrance to V, or Vaseline as barrier to labia to prevent the prog goo touching the skin, or 0.01% estriol cream which I have as back-up as my vaginal oestrogen (thoigh usually using vagifem/Vagirux). So just a few options to try. I've never used any of the proprietary V moisturisers so can;t comment here but E45 is very inert as is vaseline.
Re using Utro as a pessary - it is not designed to be used as such, and it would need to be used at the licensed dose since theoretically is not going straight to where it is needed as it has to be absorbed into the bloodstream before being transported to the uterus - notwithstanding sheila99's personal experience of this.
Also depends on your bowel habit too I would suggest. Why I say this is that on the morning visit ::) it may well all be excreted out - when I used cyclogest rectally it certainly had a dramatic effect in that area ::) !!! When the utro is used vaginally I read in a paper about absoprtion etc, that some of it is "held" at the uterus so some of it lingers a bit longer than one would expect after stopping taking it, whereas as above, in the rectum - it could be likely all pooped out the next morning....
Personally I hated taking it rectally but that's me....
Used like this (Utro rectally) would be very much off-piste so to speak as no research on this unless I've missed something
Hurdity x
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Oh Sheila,
I'd be very interested to hear your story as I really don't have a good time with utro and must confess have resorted to skipping months which I know is very dangerous.
I was advised to use utro vaginally as orally it made me agitated and gave me insomnia. I use it in the morning as I need my sleep so badly. After 5 days vaginally I get sore so did try it rectally (at night - it didn't affect my sleep).
Please could you keep me updated with your progress? My only other hope is the cyclogest pessary - but not sure it would be any better and I don't think I could face the battle trying to get it prescribed.
I have a scan next week so I'll find out if my reckless utro taking has messed up my womb.
Any advice most welcome xxxIt started to make me uncomfortable vaginally so I've used it rectally for the last 3 cycles. I've found it stronger (I get sore boobs with prog) but I think it may be absorbed faster as well as I've bled before the 12 days. One time I was a few hours late so 2 unexplained. I bled every time and it's been a good bleed. Using vaginally I only bled about 1in 3 but 3 cycles may not be long enough to tell (v late peri/meno). The bonus is that there's no mess.
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Don't think of your regime being reckless Banjo - it's about what suits each person individually. A long regime might suit U better, advised by a dedicated menopause clnininc.
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Thank you, but I'm mot under the supervision of anyone let alone a specialist.
I'm just a desperate woman burying her head in the sand. I'll know more after my scan next week.
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Banjo, I think we’re all desperate women on here to one extent or another! This HRT journey is so hard without easily accessible guidance and information. Do keep us posted.
I’m on day 3 of my utro now and itching away…the irritation is very much internal and not external/vulval at all. I think I’ll try the rectal route over the weekend as I’m going away with my husband and don’t want miserable utro to spoil our fun if you catch my drift!
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I heat you sister.
Peri has made interest in sex limited enough (even though I'm on testosterone)... 12 - 14 days a month with my vagina caked in thick utrogestan residue is not at all helping.
I'm going to continue with rectal utro as it seemed way better (apart from the insertion ;D)
As cyclogest can be used this way, I'm pretty sure it's legit.
Enjoy your weekend away.
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Thanks Banjo, you’re right, the disgusting Utro debris is really off putting! I tried the rectal route for utro last night for the first time and wow, how amazing not to wake up with a burning fanny 🙈 ! And no white muck! No obvious difference apart from a deep sleep with some really crazy dreams but that may have nothing to do with the utro…
I do wonder whether it’s just as effective this way, but I guess I’ll wait and see whether my period is as light as it should be. If it’s back to flooding and clots then I’ll know my womb lining wasn’t as thin as it should be.
Onwards…
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Crazy vivid dreams are deffo a utro thing.
I have always had very light periods all my life. Short (3 days) and very little blood (often no flow at night when I'm horizontal)
Now I take utro, should I expect them to be heavier?
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Ah sorry Banjo, I think maybe I wasn't clear about the utro/period connection! To clarify: my periods (pre HRT) were always incredibly heavy and painful, lasting about 10 days. Because progesterone keeps the uterine lining nice and thin, and utrogestan is progesterone, it tends to make people's periods lighter and shorter, as has been the case (thankfully) for me.
What I meant was, I wonder if using utro rectally will help the drug to be absorbed as well as it has been vaginally. If it doesn't absorb as well, then I would expect my period to be heavier again because the drug hasn't been keeping my lining as thin as it should.
So if anything, one would expect your periods to get even shorter and lighter on utro, as long as the drug is being well absorbed.
Sorry to add to the general confusion - I hope that's a bit clearer!
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Thank you, that was helpful.
Fingers crossed my womb lining is nice and thin.
I'll let you know how I get on x
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Hi again Peri2022
I responded to your post abut using Utro rectally and about things you mentioned, earlier in this thread but I don't think you have seen it because you continue to refer to utro rectally etc in your discussion with Banjo and whether it's "legit". I hope my comments were/are helpful and shed some light on this.
Hurdity x
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Hi Hurdity. Yes sorry I did see your message - in one of my posts I explained that the irritation is just internal rather than external - interestingly, as far as rectal progesterone being legit, I listened to a Newson podcast yesterday where they discussed the absorption benefits of taking prog vaginally or rectally as opposed to orally. Certainly it’s off license but Newson appears to endorse it…
Anyway, as an update, I used it rectally again last night but didn’t sleep well at all. Felt stoned/groggy but kept waking up. A bit disappointing after my good sleep on the first night.
On the plus side, any vaginal irritation has totally cleared up so it was obviously being caused by the Utro.
I have a Newson appointment tomorrow so hopefully I’ll get some good advice!
Thanks again for your input too.
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Please share what Newson say to you.
Thank you Hurdity for your input- I really value your wisdom but I am a desperate woman who is willing to try some unorthodox approaches.
My next step is requesting cyclogest. But first, I will see how my womb lining is doing after my scan next week.
Thanks again for your help
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Hi ladies, I’ve just had my Newson appt so I thought I’d pop in to update you if it’s helpful at all.
-Estradot: she says their pharmacy had good stock of all Estradot apart from 100mcg. This is great for me as I just need 50 which I can’t get locally.
-irritation from utro - she agrees that this may be caused by the beginnings of vaginal atrophy/thinning tissue which is now more sensitive to utrogestan than it was. She is starting me on vaginal estrogen pessaries.
-she says there’s no good evidence about the effectiveness of rectal utrogestan so she’d discourage that. But I could take cyclogest that way in the future if I decide to swap formulations.
-I asked about testosterone for energy/brain function. She was happy to start me on it but I prefer to get my bloods done first to see if I actually have low T levels, so she is arranging that for me, and then we’ll see.
All in all she was lovely and I was very satisfied that all my concerns were heard and addressed. It is expensive but as I say I got the NHS discount and being seen within 48h is virtually priceless!
Hope that helps x
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Thanks for sharing - super useful information.
Hope the oestrogen pessaries help x
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If you look at the ivf forums there's a bit more info about using utro rectally. It seems seems some places are happy this way but others aren't. I'm working on the theory that a decent bleed=OK, I'm not sure I'd use it conti this way without scans. So far for me it's been more effective than vaginally.
I think utro gets in the bloodstream vaginally and rectally, I can't see how I'd fatigue and disturbed sleep if it didn't. I've stated taking it in the morning and hoping the effects have worn off by night.
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Hi Sheila99,
Thanks for that. I too have seen IVF threads where some women have been advised to use it rectally in special circumstances.
I'm the same as you - I have to take it in the morning otherwise I don't sleep.
I'm going to continue to use the back route!! At least I'm not skipping it altogether.
I've got a scan on Monday, fingers crossed my lining is ok.
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Good luck, I hope it's OK.
It would be nice if Newson did some research on this, it doesn't look as though anyone else will.
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Hi Sheila99
My scan came back clear. No thickening of the lining. I am very lucky.
I 100% agree with you that there does need to be some extensive research on this because many women like us are struggling with the progesterone element of HRT.
I think I will continue with the unorthodox route and maybe have yearly scans.
Thanks for your help.
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I tried Utrogestan for a few weeks vaginally but had to stop due to itching and soreness.. I know it's not licensed in this country for vaginal use, although many women use it this way. I had to stop and go back to Evorel Conto because of it, it's a common complaint.
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Oh that is good news Banjo :). I'm on my 4th cycle rectally now so will see if I bleed again this month, I'm past the 6 days where I've bled previously. I'm still on 200mg.
Purplebee I don'thave that option as I'm on 100mcg oestrogen now and sadly they only make conti patches with 50. I had no side effects from evorel conti, for me it was better than utro.
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Sorry I’ve not read all replies but just to say I couldn’t tolerate Utrogestan even vaginally for all sorts of reasons but it also made me very sore. I’m now using Cyclogest pessary which isn’t perfect but I tolerate it much better. It’s messier than Utrogestan as it’s cased in wax that melts and comes out so I feel it’s not a long term option but good enough for me for now while I figure out the other elements. Might be worth a try?
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Cyclogest seems to suit some people who can't tolerate utro but my gp won't prescribe it. I find one of the 'joys' of rectal vs vaginal is that there's no mess.
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How difficult is it to get cyclogest on NHS?
I was planning to continue rectal utrogestan out of sheer desperation.
I can't be bothered with the hassle of getting an appointment to try cyclogest if NHS docs won't prescribe for hrt.
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I think the problem is that it's licensed for ivf but not hrt so it depends if your gp will go off piste.
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Ah, OK. It probably is worth asking x