Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Emjay on August 24, 2024, 12:53:12 PM
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Hi.
I have been using Utrogestan cyclically since Feb because I was still having a bleed every month.
I have suffered with pmdd for years.
I am now on 75mg patches of everol and still the standard dose of Utrogestan for 12 days a month.
I didn't feel good with the Utrogestan in the beginning but this last month since starting with 75 patch I actually felt fine once taking Utrogestan and infact I think I felt a lot better on it.
When the 12 days were up and I had to stop taking the Utrogestan I felt horrendous for probably a week or so.
Because of having pmdd and the connection with fluctuating hormones exacerbating the pmdd I am wondering if it would suit someone like me to take the 100mg continously along side the patches to have more stability.
Does anyone find this suits them best?
Not sure why only women that have stopped having periods take it this way. Would there be any problem with someone that had a monthly bleed naturally taking Utrogestan daily instead?
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I think the biggest danger is that there isn't the research to show if it's safe or not. The dose you take for conti doesn't take account of the possible huge spikes of the oestrogen you may produce yourself. If you want to be bleed free in peri your best option is a mirena. Another possibility useful in late peri is to take it for 25 days per cycle as this allows a bleed if there's been a build up. Or perhaps increase the dose of utro until your bleeds stop but you may have difficulty finding someone to prescribe this. Once you've been on hrt for a year some gps encourage you to move to a conti regime anyway.
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Ok thank you.
It's so complicated I feel. With the doses.
I think I will try taking it for 25 days.
There is stuff out there to suggest that women that suffer pmdd aswell are actually low in progesterone so hopefully it would cause any severe problems.
The g.p has suggested merina but I feel like sticking with the Utrogestan at the moment because of slight lower risks associated with it.
I have alway stayed away from taking hormones in the past so it is huge for me to even consider taking the more natual form.
Thanks for your reply.
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As long as you aren't taking less than the prescribed dose then it is absolutely fine to take it continuously rather than cyclically in perimenopause.
This MIGHT result in less predictable bleeds than if you took it cyclically, which is where the current dogma about cyclical use in perimenopause arose as this is theoretically meant to result in more regular bleeding.
There are two problems with this thinking though -
One is that cyclical doesn't guarantee a predictable bleeding pattern and since stopping and starting the progesterone is designed to actually induce bleeding, some women end up with both their natural cycle PLUS the artificial withdrawal bleeds and basically having more chaotic bleeding than they would have had.
Second is the assumption that bleeding pattern is the only or most important factor to consider rather than treating the person holistically - for example some women aren't bothered about a bit of unpredictable bleeding - which can occur in untreated perimenopause anyway - and prefer to take progesterone continuously as they tolerate the lower dose better, or because it helps them sleep.
Conversely some women who are well past menopause find they have a better quality of life taking it cyclically, maybe because they don't feel great on progesterone and really appreciate a break from it.
Individualised care means taking these factors into account rather than prescribing based solely on whether menstruating or not.
Also women with conditions that have been aggravated by menstruation earlier in life such as migraines and endometriosis are better served by keeping consistent progesterone levels rather than seesawing between none and a higher dose.
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Thank you so much for your reply.
That really helps.
I actually have mild endometriosis anyway so I think that I will try taking the progesterone continuously and see how I feel that way.
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Emjay, I also have endo and am in peri and I take utrogestan more or less continuously - but with a break for just 3-5 days to allow a bleed. So you could try that. It would mean that any build up has a chance to shed but you also get to take it most of the month.
I either stop it on day 26 for 3-5 days or, if I start to bleed a few days before that, I stop earlier and go with it. I try to wait until the bleeding has almost finished before I re-start.
I should say I take mostly 300mg every night though, not just 100mg. I think if you are on 75mcg patch you might also now be advised to be on at least 200mg a night continuous...
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I'm right now also having problems with symptoms coming back after stopping the Utrogestan for the month.
I wonder if there would be benefit to taking 100mg daily and then 200mg on the 12 days (& stopping 3-5 days at the end of the cycle for a bleed)?
I'm a beginner in all this HRT thing and trying to closely watch my body and learn what is it that it needs. So far progesterone seems to be something that my body likes a lot, as it gives me a great feeling of calm and relaxation, thanks to it I've been able to sleep again.
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rferdi yes, you can do that too.
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rferdi yes, you can do that too.
thank you joziel
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I've been on continuous now for a few months and my mental health has really taken a hit can anyone relate?
Dawn s
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It might be that you are getting P related side effects. Have you tried using it vaginally instead?
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I seem to be in a weird situation with progesterone, I'm supposed to be taking it sequentially 14 x 200. My body definitely feels better on P, I sleep better, my remaining anxiety is improved and the residual joint pain resolves....however!
I don't seem to be able to tolerate 200mcg for the whole 14 days. I've discovered I do better starting on 100 for a few nights and then going up to 200mcg BUT it then seems to vary how many days I can take 200 before I get a racing heartrate, difficulty sleeping, jitteryness, irritability. The first month I did 10 days but it's got worse since then.
I can't work out if this is my own natural cycle kicking in and giving me too much P (I had a reasonably regular cycle - aged 54 3 months ago when starting HRT). Or from reading comments on here, is it low oestrogen and it's the progesterone kicking everything out of balance/ratio during this 14 days?
I'm really confused!
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It might be that you are getting P related side effects. Have you tried using it vaginally instead?
I haven't- it's odd. I have the Dr on Friday x
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I've been on continuous now for a few months and my mental health has really taken a hit can anyone relate?
Dawn s
Are you on a therapeutic dose of estrogen? Most women are under treated. Also what about testosterone?
Anecdotally many women are better able to tolerate progesterone when they have adequate estrogen and testosterone.
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I seem to be in a weird situation with progesterone, I'm supposed to be taking it sequentially 14 x 200. My body definitely feels better on P, I sleep better, my remaining anxiety is improved and the residual joint pain resolves....however!
I don't seem to be able to tolerate 200mcg for the whole 14 days. I've discovered I do better starting on 100 for a few nights and then going up to 200mcg BUT it then seems to vary how many days I can take 200 before I get a racing heartrate, difficulty sleeping, jitteryness, irritability. The first month I did 10 days but it's got worse since then.
I can't work out if this is my own natural cycle kicking in and giving me too much P (I had a reasonably regular cycle - aged 54 3 months ago when starting HRT). Or from reading comments on here, is it low oestrogen and it's the progesterone kicking everything out of balance/ratio during this 14 days?
I'm really confused!
Why not just take 100mg every night instead of seesawing between nothing and a dose you don't tolerate, every fortnight?!
Bleed pattern is not the be all and end all, and chasing regular bleeds shouldn't come at the expense of your quality of life.
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Seasidegirl, you say "it then seems to vary how many days I can take 200 before I get a racing heartrate, difficulty sleeping, jitteryness, irritability. "
These are all low estrogen symptoms for me. They might be happening at one part of your cycle more than another just because of what your estrogen and ovaries are doing then, nothing to do with progesterone.
I would be trying to get your estrogen higher, if I were you, and see if that helps.
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Seasidegirl, you say "it then seems to vary how many days I can take 200 before I get a racing heartrate, difficulty sleeping, jitteryness, irritability. "
These are all low estrogen symptoms for me. They might be happening at one part of your cycle more than another just because of what your estrogen and ovaries are doing then, nothing to do with progesterone.
I would be trying to get your estrogen higher, if I were you, and see if that helps.
Thanks Joziel, I'm coming to that conclusion having read comments here. I was convinced it was the P but it isn't making sense.
I had a treatment plan to go from Estradot 50 to 75 but I hadn't particularly felt the need to consistently, I've added the extra half patch today and I'll keep it up until the next round of P and see if that helps.
I'm also waiting for a thyroid blood test, I have borderline hyperthyroidism and I wonder if that's possible an issue too and it seemed sensible to rule that out.
It is all so confusing! Thank you so much for your advice.
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There is stuff out there to suggest that women that suffer pmdd aswell are actually low in progesterone so hopefully it would cause any severe problems.
Hi Emjay
Just wanted to ask about that comment as I haven't heard of this? I understand pmdd is more to do with either low oestrogen and/or the dramatic fall in oestrogen that occurs in the week or so leading up to the period, and in addition either progesterone intolerance, as it is released during the second half of the menstrual cycle, and/or the progesterone withdrawal which occurs at the end of the cycle, just before the bleed and is associated with its own negative symptoms. As far as I understood, women who suffer this debilitating condition, usually feel much better during the first part of the cycle, once the progesterone withdrawal is over, and this (first part of cycle) is when oestrogen is rising and reaches a peak around ovulation - so this is when progesterone is at its lowest.
If you have any research to the contrary I would be really interested to read it.
All the best anyway!
Hurdity x