Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Pauline b on November 28, 2024, 08:55:12 AM
-
My friend has been advised by her menopause consultant that as she is on 100mcgs of oestrogen she must now take 200 ultrogestan as the guidance has changed. My GP has not contacted me as I am also on 100oestrogen is this the case ?
Could I just take it vaginally ad I understand it absorbs better ?
-
Hi Pauline b
I believe that if you're on more than 2 pumps of oestrogel or more than 50 mcg patch etc. then the BMS advice is to increase the utrogestan to 200mgs.
When I was on hrt I used it both orally and vaginally and when I increased to 200mg orally, when I switched to vaginally I just kept on the 200mgs.
More experienced ladies will be along to correct me but that's what I done xxx
-
Thanks disco girl did you mean you stayed on 100 vaginally
-
Official guidelines for HRT prescribing now recommend 200mg micronised progesterone daily with a patch of 100mcg.
This is the same whether it is used orally or vaginally.
There is evidence that vaginal progesterone has a more potent effect, however it is not possible to know who would be absolutely fine, and who would develop hyperplasia, so the NHS has to err on the side of caution and have everyone on the higher dose.
Some individuals will be overtreated on this dose, but as the consequences of under treatment are serious ie endometrial cancer, this is the best they can do.
If you wanted to remain on your current dose, either oral or vaginal, and have no bleeding, the sensible thing to do would be to get a pelvic scan every year or so to monitor your endometrium.
It is not reasonable to expect the NHS to fund this, you would simply be told to take the higher dose, however paying for a scan privately is about £100-200 and some people feel this is worth it to facilitate more individualised treatment.
-
Thank you both
Really helpful advice
-
Hi Pauline b
Sorry when I used it vaginally I used the same dose as I was on orally. So when my gynae advised to increase to 200mg orally when I switched to vaginally I also used 200mg vaginally.