Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Furyan on April 27, 2025, 12:53:55 PM
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Hi ladies
I’m at a crossroads with my HRT as I’ve recently had symptoms of too low dosing since upping my thyroid meds, which I know is common. I’m adding to a .75 patch to an equivalent .87 as I feel out the effects. At a recent gynae appointment, she mentioned that anything above a .75 patch would likely mean a mirena, this could be as my uterus was measuring at 5mm I don’t know. I want to avoid mirena if I can but take the minimal utrogestan possible.
I have a GP appointment coming up but wanted to check what sorts of Utrogestan doses people take if they go beyond .75 patch as GP never seem to know much and keep deferring to a gynae.
Thanks all x
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The recommended dose of micronised progesterone with above 75mcg transdermal estradiol is 300mg if cyclical or 200mg continuous.
It has a more potent effect on the endometrium when taken vaginally but there is not enough evidence to recommend a lower dose vaginally.
However if micronised progesterone is either not tolerated or not adequate at controlling your endometrium, which is the case in some women, there are multiple other oral progestins so a mirena is not your only option.
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If your reason for avoiding a mirena is getting it taken out quickly it might be worth having a word with your surgery, some have a nurse that will do it quickly. I spent years avoiding one for this reason but I've had one 4 months ago and it's great, no side effects (unlike utro) and no bleeds. Though of course there are other options you may want to try first.
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The recommended dose of micronised progesterone with above 75mcg transdermal estradiol is 300mg if cyclical or 200mg continuous.
It has a more potent effect on the endometrium when taken vaginally but there is not enough evidence to recommend a lower dose vaginally.
However if micronised progesterone is either not tolerated or not adequate at controlling your endometrium, which is the case in some women, there are multiple other oral progestins so a mirena is not your only option.
Thanks Bombsh3ll, I couldn’t find the BMS reference and some groups said it’s a shady area and down to discussion between patient and doctor. But 200mg on a .1 patch doesn’t surprise me especially without the research to say it’s ok to take less than that. I’ve read more bad things about mirena than good but one thing I could tell is that those who did best on mirena stick it out through the initial months when they had it rough. I may have one last go at 200mg micronised P as I up my E dose and if the side effects are still too uncomfortable my only option will be to try one of the progestins. Ultimately womb protection will have to trump everything.
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If your reason for avoiding a mirena is getting it taken out quickly it might be worth having a word with your surgery, some have a nurse that will do it quickly. I spent years avoiding one for this reason but I've had one 4 months ago and it's great, no side effects (unlike utro) and no bleeds. Though of course there are other options you may want to try first.
That’s one of my main anxieties plus reading about the strong side effects that some women have! I’ll make sure I mention this to the GP when I speak to her. x
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Just another question as I upped my patch to 100 as an experiment with Utrogestan 200mg vaginally each day. When they say the recommended progesterone dose is 200mg, is this vaginal or oral? Vaginal is stronger (for me) but it gives me debilitating side effects, muscle fatigue and terrible weight gain being the worst. Can I get away with 200mg ORAL Utrogestan with 100 patch???
Good news is, I can definitely feel the positive difference having upped my patch but I do feel the fatiguing side effects of Utrogestan is undermining it. So I’m feeling a mixture of progress and no progress if that makes sense.
I have my GP appointment this week and thinking about giving in and opting for mirena after all because I seem unable to cope on Utrogestan vaginally at this dose. Seems I need as low a dose as I can get away with.
Thanks ladies x
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The recommended dose is the same however you take it.
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The recommended dose is the same however you take it.
Ok thanks sheilla99 - a bit odd to me because oral seems weaker and wasn’t sure whether it can protect the lining with that oestrogen dose. I might try oral for the short term as it might be less potent on my system. My mind is more or less decided on the mirena now, I’ll try to ride out the initial side effects if I get them.