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[anon2021]

Thank you Ladybt28!!!  Clearly I'm all over the shop but totally agree. In fact yesterday and today I did my normal morning Oestrogel dose and then added one in the evening to see if that helped even things out. But just to throw a spanner in the works I started a light bleed as well even though it's only 20 days since my last and I've not missed any dose of either Oestrogel or Utrogestan!

Hey ho, probably helps explain why I was feeling so bonkers as was obvs pre-mentsrual!

Thank you so much for your reply and advice. Really appreciated! Reading all the posts I can clearly see this will be an ongoing trial and error situation and that I can feel confident I'm not going to overdo things and can trust my instincts!


Many thanks again xx

[Debra66]

Hello All, I am new to this group but really grateful to read your comments & useful ideas. I have been a taking Utrogestan 100mg daily for 10 days, GP said to take it continuously as I am post-menopausal. Also using 2 pumps of Estrogel daily. I have a couple of questions I hope you can help me with:

1. Could I be progesterone intolerant - very tearful, significant low mood, can't cope, worrying all the time. I had these symptoms before starting HRT but now it's how I feel daily.   

2. Anyone else taking Utrogestan continuously?

Thank you for your help

[Hurdity]

There are women taking utrogestan continuously - (Dotty is one - maybe she will see this!) but it can give rise to pms symptoms in some women. The best way to see if it is the progesterone or the HRT generally causing the problems is to start HRT with oestrogen only and then introduce the progesterone ie taken cyclically. This does give a withdrawal bleed but you would be able to adjust to the oestrogen first and see how you felt.

Utrogestan taken orally can also give more side effects due to the metabolic breakdown by the liver - there are many metabolites produced which can sometimes affect some women. In this case vaginal use is preferred although this is off licence. For obvious reasons most women in a relationship would not want to take it vaginally on a continuous basis and also it can cause bladder irritation temporarily when taken this way.

I presume you are definitely post-menopausal (ie absence of natural period for at least 12 months) hence the continuous progesterone?

If you feel like it, maybe stop the progesterone for a couple of weeks and see how you feel ( you may bleed) and then reintroduce it? When taken cyclically 200 mg is the dose. Alternatively you could keep on with it and see if the side effects settle - after all you have only been taking it for 10 days and 3 months is the usually accepted time to try a particular HRT type and allow the body to settle.

Hurdity x

[Debra66]

Hurdity, thank you for advice, it's helped confirm what I have been reading in this forum.

I will have to give it some time to settle I know. In desparation I am using 2 pumps of Estrogel as opposed to 1 which my GP prescribed. In the meantime I may try some herbal therapies to treat PMS symptoms.

[Sooze]

Debra66,
I'm taking Uterogestan continuously, although I'm only on the first month and besides the first 4 or 5 days I've been taking it vaginally. It definitely suits me best that way, but I have found that I need a small amount of Ovestin externally at night too to keep everything comfortable since starting it.

Were you on any other HRT before starting this regime and if you were what issues did you have?

If you were on nothing before it'll definitely take a while for you to feel the full benefit, possibly 3-6m I would think.  You may get gradual improvement but don't expect anything to happen overnight. Unfortunately it's difficult to be patient when we have to deal with such debilitating symptoms 

HTH.

[Debra66]

Hello Sooze,
Yes this is my first go at HRT.
I have 1 pump estrogel in the morning & 1 at night. I understand that it's going to take a while, but as you say, it's so hard to function & deal with the symptoms. What's surprised me is I had no symptoms through Peri & now after 18 months since last period;  unbelievable low mood etc.

Thank you for your supportive comments & reassurance x

[Sooze]

So an update and looking for a bit of reassurance/advice. As I seem to be Ok on the Uterogestan I've continued on 100mg vaginally but noticed a bit of spotting when I inserted it tonight (day 28).  Now I did increase the Sandrena to 1½ sachets last Friday as I was get flushing on waking, which it seems to have helped, but could this have triggered the spotting, and should I go back to 1 sachet? My GP said to try 1 sachet for around a month and up it to 2 if my symptoms weren't being controlled.

I'm going to continue with the continuous Uterogestan but I want to minimise the chance of the spotting developing to anything more - I'm going on holiday later this week.  I know breakthrough bleeding is common in the first few months of changing regimes and I don't feel like a bleed is looming - but it's been so long since I've had one I might be mistaken.

Any thoughts or advice?

[AngsanaBlossom]

I have been on 2 pumps of Estrogel for 5 cycles now and initially was on 9 days of oral Utrogestan which I then asked to up to the normal dose of 12 days as I was worried about my lining. I am 49 and Peri-Meno with regular cycles of 24-26 days. My main symptoms are/ were insomnia, low mood and horrible anxiety. Initially I felt wonderful and have had a few good months. My GP did tell me she thought I was progesterone intolerant due to my history.

Right now I am feeling worse than I have every felt. I am on day 11 of taking the Utrogeston and my low mood and anxiety have been building up to this over a week. I am crying and feel like I have PMS on hyperdrive. My period is a few days late and I can feel my ovaries pulsating. I am also having problems sleeping. I am wondering if it is the Utrogeston. I am seeing a great Meno Specialist but she is very busy and I am time limited and £ limited when I go see her. She has recommended that I swap to the Mirena coil but after reading up on it I am scared about this as I may not be able to tolerate the progesterone. Apparently my local, very busy, doctors surgery has a GP that is clued up on the meno. Perhaps I should go see her.

I am not sure if this is relevant but I have only vary rarely taken any medication in my life. For example the last time I took a paracetamol or a Nurofen was about 15 years ago. If I take anything over the shelf like a Nytol or something to help me sleep it usually hits me like a bus whereas it doesn't do anything for other people. I am thinking that maybe my system is not liking the Utrogeston. I've read you can take this vaginally but my GP didn't recommend this to me.

I need to do something but I seem to have lost all the fight in me.

[Ladybt28]

AngsanaBlossom - often GP's don't recommend to take it vaginally but quite a few consultants do and many of us on here take t that way it is perfectly ok.  It tends to work better if you are progesterone intolerant because it is not going through the stomach and therefore not being processed by the liver.  I take it that way and I'm bad with progesterone.  I take it 12 days on a cycle vaginally 2 of the 100m capsules and push it as far up as you can.  The body absorbs it locally.  Works fine.

Ref the sleeping if you are taking progesterone orally then it should be having a sedative effect when taken that way so I don't think it is that.  What I would say is that when your are younger and in peri, your own hormones tend to kick in and out on an irregular basis and interact with the hrt you are taking.  Because it is peri some months you will get surge and other months the body will produce hardly any which is why in peri you get times when your hrt seems to be controlling symptoms and then other times when you are not. There may be nothing wrong with your HRT regime at all.

I have read on here with some ladies that they up their oestrogel when they are feeling anxious because oestrogen is the feel good hormone and so it balances out any of their own drops in oestrogen and/or progesterone surges.

I know what you mean about losing all your fight - my meno journey has been pretty bad I had all the problems, nausea, anxiety, panic attacks off the scale, insommnia, joint pain etc etc - I am now post but by and large have got rid of all but insomnia (dont use nytol but natural melotonin that is what the body produces, otherwise I am like you cant wake up or feel hungover!) and depression using 4 pumps oestrogel and utrogestan 200mg 12 days cycle.  I am about to get some testosterone to help with the low libido and depression.  It has taken me 5 months to get to here so it can take a while to settle but you are more likely to get fluctuations when you are peri.

don't have any definite answers can only say from my experience and what I know.  Hurdity is usually able to comment on these situations so she might be along soon.  Hope what I say might make  some sense to you though and along with some others advice maybe you will form a plan in your head.  GP's don't always have the answers we know our own bodies best.

[AngsanaBlossom]

Thank you Ladybt28, that makes a lot of sense and I really appreciate you taking the time to write that. Sometimes the madness of it all is the main problem. If I can educate myself on what is happening to me then perhaps I can cope with it better.

I am going to take the Progesterone vaginally and see how that works out next cycle. Failing that, I will look into the Mirena Coil. I just hope my husband can put up with me until the end of all of this.

[Ladybt28]

No worries AngsanaBlossom - its a steep learning curve - so have a read of lots of posts on the forum. The more you read the more it makes sense and starts to resonate with how you are feeling personally and the other thing I would say is, generally there is no quick fix, minimum 3 months of anything and as I said sometimes you have to change tack and try something else and then you start the 3 months count down again cos it didn't come right the first time!  You just have to hang on in there rather than give up really.  Get hubby to read the section on here "info for husbands" - it's a real eye opener - he should be on board after that!! 

[Tc]

Hiya ladies.
Utrogestan. As you know my gp has said my gynae didn't give instructions on how to take it and the sticker on the box says take as directed...
I started 3 weeks ago and My plan was to take it every day until my appointment with gynae tommorow which meant I would've been on it for 21 days and I could then ask about it but....
My appt has been moved to two weeks time which means I will have been taking it for 35 straight days by then.
My leaflet says take for 25 days.
Does "continously" mean that . if,say, you were on it 3 months you would take it each and every day of that 3 months?.
Best wishes to you all x

[Dotty]

Tc.... if you are post meno you take the Utrogestan every day with no break. Are you post or peri menopause? X

[Tc]

Thank you ladies. I'm post meno (surgical).
I will just keep on with it til my appointment now. Thanks for that.
Xxx

[Ladybt28]

Hey Dotty, I am post meno at 57 and I don't take it every day?  I think there is a choice as to what you do.  I choose the system to take it on a cycle and have a bleed because it doesn't agree with me to take it continuously.  The max I can manage (at a real struggle is 10 days) and that is agreed with my NHS consultant and I know there are consultants and GP's who advise even lower number of days for women who react badly to progesterone but have to have it because they have a womb.

I have a chart on my wall given to me by the hospital and it shows both regimes that are regularly prescribed to most women within the NHS guidelines (although progesterone intolerent women often have to go outside these guidelines for their own sanity!)

it says and shows in the chart: I have copied it:
 "Utro 2 capsules to be taken 12 days in last half of cycle (on days 15-26) and withdrawal bleeding,like a period, may occur in the following week, or
Utro 1 capsule is taken on days 1-25 of the cycle and withdrawal bleeding is less likely with this schedule".

Does that answer your question Tc?

My chart shows 30 days total on the cycle - so it would appear to me that although you take the utro every day of the month up until day 25 - so you do in fact stop for a few days (depending if the month is 28 days long or 30 days - most in the year are 30 days) as Stellajane says.  That said I am pretty sure ladies who take it on the continuous cycle here do take it without stopping.

Sure one of them will be along soon! but I can only tell you what the Bessins leaflet (its separate from the one in the Utro box of capsules) that was given to me by the meno clinic at the hospital says.  It shows both uses.