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[GetStuffedPeri]

Hi Howellis - welcome!  My wife has reacted terribly to the utrogestan in this regime - we are gutted because the gel works wonders but the progesterone renders her feeling as sick as a dog, a complete zombie, etc etc.  She has been on a conti regime (3 pumps and 100mg every day) for 9 weeks and we are now looking to move to a sequi regime so she can have less days on the utrogestan.  Will seem a bit strange as she's been period free for 18 months but she cannot function on this tablet every day (orally or vaginally). 

All that said - your symptoms could well be caused by too much estrogen.  Whereabouts in your meno "journey" are you? Periods/symptoms/age etc? Could you perhaps drop to half a pump?

Best of luck with whatever you decide to do, but I would suggest to give it more than a week if you can bear it - the gel works WONDERS after a week or 2, honest 

[Springtime]

Hello lovely ladies – this is such a wonderful resource 😊

Question:
How do I safely switch from sequi oral to conti vaginal Utrogestan if there is no bleed during the prog-free gap?

I am postmeno, 60 yrs. Been on HRT for 4 years. My prescription so far, taken in the evening:
1 pump estrogel (75 mcg) on thighs
1 peasized amount of Testogel (behind knees)
200 mg Utrogestan (oral) X 12 days per month, to be reduced to 100 mg cont daily or every other day.

Looking for a minimum amount of HRT as I need it longer term for bone health.
Because of increased breast tenderness/size and low-dose of estrogen I asked GP whether I could less Utro. GP recommended to use 100 mg Utro vaginally and on a conti regime daily or every other day, but she wanted to first confirm with a specialist. I am still waiting to hear back but am now approaching the end of my Utro free phase (day 17/31), so am not sure whether it’s safe to move from oral 200 mg to vaginal 100 mg (daily or on alternate days) after a 17 day gap? I failed to find an answer on the forum as to how I could transition safely.

Have had almost annual scans, lining always thin.
Never having bleeds during prog-free break.
Have a small cyst which has remained the same size.
Tolerated progesterone well, just made me super sleepy/drowsy 🤪 .

I worry that 100 mg on only alternate days isn't safe enough, but I could perhaps take it daily and have a 3 day gap once a month? Hurdity mentioned this somewhere but couldn't trace the thread.

I'm sorry about the long message but would love to hear your thoughts.

[sheila99]

If you don't bleed on your current regime it's most likely because you're on low dose oestrogen so there hasn't been a build up. I would take the 200mg x 12 days, give it 3 or 4 days to make certain you won't bleed then continue with conti. If you're worried about a build up you could arrange your own scan, I believe it's around £80.

[Springtime]

Wow! What a prompt reply, MUCH quicker than my GP 

Resuming 12x200 mg Utro (did you mean orally?) and then have a 3/4 days Utro-free break before switching sounds like a good plan - even though I am quite sure there won't be a bleed.

After the 3/4 days break are you suggesting that I'd switch to 100 mg daily (vaginally) with a 3 day break each month? Or did you mean 100 mg on alternate days and without an break?

And about the £ 80.- scan: good to  know, I'd expected this to be more costly. You wouldn't be able to recommend a particular clinic anywhere in Greater London or the Southeast?

[Jaylow]

I take it there isn’t an alternative to utrogestan for those who like using the gel? Apart from the mirena coil.
There’s obviously a progesterone in some patches along with estrogen, but not a progesterone only patch?

[Hurdity]

Springtime - just to add that the licensed dose of utrogestan for continuous use is 100 mg orally for 25 days per 28 day cycle although in practice this is given daily. The 3 day break is to enable a bleed if there is to be one. As you know used vaginally for HRT is still bizarrely off licence and havling the vaginal dose compared with oral also off-licence.

Personally if you are switching to conti as well as vaginally I would start with daily 100 mg utro with the 3 day break for a few cycles and see how you get on, as you suggested yesterday and then take it from there.

Re scans - I've had these a couple of times through ultrasound direct - they operate nationwide I think?

Hope this helps

Hurdity x

[Hurdity]

I take it there isn’t an alternative to utrogestan for those who like using the gel? Apart from the mirena coil.
There’s obviously a progesterone in some patches along with estrogen, but not a progesterone only patch?

Correct there are no progesterone only patches but the other licensed product is Provera available in tablet form which some women use successfully alongside transdermal oestrogen.
https://www.menopausematters.co.uk/to_progestogens.php

Hurdity x

[Springtime]

Springtime - just to add that the licensed dose of utrogestan for continuous use is 100 mg orally for 25 days per 28 day cycle although in practice this is given daily. The 3 day break is to enable a bleed if there is to be one. As you know used vaginally for HRT is still bizarrely off licence and havling the vaginal dose compared with oral also off-licence.

Personally if you are switching to conti as well as vaginally I would start with daily 100 mg utro with the 3 day break for a few cycles and see how you get on, as you suggested yesterday and then take it from there.

Re scans - I've had these a couple of times through ultrasound direct - they operate nationwide I think?

Hope this helps

Hurdity x

Perfect, thank you so much for clarifying this Hurdity, I’ll give the conti vaginal 100 mg Utro a go for 25 days and then have a break for 3 days. Can’t wait 😊 .

Three more questions, if I may:

a) When is a good time to start the new regime? I am currently on day 18, the penultimate day of my Utro-free phase. Can I start the new lower dose conti/vaginal regime tonight or is it safer to have another round of 12x200 mg of Utro first, check for a bleed (won’t happen though) and then start the 100 mg dose after a shorter gap?

b) I apply all items (estrogel/testogel/Utrogestan) together at the same time in the evening?

c) I’ll assume that unlike when taking Utro via the oral route, I no longer need to observe the 2 hour no food intake rule? 🥳


Very grateful for the recommendation re ultrasound scan: I’ve just looked up Ultrasound Direct.

x

[jag2107]

Hi I’m just going into my 3rd month of utrogestan and estrogel  -2 pumps . Month one wonderful , month 2 when I came to the break between days 25-28 as advised to do by my dr I felt awful . Hot flushes dragging sensation in my uterus , and then bleeding , not a lot . I’m now in month 3,  6 days back into taking both and I feel much better in myself but still bleeding slightly and period like pains . Is this just the settling in time on the hrt and can you not have a break from the utrogestan , will this stop this problem ??
Thanks

[alibeau]

I've been on 3 pumps oestrogel and 2 oral utro 12 nights per month since FEB.  I am 49 and peri.

I felt a real boost when I switched to this regime from Femoston 2/10.

However I now think I am forming a possible pattern of my anxiety kicking in quite badly when I finish the utro tablets and this takes about a week to subside.

Is there any way of improving/avoiding this?

Many thanks.

Ali x

[alibeau]

Can you just try using it continually Ali to prevent withdawal symptoms?

I've no idea Avalon 

It's been so long since I've seen my preferred 'hrt' GP, for the last review I had in Jan with a different GP I had to 'tell' her the regime I wanted to switch to as she was pretty clueless.  Thank god for this forum and the wonderful advice given..... I have no idea if I could/should take the utro continually!

Thanks for your reply.

Ali xx

[pepperminty]

Hi Alibeau, whilst in peri our own hormones can go up and down in the backgound also.  Try magnesium rich foods and breathing exercises also, as this may help.

Sometimes it is because we need more estrogen also. Or have you been using suncream or more moisturiser during the weather change which could effect absorption? Or have you been prescribed the other type of gel which some ladies don't find works so well. Liz Earle did a pod cast on this and there are threads here about it too.

Just some ideas incase .

Peppermintyxx

[Wannabewell]

Hello,

I hope you don’t mind me joining.

I’ve just been prescribed Utrogestan and Oestrogel.

I’ve missed 8 periods and have been struggling more and more with peri symptoms over the years and particularly last few months. Very low moods particularly bad.

I’ve not had HRT before. After reading up around I decided to ask for this regime.

I’m a bit concerned because it looks like my pharmacy don’t have it? Is there a problem getting it in U.K. at the moment?

If so which chemists stock it?

If I can’t get it I’m not sure which type of HRT to ask for. I get migraines so transdermal is advised.  Also I have a history of being sensitive to progesterone (PMS,  pill made me moody etc).

Any help at all or reassurance would be really appreciated.

Thank you. X

[pepperminty]

Hi Wannbewell,

as far as I am aware there is no shortage , so I would speak to the chemist and ask why they can't get it.

PMXX

[sheila99]

I haven't had a problem getting it either, any pharmacy should be able to order it. I couldn't get on with the pill either, no side effects from the prog on evorel and get fatigue on utrogeston. I don't thing intolerance of the pill necessarily means you will have a problem with hrt.