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[Sid]

Hi
I am 53 and peri and was prescribed Evorel 50 patches and 12 days x 200mg Utrogestan in Jan of this year. My specialist started me on this regime because a DEXA scan showed I have severe osteopenia (genetic, unfortunately, osteoporosis was a factor in the deaths of my mother and grandmother). The hope is that HRT will help to minimise further bone loss. I am finding quite a bit of breast tenderness and swelling but this is bearable. My main issue is that I am starting to bleed before I finish the progesterone. My specialist suggested starting it on day 11 of my cycle rather than day 15 as she thought my own hormones were probably kicking in.  I have done this but am still not managing to take 12 days of Utrogestan. I normally start to bleed after day 9. Any advice would be much appreciated. Sid

[Dancinggirl]

Hi and welcome to MM Sid

I'm afraid many women get erratic bleeding when using Utrogestan.  Though it is bio identical and therefore often deemed preferable to other progesterone types, it can give these issues with erratic bleeding. 
Have you tried using it vaginally? This will often minimise side effects and delivers the progesterone more directly to where it is needed, so could work more efficiently and control your cycle better.  I wouldn't start Utrogestan earlier in you cycle.  You could switch to Provera that is a bit more powerful, so better at controlling things, or have a Mirena fitted as this would probably result in no bleeding at all after a few months.
I would try using Utrogestan vaginally first (just push the capsules up inside the vagina, as high as you can, before bed) - for days 15-26 and see if that helps.
I did find that my bleeds often started before the end of any progesterone phase so it's nothing to worry about.  The important thing is to have a good bleed each month to protect the womb lining. DG x

[Sid]

Hi
Thanks very much for your reply. I have been taking the Utrogestan PV (my specialist had told me this would be fine). I think that she suggested day 11 because my cycle had often been about 24 days before starting HRT (I had been having regular periods ranging between 2 weeks and 8 weeks but often around 24 days).  I do get migraines which seem to be a bit aggravated by the Utrogestan, so would be a bit nervous about taking more powerful form but may be a Mirena would be effective 

[Dancinggirl]

I found the Mirena the least problematic. Do look under TREATMENTS on this site for more info on the Mirena. DG x

[Sid]

Definitely intend to carry on with HRT - my bone loss is already quite serious despite me being very physically active and not having been through the menopause yet (when most bone loss would normally be expected). My specialist reckons HRT is the best protection at this stage 

[Sid]

Hi Stellajane,
I was quite slim - was 8st 2lbs - but my sister, a GP, told me to put on a bit of weight after my diagnosis (am now 9st). My mum was thin as a younger woman but neither of us had any obvious risk factors - she, like me, always walked 2 or 3 miles every day (she never learned to drive).  She was only diagnosed with osteoporosis after a horrible fracture to her wrist. It needed a plate fitting but the bones were just too fragile to take the screws so she was left with virtually no function in that hand. She was prescribed alendronic acid but too late for it to be effective. I've been told I am too young for bisphosphonates (and am not postmenopausal). The clinician who did my scan (which I paid for privately) was really sniffy and said she didn't know why my specialist had suggested the scan as ‘you haven't even been through the menopause”. She did look a bit chastened though when she saw the results! 

[sheila99]

I've only had 2 cycles on utro and both times the bleed has come a couple of days after starting utro. In peri, 200mg vaginal utro, I don't think my own body is contributing much.