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[SpenA]

Hi,
I am new to this group.  I am 47 and have just started Hrt- 1mg Divigel and 200mg Utrogestan for 14 days.  I was having night sweats, low mood which is why I started hrt though was still having periods- much lighter than they would normally have been and not as regular.  After 7 days of taking the Utrogestan I have started bleeding very heavily. (In the last few years I have had very heavy periods at times but it had settled in the last 9 months) Should I continue to take the Utrogestan for the full 14days ?  Does anyone know why this would happen? I thought it was after you stopped progesterone that bleeding would start.  I researched alot before taking Hrt and felt bioidentical divigel and micronised progesterone were the best/safest option available which my GP agreed to prescribe so feel a bit deflated now.
Thanks.

[Dancinggirl]

I'm afraid this can happen on Utrogestan as it isn't as powerful as the synthetic progesterones, especially when taken orally. You should take it for the full 12 days though, to ensure the lining sheds properly.  The lining may have built up too much causing a spontaneous shedding but it is early days for you on this HRt regime and your body may well adjust over the next few months.  Dg x

[SpenA]

Thanks Dancing girl.  Hopefully it will settle down.  About 18 months ago I tried going on Cerette, the progesterone only pill, but I just bleed continuously till I came off it after 7 weeks so am worried that this is happening again.  I didn't really understand why that happened and now feel confused also. 

[sheila99]

I think you're till in peri? In which case it could be because of how much your own body is producing.

[NorthArm]

I've been doing some reading on this.

Apparently if you start Utrogestan before day 15 of your ‘cycle', then breakthrough bleeding is common. The usual cycle using this regime is 15 days gel / patch / tablet then adding Utrogestan for 12 days from day 15. If breakthrough bleeding is a problem, then Utrogestan can be added at about Day 17 instead. If it's still a problem, then Utrogestan from day 19 for 10 days apparently.

I've just had a failed attempt at having a Mirena inserted (scar tissue from previous caesars) and had been bleeding every two weeks with Utrogestan. So, while I'm waiting for a gynae appointment to have the Mirena, a hysterectomy and d&c under general anaesthesia I've decided to stick with the Utrogestan and try one of the above methods xx

[Dancinggirl]

NorthArm - I don't where you got your ideas about the way to take Utrogestan but I'm afraid you are not correct about the way Utrogestan should be used.  It is common to get erratic bleeding with Utrogestan because it is not as powerful taken orally, so often shedding (bleeding ) will occur as a result - I had this problem with both the sequential and continuous versions with Utrogestan and unfortunately I couldn't use it vaginally as it irritated my urogenital atrophy too much.   Delaying and shortening the Utrogestan phase of a sequential regime could make erratic bleeding worse.
Some erratic bleeding is likely when first starting any HRT regime - the body needs to adjust to the hormones.
Here is the section from this site that clearly gives the guidelines on using Utrogestan:
https://www.menopausematters.co.uk/to_progestogens.php

DG x

[SpenA]

Thanks for those replies.  I did start the Utrogestan on day 15 of the cycle.  Hopefully it will settle down in the next cycle.