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[Nicola Winter]

I'm now on daily desogestrel (mini pill) and uterogestan. I'd like to find a good regime for the utogestan to avoid a bleed, and also keep other unpleasant symptoms of the uterogestan at bay. I wonder what the smallest dose of uterogestan is over each month that I can get away with? I'm trying 100mg orally at night every other day, but I'm getting IBS symptoms from the uterogestan days. Maybe vaginally 100mg every other day 🤔. Any suggestions would be welcomed.

[Flossieteacake]

Would it work to use two desogesteral instead? That can be used as the progesterone part of HRT.

[Dotty]

https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

I was just about to say the same as Flossiecake 😊 …. You can use 2 x desogestrol as the progesterone . See page 7 of the above document.

[Hurdity]

Looking into this further, the references quoted in the BMS article refer to a contraceptive product called "Liseta" which consisted of 1.5 mg oestrogen (for 24 days), 1.5 mg desogestrel (12 days) and 4 placebo days which was studied initially to investigate its effect on various biological factors including the endometrium, and then comparing its efficacy to an HRT product containing MPA.
https://pubmed.ncbi.nlm.nih.gov/10714908/
https://pubmed.ncbi.nlm.nih.gov/8429799/

I wonder what happened to this?

The BMS is referring to the small study which showed no adverse effects on endometrium for a small group of women taking this product for one year: "The treatment alleviated vasomotor symptoms effectively in all the women and induced regular withdrawal bleeding in 86% of them. Secretory changes were observed in the endometria of 16 of the 20 women with adequate endometrial samples assessed after 12 months of treatment. No signs of hyperplasia or atypia were found. "

As always the effects are likely to be dose dependent so those on higher doses of oestrogen will need to be monitored more closely on this off-licence regime.

Hurdity x

[Nicola Winter]

I kind of wish I didn't need the mini pill, it's not for contraception, it's to stop the heavy bleeding which I was getting on the uterogestan alone as the progesterone element of HRT. I want to persevere with the uterogestan because its better for my body than the synthetic mini pill, but just want to find the right amount to protect my uterine lining, the right route and regime to keep the side effects to a minimum. The mini pill kills my libido 🥺 but I can't seem to find a better solution. I'm contemplating the mirena, but had that years ago and it didn't agree with me, so that puts me off.

[Dotty]

Hi if you look at the article that I posted I think it advocates taking 300mg of Utrogestan instead of 200mg.