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[Anonymous1]

Hi,
I recently started HRT Sequential (Evorel 50) and Utrogestan 100mg x 2/day.  I noticed a signficant improvement in my mood and motivation on Everel 50.  However, I experienced some unpleasant side effects on Utrogestan; including headaches, depression, anxiety, feeling groggy/unwell and tiredness.

I changed to taking Utrogestan vaginally 100mg/day x 1/day.  The side effects were a bit less but still bad. 

I have chronic fatigue due to long term complex mental health difficulties, chronic stress and peri/menopause.  I was not able to tolerate the further reduction in my mood on Utrogestan and stopped the HRT after the first month.  I feel better without it than when I was on the Utrogestan.

I booked an appointment at a private menopause clinic.  She suggested I take the Everel 50 to get my oestrogen levels up and then re-introduce Utrogestan 200mg orally or Cyclogest 100mg/day vaginally or Everol Conti continuously.  I could also consider the Mirena coil.  She advised me to trial things for a month.  She said the Mirena coil can cause a hormonal surge so can take longer to settle e.g. 2-3 months.

It sounds like a lot of trial and error.  For example:- I could end up trialling something a whole month and the side effects still might not improve.

Did anyone have bad side effects on Utrogestan which got a lot better after a month?
Did anyone tolerate other forms of Progesterone better?

I am just wondering whether it is the right time for me to trial HRT if I may have to endure a further reduction in my mood for a month or possibly a few months trialling Utrogestan or alternatives. 
I have heard that the Cyclogest can sometimes be better tolerated.  However, I tend to be very tired after my evening meal due to chronic fatigue so it will take more effort to use this than a tablet.

[Mary G]

I would be inclined to try Cyclogest.

My experience is probably not relevant to you but I found Utrogestan triggered my silent migraines.  Other women have different problems with it like low mood and insomnia but generally speaking, it's not well tolerated and you don't have to be progesterone intolerant to have difficulties with Utrogestan.

50mg Evorel is not a particularly high dose of oestrogen and if you suffer with depression, low mood and fatigue, 200mg Utrogestan is probably too high a dose in one hit.  Some private clinics suggest using 100mg Utrogestan vaginally every other day - I tried this but it was a massive fail and it didn't improve over time. 

100mg Cyclogest is also a high dose.  I would be inclined to try the Cyclogest continuously at a lower dose and have regular scans because chances are, you don't need as much as 100mg every day. 

I find I can take 50mg progesterone (but not Utrogestan) every day with zero side effects but 100mg seems to knock out the positive effects of oestrogen and trigger my migraines.

Unfortunately progesterone is the Achilles heel of HRT and difficult to get right.  It is not helped by the high doses that are prescribed either.

[Anonymous1]

Thank you Mary.

[Hurdity]

Hi Anonymous

I used Cyclogest for the first 3 years on HRT but the dose I was prescribed was 400 mg for 11 days per 28 day cycle off licence from NHS GP. I used to get regular migraines on withdrawal. Later utrogestan became available so I changed to that and have been taking it for the past 13 years. Usually on long cycle and always 200 mg for approx 12 days vaginally. Needless to say I hate it! I think my tolerance to progesterone has decreased as I've got older. I would be very happy never to have to use progesterone again.

Yes it makes me tired, and especially in the mornings, and various other side effects. The point is that all progesterones have a sedative effect = that is part of what this hormone does - and at the doses needed for endometrial protection, is higher (in one dose) than we naturally experience, other than during pregnancy.

I would suggest that one reason some say that Cyclogest is better tolerated is that the dose given seems to be much lower than I was given. As far as I recall there are not studies researching the effect of Cyclogest on the endometrium as part of hRT, though some earlier studies do not specify brands, when talking about micronised progesterone. I haven't checked recently.

Cyclogest does not come in lower doses than 200 mg since it is designed for fertility and so I am puzzled that your meno specialist has prescribed 100 mg per day, unless she means on average ie 200 mg every other day. It is very important to be monitored when using off-licence regimes like this especially at that dose - to ensure your endometrium is properly protected. I didn't need to worry because the dose I was given was very high!

Possibly some synthetic progestogens have less of a sedative effect because they can be taken in lower doses due to being more stable in the blood? But they can have other progestogenic side effects which are undesirable too.

Chronic fatigue - have you had thyroid function checked properly? Ditto you may be be low on testosterone....

All the best with your trial and hope you find something that works for you soon!

Hurdity x

[Talli]

I e just started Utrogestan and Lenzetto and after a few days I felt horrendous. I think it was the Utro and I have no stopped it and symptoms are very slowly getting a teeny bit better but still awful.
I totally sympathise with you

Talli Xx

[Evie606]

Hi,
I recently started HRT Sequential (Evorel 50) and Utrogestan 100mg x 2/day.  I noticed a signficant improvement in my mood and motivation on Everel 50.  However, I experienced some unpleasant side effects on Utrogestan; including headaches, depression, anxiety, feeling groggy/unwell and tiredness.

I changed to taking Utrogestan vaginally 100mg/day x 1/day.  The side effects were a bit less but still bad. 

I have chronic fatigue due to long term complex mental health difficulties, chronic stress and peri/menopause.  I was not able to tolerate the further reduction in my mood on Utrogestan and stopped the HRT after the first month.  I feel better without it than when I was on the Utrogestan.

I booked an appointment at a private menopause clinic.  She suggested I take the Everel 50 to get my oestrogen levels up and then re-introduce Utrogestan 200mg orally or Cyclogest 100mg/day vaginally or Everol Conti continuously.  I could also consider the Mirena coil.  She advised me to trial things for a month.  She said the Mirena coil can cause a hormonal surge so can take longer to settle e.g. 2-3 months.

It sounds like a lot of trial and error.  For example:- I could end up trialling something a whole month and the side effects still might not improve.

Did anyone have bad side effects on Utrogestan which got a lot better after a month?
Did anyone tolerate other forms of Progesterone better?

I am just wondering whether it is the right time for me to trial HRT if I may have to endure a further reduction in my mood for a month or possibly a few months trialling Utrogestan or alternatives. 
I have heard that the Cyclogest can sometimes be better tolerated.  However, I tend to be very tired after my evening meal due to chronic fatigue so it will take more effort to use this than a tablet.

Hi there,

I felt horrendous on Utrogestan but have being doing fine on Cyclogest 200mg, taken rectally just before bed every other night.
I don’t find it increases fatigue at all and I have issues in that area due to autoimmune.

E x

[Keep On Swimming]

Hello Anonymous,

I have tried Utrogestan orally and vaginally and it makes me so ill and dizzy after just a few days I have to hold on to the wall to stand up... Then I was told to double up my Cerazette progesterone-only pill but it gave me the same symtoms - I have long covid with an ME / CFS profile and progesterone makes me crash. I know you understand what I mean!

I am under the care of a meno specialist in the UK because I live in France and there is no perimeno care here. She is happy for me to stay on just 1 Cerazette pill as long as I have regular bloods done to check my oestradiol levels are not too high and a regular scan. She said that if we need to add in extra progesterone then we will do so with Cyclogest 50mg (by cutting the pessary in half) every evening. She said that not all women need such high doses of progesterone - I just wanted to let you know that some meno specialists get that not all women can cope with 100mg of progesterone every day. Obviously she asked me lots of questions and this is an individual prescription for me, but something you could ask your own meno specialist.

All the best xxx

[Banjo1973]

Hi Keeponswimming,

Thank you so much for sharing. I'm very interested in progesterone prescribing. Like many women on here I don't get on with Utro. I also know that I personally don't need anywhere near as much progesterone as some women do.

I've got Cyclogest to try on my next cycle and I really hope that works.

Thanks again, and good luck everyone in funding a solution x

[Anonymous1]

Thank you everyone for your responses.  I have stopped the HRT and feel a lot better than when I was on the Utrogestan.  I will try it again in a few weeks or so.  I have ordered a box of Cyclogest from a independant pharmacy to try.   They let me have it as a one off.
 

[Keep On Swimming]

Hi Anonymous1,

Just to let you know that my meno dr let me get comfortable on oestrogen before asking me to add in progesterone (which was a failure so I'm just on my POP which I already mentioned).

Maybe you could ask if you can just start on the oestrogen part of your HRT to let your body adapt to that for 2 - 4 weeks before adding in the Cyclogest? I felt like a new woman after just 5 days of oestrogen!

All the best xxx

[violetbat]

I have recently switched from utrogestan ( which I took sequi for 5 years and hated it) to norithisterone, which I know I can tolerate better.
It’s not perfect, but it is tolerable.

[Anonymous1]

I have recently switched from utrogestan ( which I took sequi for 5 years and hated it) to norithisterone, which I know I can tolerate better.
It’s not perfect, but it is tolerable.

That's good to hear.  Thank you for your reply.

[Anonymous1]

Hi Anonymous1,

Just to let you know that my meno dr let me get comfortable on oestrogen before asking me to add in progesterone (which was a failure so I'm just on my POP which I already mentioned).

Maybe you could ask if you can just start on the oestrogen part of your HRT to let your body adapt to that for 2 - 4 weeks before adding in the Cyclogest? I felt like a new woman after just 5 days of oestrogen!

All the best xxx

Thank you for your responses.

[Blythe]

Oh I’ve just posted a new thread. I hate the bloody stuff.

Funny as I spent years going IVF and used to stick 1000mgs up there and loved it then!!


Anyhow, this is one for Hurdity. I want to try long cycle with it but I’m not sure exactly what that looks like. Is it just taking it for 10-15 days every three months?  I have a specialist menopause appt today but that is to try and get some testosterone. I was going to raise the progesterone problem but it is an NHS appt so I don’t expect any support for a long cycle.

[Anonymous1]

I thought I would post an update.

Background;  51, post meno March 2023.  Pre-existing health problems:  Chronic fatigue, mental health - On medication/supplements.

I started Cyclical HRT a few months ago (Evorel 50 and Utrogestan 200mg/day Days 15-28).  3 month prescription was issued.  I experienced a signficant improvement in my mood and motivation within 2 days of starting Evorel 50.  I experienced very unpleasant side effects on the Utrogestan orally and vaginally; including severe depression so stopped the HRT after the first month.  I ordered Cyclogest from a independent pharmacy and also experienced side effects with this. 

I felt very depressed when I stopped the HRT for a month.  I think this is because I am now 12 months withouth a period. 

I saw a private meno nurse whom suggested taking Evorel 50 for a month i.e. optimising oestrogen; before re-introducing Utrogestan or a different form of progesterone on a continuous regimen.

I re-introduced Evorel 50 and once again noticed a siginficant improvement in my mood and motivation within a few days.  I asked my GP to prescribe Evorel Conti.  After 2 weeks on Evorel 50 I decided to re-introduce progesterone at half the normal dose to see if I tolerated it.  I tried the following:  Evorel Conti 1/2 patch, Evorel 50 1/2 patch. 
I felt OK on this.  I noticed a small improvement in my sleep quality and reduced anxiety. 

After a few days on the reduced dose I started using the Evorel Conti patch on it's own (Normal dose of progesterone).  After 1-2 days on this I noticed that I felt really tired, a bit sedated and now my mood has gone flat.  I assume it is because of the increase in dose of progesterone.  I know it is very early days but I am disappointed.  I can see that a lot of patience, waiting and trial and error is required to find a regiment that work.  I'm pleased that I have had less side effects than on the Utrogestan.

I think I am going to go back to Evorel Conti 1/2 patch and Evorel 50 1/2 patch for the next few days to see if it is definetely the progesterone.

I know that I will need to take the full progesterone dose soon.