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[strawberry]

Hello,
This board has been tremendously helpful for me and this is my first post. I am on cyclical HRT and still cycling in perimenopause. I started in late October 2023. The standard 200 oral progesterone plunged me into darkness and immobility (I am angry I was given no warning about this common effect). After trying it continuously every other day, I settled on vaginally inserted Prometrium pills (this is a US formulation but I get the impression it correlates to Utrogestan. I am not recommending, and have no medical training, but after reading several studies, I got the impression that more progesterone was going directly to uterus and decided to take the calculated risk since I still produce progesterone with my cycle to use the 100 mg pills, ie decrease my dose. My over-progesterone-ized feelings include having a sense of immobility, demotivation, ahedonia and a kind of chemically induced passivity that I find very triggering.

I started looking into half-life and build up of this drug in the system since these feelings begin to creep in toward the end of the cyclical period even on 100 vaginally. I also felt concern about the dyes they use in Prometrium. In this research I found Crinone, a suppository used for this reason that apparently does not have dyes and additives(?) or at least is formulated for vaginal use. I found it in this study, which reports NO side affects when people are using this for HRT. The study also starts the drug affect was observed to be 10x the oral route. Much higher than the comparisons of using the same pill orally and vaginally. fwiw:
https://d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/349/Vaginal%20progesterone%20and%20the%20vaginal%20first-pass%20effectClimactericVol%2021,%20No%204.pdf
 
Has anyone used this, or have thoughts? Also interested in hearing if anyone is still having intolerance symptoms using progesterone vaginally.

thank you!

[Mary G]

I have never tried Crinone but I have used both Utrogestan and Cyclogest vaginally and I can say that Cyclogest @50mg had zero side effects whereas 100mg Utrogestan vaginally was terrible.  I didn't get on with 100mg Utrogestan every other day either.

Obviously there are exceptions but generally speaking, Utrogestan is not well tolerated and is the mostly frequently discussed problem on here.  Most women do better with it vaginally but even then the side effects are significant.  There is a school of thought that you can use a lower dose if used vaginally which makes sense but in my opinion, 100mg progesterone in one hit is too much and seems to cause side effects and knock out the beneficial effects of oestrogen.  In my case, it triggered migraines.

This is just my personal opinion (again) but I think studies are only useful up to a point and should not be taken as gospel because they often conflict.  The studies on HRT carried out in the early 2000s did far more harm than good and turned out to be deeply flawed.  God knows how many years those studies set HRT back.

If you have problems tolerating progesterone, the only way around it is to take a sensible, tolerable dose ie 50mg ish vaginally and have regular scans to make sure you are getting adequate clearance/thinning.  It's better and safer to have regular scans anyway because it picks up other conditions and checks ovaries, bladder etc.  There is a chance that you will be unlucky and need a high dose of progesterone but it's far better to find out for sure than to keep guessing how much you need.

I would say Cyclogest is definitely worth a try.

[Peanut31]

Hi

I’ve been advised to try Cyclogest but half the capsule to 100mg (they are 200mg prescribed).

I’ve not used it yet, what did you notice using Cyclogest

I just can’t get on with progesterone, I know for a fact it’s progesterone as tried a month without it and felt so much better. My mood is so low on progesterone.

I note you said you got on better with Cyclogest, did you have to cut the tablet up as you mention 50mg.

I take progesterone 14 days on, 14 days off and one pump of oestrogen.

I’ve now sourced a local company that offer scans to check the lining of womb.

Any advice greatly appreciated.

Best wishes

[Mary G]

I found Cyclogest had zero side effects.  I have 400mg pessaries and I cut them up into 50mg doses.  I use them intermittently as a booster with progesterone gel. 

I tried them every night for a few weeks as an experiment and still found them to be very good and no cumulative effect that I had with Utrogestan.

I think the low dose is the key to success and it definitely minimises side effects.

I find 50mg is enough with one pump of Oestrogel and hopefully you will be the same but obviously it's best to have regular scans to make sure.

[Peanut31]

Thank you for your reply.

That’s really helpful.

Best wishes