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[NikkiLM]

I've been on cyclical Sandrena estrogen and Utrogestan progesterone for around a year now, and since day one I've had terrible cramping and digestive issues during the 12 days I'm using the Utrogestan.

A few months ago I spoke to my GP about taking it vaginally, as I thought this would help ease the cramping and gut issues. I've taken 2 capsules vaginally on days 12-26 for the last 3 months (as advised by GP), and whilst the cramps and other issues have eased, I've had thrush every month since using it this way.

I'm wondering if anyone that suffers from progesterone intolerance has found an alternative body identical progesterone that they can tolerate? I've read about cyclogest, but I don't know how easy it is to get this prescribed as HRT. Any advice would be appreciated. Thanks 😊

[K80m]

I don’t have any advice I’m afraid but have had awful gut issues since starting hrt (very painful bloating/intolerance) so will follow this thread with interest. I hope someone can recommend something for you.

[CLKD]

The vaginal walls become thin as oestrogen levels drop which can present as 'thrush'.  NicclLM - is there a discharge/odour and has the Nurse taken swabs to confirm and advised appropriate treatment? 

It may be that inserting anything into the vagina may cause itchiness.  Do read our 'bladder issues' and vaginal atrophy threads.

U could also put the product name/s into the search box to read other threads on Utrogestan, make notes ;-)

[NikkiLM]

It definitely seems like thrush to me. The only thing that's clearing it each month is taking Fluconazole.  In the initial stages of peri I used to suffer more from vaginal irritation, which I learned to manage with a vaginal moisturiser. Whilst I've not had a swab taken, I'm sure it's thrush based on symptoms. I'm trying to get a GP appointment to confirm this, but it's so hard where I live. I've got an appointment with Newson clinic, but it's not until September.

[bombsh3ll]

Why not just ask your GP for the cyclogest pessaries whilst you wait for the Newson appointment.

They are licenced for vaginal use (although not for HRT). They are like waxy bullets, not capsules. I used them as an IVF patient.

Tell them about your difficulty with the capsules.

They might say no but you've nothing to lose by asking!

[Penguin]

I used cyclogest rectally for ivf and it was fine. Definitely worth asking for. I know they usually only prescribe it on the nhs for ivf or miscarriage prevention but I'm sure I've heard a couple of people on here say that they've got it from their GP for hrt.

[sheila99]

It may well be related to va starting. I was fine using it vaginally for a long time but now it feels like thrush but think is probably irritation because of va. I've used it rectally for 5 cycles. Very much off licence but I had a decent bleed every time vs approx 1 in 3 vaginally so for me it seems to be working better this way. My GP wouldn't prescribe cyclogest because it isn't on the list. As you've already had vaginal irritation I would ask for topical oestrogen, it will only get worse without it.

[Hurdity]

I always get vaginal or more specifically, labial irritation when using Utrogestan vaginally (which is the only way I have ever taken it) and it's not thrush, not sure what the reason is. Also causes increased nocturnal urinary frequency.

Cyclogest is licensed for both vaginal AND rectal use, but as we know, not for HRT. I used it for several years before Utrogestan was available (for HRT) - prescribed by my wonderful enlightened gynae specialist GP ( at 400 mg for 11 days per 28 - somewhat higher dose than recommended) - but then once utrogestan was talked about on here in 2011 (because it was becoming more widely used) I switched to that.

You could always quote the BMS recommendations if your GP is reluctant:

"In the UK, vaginal micronised progesterone preparations that offer the doses
commonly used within HRT include 100 mg vaginal progesterone tablets (Lutigest) and 200 mg
vaginal pessaries (Utrogestan or Cyclogest). The latter combinations are not licensed for use as
HRT but can be used off-license to provide the progestogen component of HRT in women who
experience progestogenic side-effects with oral intake."

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

Hurdity x

[AKatieD]

Use Crinone which is a body identical progesterone, but g.p. wont support so have to get privately. No problems with it

[CLKD]

NikkiiLM - at the end of each period I would have 2 days without a bleed followed by 24 hours of brown discharge and intense itching high up.  When I stopped The Pill I had thrush, definitely different to the VA symptoms experienced many years later.  The Gynae Registrar gave me a pessary and told me not to scratch    .

VA can also mimic repeated urine infection-type symptoms really really well which is why many GPs dole out antibiotics rather than thinking along the lines of VA  .  Whilst they will ease symptoms of the need2P - I would sit on the loo as the place to relax with a cuppa in one hand and barley water  in the other.  ABs will reduce any inflammation but won't help with the loss of oestrogen.

Getting older aint for wimps! 

[NikkiLM]

Thanks for your comments everyone. I will ask for Cyclogest when I finally get to speak to a GP, and I'll quote the BMS recommendations (thanks Hurdity for the link).
Sheila99, did you use the Utrogestan capsules rectally? I had considered trying this, but I wasn't sure if the capsules were okay to use this way.

[sheila99]

Sheila99, did you use the Utrogestan capsules rectally? I had considered trying this, but I wasn't sure if the capsules were okay to use this way.

Yes but it's off licence this way. According to the Internet there are some places that let you take it this way for ivf but I haven't found anything for hrt. You could arrange your own scan after a few months if you want to check the lining isn't building up.