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[Hopeful2]

Hello ladies.

I would appreciate some advice please.

2 months ago I upped my HRT to 1.5mg sandrena. I take 100mg utrogestan days 1-25, but she said I should take it continuously as it may help with erratic bleeding. I've been reluctant to do it as I thought you shouldn't have had a period for a year before taking utrogestan continuously. But as I'm 51 does that not matter. Would you suggest I take the utrogestan constantly now. Thank you for your help.

[bombsh3ll]

There is no meaningful difference medically between taking it 25/28 days or every day.

It is purely a matter of personal preference.

Some people like to have that short break to schedule a bleed, or to fit in with bleeding that they are having anyway.

However as you mention that you are having erratic bleeding on the 25 day regime anyway, it is probably unlikely to make much difference either way, and it will stop when it stops.

There are alternative bleed free options if you prefer.

[K45]

It is entirely up to you how you take it and my GP said last week continuous is fine as cyclical was just awful with huge fluctuations and withdrawal symptoms every 4 weeks. I think I read that after 6-12 months of cycling you can move regardless of whether you have periods or not as the cycling causes withdrawal bleeds anyway.  I was terrified changing the dose might make things worse but a week in and I'm glad I have as 200 mg daily was too much! You could always just give it a go for a few months and if you don't think it's working then return to 25 days.

[Hopeful2]

Thanks so much ladies for your kind replies 💐.

If I were to go up to 2mg sandrena would I need to up my utrogestan? Thanks for your help.

[bombsh3ll]

Based on current guidelines yes.

That would be 2 utrogestan capsules daily.

[Hopeful2]

Thank you for replying again bombsh3ll ☺. I'm going to ask to up everything.

[joziel]

I think you should request more utrogestan unless you can't tolerate it. You can also experiment with taking some or all of it vaginally and seeing if that impacts bleeding. Often we absorb better vaginally so if you\ve got a doctor who won't increase the dose, you can absorb more of it and achieve the same that way...

I currently take 300mg days 7-14 and 400mg days 14-26. Of that, 100mg I currently take vaginally and the rest orally.

Before doing this, I was taking it all orally and I was bleeding around day 17-19. It's only my first cycle taking any vaginally and I'm already on day 21 without a bleed yet, it will be interesting to see if I get to the heady heights of day 26. I might experiment by going back to orally next cycle and see what happens - only because I have also reduced my T dose (I was slightly above female range) and have started back on thyroid meds so all these things can also affect cycles.

[dangermouse]

Sorry to jump in here but does anyone know if you can take the 200mg Utrogestan (pessaries) orally?

I wasn’t sure if they were just a different shape but same materials as I was surprised there was no oral 200s.

[bombsh3ll]

Yes you can, assuming you are using it for endometrial protection.

If it is for fertility treatment the vaginal route is recommended.

Medscape.NZ have a helpful information sheet on this.

[dangermouse]

Thanks so much! Just using it for progesterone only.

[bombsh3ll]

Then you can use it whatever way suits you!

[joziel]

If you mean the Cyclogest pessaries (which are 200mg each), I think they are made from some waxy stuff which dissolves in the vagina. I don't know if you can take that orally....??

Utrogestan (100mg each) you can use either way...

[dangermouse]

Thanks Joziel, no it’s Utrogestan 200mg pessaries. I know there were always 100 and 200 options but I didn’t realise the 200 was a pessary (if you Google it you’ll see the box) but sounds like it’s still encased in a capsule.

[joziel]

Oh right, I didn't know 200mg utrogestans existed!