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Progestogens


PROGESTOGENS - The following progestogens can be given with estrogen only regimes:

PROVERA -
also available as

MPA

10 mgs daily for 14 days per 28 days

UTROGESTAN micronised progesterone 200mg daily at bedtime for 12 days per 28 days (days 15-26 inclusive)
Price: €6.05 for 30

Careful explanation is required as to the timing of administration of the separate progestogen, in order to synchronise it with the existing cycle.


MIRENA
Mirena is a levonorgestrel releasing intra-uterine system. It is licensed in the UK and Ireland as a contraceptive agent, for treatment of idiopathic menorrhagia and, from August 2004, also for the progestogen component of HRT. It is particularly useful for:

  1. Persistent progestogenic side effects from systemic HRT despite changes in type and route of progestogen.
  2. When contraception is required along with HRT in the perimenopause.
  3. When withdrawal bleeds on sequential HRT are heavy, after investigation if indicated (see WHEN TO REFER).
With Mirena in situ, systemic estrogen alone can be administered as the Mirena provides adequate endometrial protection and the estrogen dose and route can be tailored to meet the patient's needs.
Progestogenic systemic absorption is minimal so reducing systemic progestogenic side effects. The endometrial effect of Mirena can significantly reduce bleeding and when used as part of an HRT regimen, 30 to 60% of women become amenorrhoeic. Although Mirena used for contraception is licensed for 5 years, the license for use for the progestogen part of HRT is currently 4 years.
Price: €107.88

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