Hi Rivadan
Really sorry to hear that utrogestan is not working for you.
![Sad :(](https://www.menopausematters.co.uk/forum/Smileys/extended/sad.gif)
Have you found another one that works better or are you still looking? Do hope you manage to find something that makes you feel OK but it may be that you like Bombus and Night_Owl are extremely intolerant to any sort of added prog taken/applied.
As far as what is superior is concerned - it depends on what you mean by superior! If you mean that it causes the least bad side effects - that's a matter of opinion and how differently we all experience it. Personally it is far superior to anything else I've tried - even the other natural prog - Cyclogest - and I'm sure that has something to do with the dosage prescribed. I think for most women who have prog problems the worst are the migraines, and for others it's the anxiety, fog head, depression, irritability, decline of libido that seems to come with some of the synthetic progestins like norethisterone or Mirena. Others are happy on lots of them!
My view is that if you can tolerate it - apart from the expected tiredness and other usual prog effects, then it is superior to all other synthetic progestins - because it is bio-identical and therefore more natural, and the body will benefit from any other metabolic effects of progesterone besides protection of the uterus.
From what I've read (and sorry haven't got a link to hand) synthetic progestins do not have the same beneficial effects other than this (protection of the womb), and therefore since we have evolved to use it in a cyclical way I am prepared to put up with it ( but I am lucky in that Utro has only minor side effects). I would not want to take any prog on a conti basis though because of the sedative effects - but as always it is a balance between the benefits of oestrogen, whether you want a bleed and the side effects of the prog.
I know also that remaining cyclical for a long time is not without its risks - I think the latest research re breast cancer shows that oestrogen and prog is more risky than oestro alone or no HRT? (Really must get some links sorted out!).
Hi again Bombus - as I said before it could well be the sudden increase is not tolerated well as I said earlier - this is not how it works in the natural cycle. One day there, next day at v high concentrations. It;s a pity there aren't eg 3 different strengths eg start at 50 mg for a few days, then 100 then finally 200 mg for a couple of days and then decrease in the same way. Of course that might prolong the withdrawal effects of pmt.....
There is always the option of going on a longer cycle - like I am doing - every two months which means that any side effects only occur 6 x per year and the same for the bleed. Again probably not without some risks. Not sure how long I will want to put up with a bleed - since I am now 58 but I never really stopped for any length of time - probably about a year was the longest.
Why aren't the researchers looking into all this? After all most of us will spend nearly 30-50% of our lives post meno so we deserve better than this!
Hurdity x