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[Hurdity]

Hi SusieJ

Glad this is working for you 

A couple of questions - firstly do you have the three days off as you mentioned you take 16 days out of 25? If you do not take Utrogestan from days 25 - 28 do you get a bleed at some point?

Also what oestrogen dose do you take and in what form as this will have a bearing on how well a lower dose of utrogestan keeps the womb lining thin?

While I'm at it - how old are you and whereabouts in menopause, how long on HRT etc?!

Hurdity x

[Mary G]

SusieJ, well done, I tried to use 100mg Utrogestan vaginally every other day and only got to about day 6 before getting a migraine so I had to ditch it.  If you can use it in this way and it works then that is great.  I hope it continues to go well for you.

[peri]

Your way of taking it is good to know Susie, I'm 51 and a bit and looking forward to the day when I don't have to have a period and all that that entails and this may be the way forward. I've attempted long cycle and delayed my bleed to fit around holidays etc, bit I don't feel well when I do this.  I do better when I have some progesterone, definitely calmer.  Are there any benefits re weight (I have permanent water retention around my tummy) or libido?

Thanks in advance.

[Hurdity]

Hi peri - progesterone depresses libido unfortunately so it is not likely to improve when taken continuously. It also can lead to more water retention although I have heard that this can also occur temporarily with increase in oestrogen in some women. I am always more bloated when on the progesterone phase of the cycle - so pleased to keep this to the minimum every 6-8 weeks - now trying 2 monthly. There's a fine line between calming and sedating/depressing/causing fatigue! The dose in menopause is higher than many women can tolerate and higher than is produced naturally (except in pregnancy) as I understand, hence the side effects.

It would be good to be able to take a lower dose and keep the womb lining thin although personally I still wouldn't want to take it continuously. I have never taken it orally though so have no idea how I would feel for example taking 100 mg - but since I get side effects from 200 mg vaginally I imagine I would still get them!

Hurdity x

[peri]

Hi Hurdity, thanks for that it's all helpful to know.  It's not that my current regime doesn't work it's just I'm always open to tweaking it to make it even better.  I take utrogestan vaginally too, I find it builds up and makes me tired (always sleep well when on it) + it makes my bladder sensitive but definitely preferable to the other progesterone s I have tried.  The bloating and libido are other memo issues I'm attempting to resolve, otherwise for the most part I feel good, it's all a balancing act isn't it.

[Meeka]

I usually take utrogestan vaginally but thought I would try it orally this time.  took 200mg for 7 days and although I could really feel its affects, it didn't produce a bleed for me.  I do get a bleed when I use 100mg vaginally for seven days so I guess it is definitely more effective used vaginally.  It makes my bladder feel very sensitive though.   I get a migraine either way. 

[SusieJ]

hi All

Sorry for the long delay in replying - I've been away for a while...

To answer your questions:

Hurdity: I'm 45, perimenopausal rather than post menopausal and have been on HRT after severe early menopausal symptoms (primarily vasomotor) for three years. I'm taking Utrogestan orally every other day and not having a three day break. I haven't had a bleed at all. My gynae recommends that women take 100mg every day for continuous use without a break although I've read research which suggests this is more likely to cause spotting: the 25 day, three day break regime is intended to regulate break through bleeding. However I've also read research which suggests that women take it for 21 out of 28 days, or 25 days in a calendar month. So I suspect this is a rather imprecise science though of course it's always best to follow the manufacturer's directions where women can...

Meeka: I live in Edinburgh where there's a specialist menopause clinic run by Dr Ailsa Gebbe, and she's my doctor. She's quite happy for women to manipulate their dose, though is clear about increased risks etc. My GP is much more anxious about it so I'll have to see how it goes...

Peri: I suspect everyone is different, but Utrogestan has definitely increased my libido. Apologies if this is much too much information and do skip this bit if you're of a sensitive disposition -  one of the effects of utrogestan for me is that it has increased the production of vaginal fluids and my sexual responsiveness has been greatly enhanced. This is one of the reasons why I've really wanted to persist with it...

The big change for me is that with a conti regime everything is much more stable: I don't get bloating or mood swings and that's a real advantage. I was very resistant to a conti regime before just like Hurdity, but actually I do feel much more stable and I don't miss having a bleed.

Having said all this, after three months of taking it like this I have recently found myself getting very tired again and I am wondering whether this is chemical - I'm having to go to bed at 9pm and feeling like I'm plodding through the day. This could be related to me trying to up my dose a bit (taking it two days in a row, then a break, then once, then a break, then two days in a row, and so on). Or of course it could be completely unrelated and I might be getting a virus! So, I'm going to try taking a break from it for a few days and see if I feel different, then start again. So I guess it's possible this may not be a sustainable option after all - and of course I don't know how the scans are going to look. But I'm really hoping it works. I'll keep you all posted.

Good luck everyone!

Best wishes

Susie

[peri]

Thanks for your reply Susie , it's certainly interesting to know there is another way to take utrogestan.  I'm thinking of waiting until I'm 52 (only next summer) when I'm calculating my periods should have stopped anyway and then trying the conti regime.

[Hurdity]

Hi SusieJ

Progesterone has a sedative effect which some women find calming at low dose, but often it becomes more like fatigue or depressing at the higher doses needed to be taken orally to keep the womb lining thin - because so much is lost due to digestion, the liver etc

It does seem to have a cumulative effect too - at least with some women - I usually start to feel progessively worse - more tired and foggy headed after about Day5 of taking 200 mg vaginally and that doesn't disappear until a few days after stopping taking it. Oh I think I said that earlier! I have never taken it orally, nor 100 mg though.

Hurdity x

[SusieJ]

Hello All

I haven't been on here for a while as I've been doing so well on an alternate day dosing of Utrogestan. I promised to check back in after I saw the specialist for my annual review, which was yesterday, so here I am.

So. For the last 18 months I've been taking utrogestan every other day. This was because I was getting so exhausted on daily dosing that we thought I was just taking a long time to metabolise the drug and spacing it out would help. And it has! I feel absolutely fantastic - not tired, no bloating, no problems with mood. However because this is an unlicensed dose I need to go back for annual scans. So I had my first scan in 18 months yesterday.

The great news is that the scan shows that the alternate day dosing is doing its job at the moment. The endometrium lining is very thin, and I'm not having any bleeds (I initially had a few days bleed around every 10 weeks but that's stopped).  So I know this works for me - but I am taking a very low dose of oestrogen (1mg) so I probably can get away with a lower dose of progesterone than many, and everyone is different in any case.

However, even though all is great and I feel great, the specialist would still ideally like me to up my dose to get to a full dose by this time next year. This is because in general utrogestan is a little weaker (i.e. less protective of the womb lining) than the synthetic progestins, and so taking less than the licenced dose is particularly risky. Of course there is the issue that because utrogestan is relatively new there aren't yet different licenced doses for people taking different amounts of oestrogen (like there are in the synthetic progestins). So the licenced dose assumes a 2mg oestrogen dose rather than the 1mg I'm taking. But all the same, the advice is ideally to do what is on the label. I've found over the last 18 months that I've got increasingly used to the utrogestan: to start with, a dose every other day was making me feel tired but now I don't even think about it. So I'm going to start building up the dose very very slowly and hope that by this time next year I'll be on something that is nearer to standard. However, if the side effects return I'll go back to the alternate day dosing and just keep it all under very close review.

Again - this is me and how my body works: it may be different for everyone else and it may change for me in the future. But for now, this has been a great solution and I feel like I've got my life and my self back!

xx Susie

[Hurdity]

Hi SusieJ

Thanks so much for coming on here and giving us your update - this is really helpful to other women!

When you say 1 mg oestrogen I presume you mean orally? So you are taking a low dose oestrogen and managing with 100 mg oral utrogestan every other day. Did the clinic say what your actual endometrium measurement was on this regime?

So interesting to know that you have no side effects from this dose which would be equivalent to 50mg per day - which many of us say should be available as a dose - especially vaginally! I can understand your specialist saying it would be preferable to take the licensed dose but as you say the licensed dose is very much a "one-size -fits-all" and for oral use only - which is generally fine, other things being equal, for medium dose oestrogen but more or less may be needed for higher or lower oestrogen doses.

Another option though would be to take a higher dose for one month a year maybe? Although I am on cyclical HRT (in my 60's) I am on a long cycle with vaginal utrogestan every 6-8 weeks - and my GP (Gynae specialist) is happy for me to do this as long as I have an annual dose of norethisterone  for one cycle to "strip" the lining as she called it. Just a thought if you found that the licensed dose is too high.

So please to hear you have your old self back - many of us would love to be able to say this - although I feel pretty good considering I'm in my 60's!!!

Hope the good feelings continue SusieJ

Hurdity x

[Rhiner]

Hi SusieJ, I too am taking Utrogestan 100mg on alternate days and have been doing so for 9 weeks now.  Initially I felt a little rough, but like you, I now feel very good and have had no spotting.  I was still a little low on Oestrogen alone, but my mood seems to have slowly lifted on the Utrogestan and can honestly say that I am back to my old self.  I just hope it lasts!

I am under a private gynae for this regime and will be having a scan in March. If I do have any spotting, the scan will be brought forward.

Good to hear your experience!
Rhiner

[Dana]

I'd totally forgotten about starting this thread. I don't use utrogestan anymore, but it's great to hear this method is working for you. It would be good if there was less of a "one size fits all" approach with Utro.

[matildamouse]

Thanks for the update SusieJ and Rhiner. It is very informative and helpful.

I am currently also on alternative day vaginal progesterone 100mg with a Estradot 50mcg patch under supervision of my Dr. I will have a scan end Dec to see if it works well enough. If I take it daily I get a lot of periodlike cramping and backache which does not occur with alternative day dosage so I really hope it is effective. I have been on the 50mcg since 1 Nov (been on 37.5 before) and I am contemplating whether it might be a bit too much. My breasts are both a bit tender, lots of vaginal lubrication and I had a hot flush or two again. But I also do not want to change back to 37.5mcg before the scan in order to see the effect of the 50mcg. My Dr is on long leave atm. Any opinions ladies? Thanks

[soniad]

Hey Matilda!

I went up to 50 mcg around the same time as you - but felt it was too much.I had very sore boobs, yet also felt 37.5 was not quite enough.

After 2 weeks I decided to snip a little bit off the 50 mcg patch and that brings the dose down to around 44 mcg.

It's working well for me!