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[Cassie]

Hi Ladies, I was reading the pamphlet that came with my 100mg Utrogestan and I noted the following, don't remember seeing this on the previous pamphlet, wonder if the guidelines have changed....mmm??

Dosage & Directions for use:

In general the dosage of Utrogestan is 200mg daily at bedtime, for the last 14 days of oestrogen treatment per cycle, particularly, if the patient does not wish to have regular cyclic bleeding (ie from day 8 to day 21 for a 28 day cycle and from day 12 to day 25 for a 30 day cycle)....

That confuses me... cos surely that would cause a bleed??

It then goes onto say...

Patients who prefer to have withdrawal bleeding should be administered 300mg of Utrogestan daily for 10 to 12 days of oestrogen treatment.

Since when is 300mg the prescribed dosage, any ideas??


Just to add something extra, for those ladies, that tend to get early bleeding whilst on Utrogestan, Sarah 2, I know that you mentioned that this happens... this is what the pamphlet has to say..

If breakthrough bleeding occurs during the 2nd week of progesterone Utrogestan therapy, the situation is likely to reflect early endometrial atrophy and requires re-evaluation of the oestrogen dose. Spotting usually disappears, if the oestrogen dose is increased.

If breakthrough bleeding persists after adjusting oestrogen levels, endo-uterine examination should be perormed.

If breakthrough bleeding occurs during the 1st week of progesterone Utrogestan therapy this may be due to either endometrial atrophy or an oganic lesion and uterine examination is recommended.

  Hope this helps...x

[Sarah2]

Hi cassie

Thanks for that info, though none the wiser now!

I don't understand this part at all:

ie from day 8 to day 21 for a 28 day cycle and from day 12 to day 25 for a 30 day cycle)...

It says that you would have a bleed from day 8 to day 21, or from day 12 to day 25...



I've been to check both boxes of Utrogestan I have- the 100mgs and the 200mgs. Neither gives the information you have quoted. Both say use the tablets for 14 days of each cycle ( days 15-28, at bedtime) and then a bleed should follow. The 200mgs leaflet says that if a bleed is not wanted, then 100mgs can be taken for 25 days out of 28.

It might be worth looking at the date of the leaflet you have- this is right at the end of the leaflet where is may say 'Information updated'.....and a date. On my 200mgs the date is late 2012.

300mgs used to be prescribed in the past. My gynae refers to it in something he wrote which will now be updated. 300mgs was the normal amount but was then considered to have too many side effects.

Re. what it says about early bleeding. I'm not too sure about that! Also spotting can occur due to poor absorption regardless of the uterine lining. This is the part that doesn't make sense to me because when I was on Northisterone I had very heavy bleeds. I haven't changed the amount of oestrogen so it doesn't follow that my lining would be atrophied by taking Utrogestan.

These are two extracts from a very long paper but they look at dosage and what is considered normal bleeding. 'Normal' is bleeding that occurs from 3 days before the END of taking the last tablet.

A clear dose-ranging
effect has been demonstrated, and long-term
protection of the endometrium has been
established. Micronized progesterone has
been used widely in Europe since 1980 at
dosages ranging from 300 mg/d (taken at
bedtime) 10 days a month for women
wishing regular monthly bleeding to 200
mg 14 days a month or 100 mg 25 days a
month for women willing to remain amen-
orrheic. This therapy is well tolerated,
with the only specific side effect being
mild and transient drowsiness, an effect
minimized by taking the drug at bedtime.

The l-year study by Archer et
a17” used a broad definition of regular
bleeding as bleeding starting up to 9 days
before progestin withdrawal and found
that cyclic HRT employing the current
progestins induced irregular bleeding in
16% to 19% of cycles. The 6-month stud-
ies by DuPont et a16' and Gillet et a17'
which used a more restrictive definition
of regular bleeding as bleeding starting up
to 3 days before progesterone withdrawal,
found that cyclic HRT employing mi-
cronized progesterone produced irregular
bleeding in 11% to 23% of cycles[/b]


Worth noting that irregular bleeding can occur in almost a quarter of women- which is what I was warned of by my gynae- that everyone reacts differently to utrogestan.