Hi newbaby1234
As Cassie says I do use Utrogestan on a long cycle but it is impossible to say what will be OK for you!
Personally that sounds far too little to me. The licensed dose is 200 mg orally for 12 days per 28, or 100 mg daily if post-menopausal.
As you probably know the maximum dose of oestrogen that this progesterone dose will oppose is not given so the progesterone dose is a one-size fits all approach - which of course we are not. I imagine the 100 mg daily dose is calculated to oppose the average post-meno dose of oestrogen which in the combi patches is 50 mcg which you are taking.
There are also research papers with studies showing the (average) amount of progesterone needed to prevent endometrial thickening (and specifically hyperplasia which can lead to cancer) - I can have a look at some of these if you want - haven't done so for ages!
In addition there are studies which show that the amount of progesterone needed when used vaginally is far less than with oral use - because of the "uterine first pass effect" which means it goes straight to the uterus where it is needed, rather than lost in digestion and metabolism as when taken orally.
Most GPs will not advise deviating from the licensed dose - unless you find one that is enlightened and knows something about menopause and HRT. I have a female GP like that who knows I have read a lot about it, and is happy for me to use utrogestan on a two monthly cycle.
Somewhere in one of the papers I read that approx half the amount of progesterone was needed vaginally compared to orally ( but this would be on average) and therefore I used to take the monthly oral dose two monthly. However when I worked this out I felt that this was not quite right because with a 4 week cycle - you have 2 weeks oestrogen followed by 2 weeks oestrogen and progesterone. In an 8 week cycle you have 6 weeks oestrogen followed by 2 weeks oestrogen and progesterone. So this is 3 times the length of time of unopposed oestrogen so because of this, and because I had a thickened lining last year, I have shortened my cycle to 6-7 weeks mostly - with the odd 5 week or 8 week one depending on when I'm going away etc.
Also you will find many (private) gynaes now do not seem to favour long cycle HRT - this is because of some limited research carried out (maybe Scandinavia? - again can look up if you want) where there were cases of endometrial hyperplasia occurring.
Many gynaes now seem to treat progesterone intolerant women with a cycle no longer than 6 weeks, or have frequent scans eg 6 monthly, or to take a shorter course of progesterone (or other progestogen like norethisterone) 7 days monthly and with an annual scan.
Sorry this isn't the answer you want but I wouldn't risk taking so little without the sanction and close superivision of your doctor.
What does your gynae or doctor advise?
As an afterthought if this is the first time you have taken HRT since becoming post-menopausal, then you might get away with longer cycle for the first few if your uterus is very thin - but still ask your doc!
Hope this helps and let me know if you need any of the refs
Hurdity x
