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[Andie]

Hi Ladies,

I know this has been mentioned before but I wondered if there was any new advice?! Any ladies that live in Australia do you know if it has become available here yet? Recently moved out to Melbourne and settled on sandrena and uterogestan so loathed to swap to something else!! Thanks

[CLKD]

   if you do a search for our UK but OZ-based member 'SuziQ' you could send her a PM perhaps? or do a  search for the product - using the button top left of screen?

[Dana]

As far as I'm aware there is little chance of Utro being approved in Australia anytime soon. I did a fair bit of research into this a while back and posted the details here. http://www.menopausematters.co.uk/forum/index.php/topic,23524.msg358303.html#msg358303.

However, as per my final comment on that thread, my opinion changed about Utro after I made my initial post. I was initially very critical of Australia's lack of approval, but after my own personal use of it (it's very easy and fairly cheap to obtain on the internet if you really want it) I now also have my concerns about the long term use of Utro and I understand why Australia is reluctant to approve it.

Australia has probably one of strictest set of requirements in the world for medication approval, because it was one of the first countries to approve Thalidomide, and we all know what happened there. So the TGA is extremely cautious. If they aren't 100% certain of the long term safety of something they won't approve it, and I believe they do have concerns about long term uterine health if a progestin isn't also used.

However, all HRT use comes down to personal choice, and I understand that of lot of women on MM prefer to use Utro. I just know that from my own personal experiences I prefer not to, because I'm not convinced it was doing a proper job of shedding the uterine lining, and I prefer not to take that risk.

[Cassie]

But Dana Utrogestan is a progesterone, which is way way better than a progestin....much healthier as well in my opinion...

[Dana]

Like I said, it's my personal opinion that using Utro alone does not shed the lining sufficiently enough - at least not for me, and I have personal proof of that. It really doesn't matter how healthy something is if there is a risk that the uterine lining is going to build up. There is also very real evidence that the Australian TGA also has concerns about it. I also have a friend in the USA whose OB/GYN prefers not to prescribe Prometrium (their version of Utro) because he also has concerns about it.

However, like I also said, it is everyone's choice to use what they prefer. This is how my body reacted to it, and everyone is different. So I won't be getting involved in any discussions or arguments about whether Utro is right or wrong. I use a progestin transdermally, so there isn't that much risk with that. I would honestly say that if you are going to use Utro, make sure you get regular scans or use a progestin maybe a couple of times a year to be on the safe side.

[Andie]

Thanks ladies and sorry for my late reply. I don't have a uterus so no worries there! I use it with sandrena as history of endo.

I agree that Australia is very different when it comes to approving medications. I work in cardiology and am astounded that evidenced based medications used routinely to prolong life in UK Are not PBS listed here. Hope you are all well.

[lancashirelass]

Susan evans is a.good.gynae.in australia might be worth emailing her.office

[Grumpymum]

Hi Dana, would you mind outlining in a little more detail your concerns about Utrogestan. I have been taking it for three months now with only a scant bleed on one month. I've just had a scan which shows my lining is ok at present. I promise not to shoot your opinion down in flames, I'm just interested. If you would prefer to private message me, that's fine. Thanks.

[Hurdity]

There is nothing wrong with the ability of Utrogestan to change and shed the lining (it is identical to our natural hormone after all) - but it is dose dependent - in other words the more oestrogen you take, the more progesterone you will need. Added to this the molecule progesterone is unstable, so larger quantities need to be taken (compared to the progestins) in order that sufficient remains to get to the uterus where it is needed. This is why many women have problems with side effects because the dose taken is (and has to be) initially higher than the ovary would produce (continuously to keep at the right level).

The difficulty might come when women use higher doses of oestrogen (meaning more progesterone is needed), or longer cycles and of course some women do not absorb progesterone so well orally - which is subject to the vagaries of the digestive system).

Notwithstanding Dana's personal experience, rest assured that the licensed dose of utrogestan should on average be sufficient to shed the lining of for example post-menopausal women on the average medium dose of oestrogen ( eg 50 mcg patch). You can never say absolutely 100% though as we are individuals! What hasn't been determined so much is whether it is sufficient for higher doses of oestrogen or longer cycles. Of course there will always be women for whom it is insufficient ie there is variability between individual women, but for these women a higher dose of utrogestan should do the trick .

The information was all based on trials of dosage and endometrial thickness and would not be permitted if it was not safe. However I believe that all women on HRT should be offered a regular uterus scan on NHS in the same way that we have breast mammograms, cervical smears, and bowel cancer tests.

Personally there is no way that I would use a synthetic progestogen long term because of effects that the synthetics can have different from progesterone (so I've read).

Grumpymum - please do not worry. How much oestrogen do you take and how much utrogestan and where are you in meno? If you are only having a light a bleed then your lining is not building up and the progesterone is more than adequate. Your scan confirms this!

Dana - I respect your personal opinion but would not want to put anyone off taking utrogestan for safety reasons.

Hurdity x

[Grumpymum]

Thanks Hurdity. I'm 51 and been on HRT for a year so don't know about natural periods but after my last blood test the doctor said my own hormones had given up! I'm currently on estradot 50 patches, but I've been starting to put one and a half patches on (75) since my scan last week to see if that helps as I'm still getting symptoms especially mood/anxiety problems etc. I take utro 200mg orally, days 15-26. I'm seeing GP later this week, but the result of the scan was good.

Thank you again. You are such a comforting source of knowledge. x