Thank you both, Hurdity I am 54 and post meno & would prefer not to take tablets as I'm a migraine sufferer. I forgot to add in my original post that i have also been getting headaches every afternoon 
though my migraine has improved since being on HRT overall.
Hurdity...If I was to go onto a separate oestrogen patch & Utrogestan how many days would I take it for to have a cycle?? Would it be 2 weeks the same as the other progesterones? And would Utrogestan taken as a tablet every day be ok with me suffering migraine?
Hi again Goosieloosie
You've had some great information from Mary G about her regime and Prof Studd's prescription for women who are highly progesterone intolerant.
My answer to your original question would be to start with taking the licensed dose of Utrogestan 200 mg orally for 12 days and see how you get on.
Like you I began to suffer with migraines when I was in the late reproductive stage - when I was getting really bad pms just before my period. I think in my case it was probably progesterone withdrawal - which is one reason for the pmt symptoms of headache, tension, irritability because they stopped as my periods stopped and were replaced by flushes and sweats. When I started HRT I continued to get them after the withdrawal most cycles, for a few years. Also sometimes during the progesterone phase.
It doesn't necessarily follow that because you might not tolerate synthetic progestogens, the same will be true for progesterone. Many women are quite happy on this - OK with some mild sedating side effects or head fog - but tolerable. I agree that the licensed dose is designed so that the incidence of endometrial hyperplasia in minimised but better to start with this and cut back if it's doing its job but you find the dose too high. The 7 days a month regime is the absolute minimum for highly progesterone intolerant women and will lead to endometrial hyperplasia in some women - and this will depend to some extent on the oestrogen dose. Prof Studd's own research from the 1990's demonstrates this - I think 12 days a month pretty well elimninated any thickening in the studies he carried out ( this is from memory - I would have to look up the papers again), but the percentage of women with hyperplasia increased as the number of days was reduced.
As has been said this could be monitored by means of a regular scan ideally annually. Originally Studd said on his website that when women used progesterone for 7 days, the threshold for endometrial sampling would need to be lowered - in other words any signs perhaps of spotting etc, a biopsy or scan should be carried out.
If you are using this regime on NHS then I would not use 7 days per month unless you are prepared to pay for an annual scan - or unless your oestrogen dose is very low. Even so I would still feel women should be scanned.
Interestingly where Utrogestan is licensed for vaginal use for HRT - such as in France - the same dose is given as for oral use, although the research papers have demosntrated as Mary G says that maybe 50% of the oral dose can be used vaginally to give the same effect. As far as I understand though - it is a combination of dose and duration of progestogen that is needed, so for example giving a very high dose of progestogen vaginally for says 5 days wouldn't do the same job ( because much would be lost).
I'm not saying don't do the 7 day course - but this is just omne option, but I wouldn't start with this unless you are on a v low oestrogen dose - and in any case you may be quite happy on it, or even not need it at all if the Femseven agrees with you
Just to say also I use 50 mcg Estradot patch and Utrogestan 12-13 days per 2 months vaginally and I am post-menopausal - this suits me fine. I am on the prog at the moment and feel a bit tired but not too bad.
Sorry if this is a bit long-winded but hope it's helpful!
Hurdity x
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Topic: Advice please, changed HRT and feeling awful (Read 11033 times)