Hi Dawncam - I welcome you when you posted on the other thread and suggested you posted here - sorry you haven't had more responses but it is bank holiday weekend! I have barely been on the forum over the past week really.
However - it does so happen I am on almost the same combo! I use Estradot patches (Estradot 50) and utrogestan which I use vaginally on a long cycle varying from 5 - 8 weeks depending on my commitments and how I feel! I take it for 12 days x 200 mg. This is approved by my lovely female gynae GP (local, NHS). Actually because I now have testosterone (small pea-sized blob) every day - (I did have to go privately for this initially but did not cost much and nowhere near Studd's fees) - I increased my estrogen very slightly by 12.5 mcg so that I did not become too T dominant and get too many androgenic side effects - so probably now on 62.5 mcg (unofficially!). I will spill the beans to my doc when I start running out of patches too quickly!!!
I have always found Estradot patches to be brilliant and they have always kept flushes and sweats under control and I feel fine.
Re the Cyclogest - I am also probably one of the few women posting on here who have used this!
I have posted at various times about it including this thread:
http://www.menopausematters.co.uk/forum/index.php/topic,29259.msg465679.html#msg465679I used these for the first 4 years of HRT (because utrogestan was not available - and my GP had been prescribing it for years - interestingly she studied under Studd maybe 35-40 years ago) - at 400 mg daily for 11 days per 4 weeks for a 50 mcg patch in late peri-menopause and it was fine for me. At the time it came as 200 mg capsules so I used to put one up the front and one up the back (ie vaginally and rectally) each night.
I found that it was quite strong and used to make me foggy headed and sometimes give me migraines - but I also got these on withdrawal ie when I stopped the pessaries and went back to oestrogen only. I felt fine once it had cleared my system though. The dose prescribed for me for HRT is far too high for continuous use - and especially for a low dose of oestrogen and it would only be given continuously at this dose to maintain a pregnancy. Unfortunately because it is not licensed for HRT there have been insufficient studies available as to the dose needed for this purpose (but presumably there have been studies re systemic absoprtion and pregnancy - although I've never looked these up) so I presume docs who prescribed it erred on the side of caution. It was double the amount of utrogestan because I presume less of it got into the system due to the preparation ie waxy capsules.
I used Cyclogest for several years (4.5) before switching to utrogestan in 2011.
It is very interesting that you raised this - about rectal use - which I'd completely forgotten about as I'm happy on utrogestan - because this could be a way forward for taking progesterone for those who suffer the side effects from oral use, and bladder irritation from vaginal use. I think it is not prescribed much - but some gynaes still do so I gather - Nick Panay being one, and it is an option for badly progesterone intolerant women.
Used rectally it will be absorbed systemically before being transported to the uterus - but of course it avoids the metabolic by products of digestion that occur from oral use although I think it is still metabolised by the liver - I'm not clear about the relative amounts (in the system) compared to vaginal utrogestan, and vaginal vs rectal cyclogest - not even sure if this info is available.
There was this in the side effects table: "Diarrhoea and flatulence may occur with rectal administration". It did have an interesting effect the morning after rectal use..... but as always with all of this you have to weight up the advantages and disadvantages of each treatment.
Woah I've gone on a long time - but hopefully some of it is helpful!
Hurdity x