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[Rosie500]

I've been taking Utrogestan 100mg orally (conti) for 10 months or so at night, no particular problems, no bleeding. I would say I feel about 70-80% of my "normal" self on HRT which I will settle for; it's heaps better than 0%!  However the Utrogestan leaflet says to take it without food and sometimes I eat late so wondered about absorption... It doesn't make me sleepy so changed to taking it in morning a month or so ago (don't eat breakfast) when I do my estrogel (3 blobs) as I recently spotted in leaflet it says take at same time as oestrogen. I have occasionally forgotten a tablet over the months, especially if travelling and out of routine, but reckoned (or hoped, maybe erroneously) that wouldn't be an issue if taking conti (ie would equate to 25/28 days). If I've been "good" at taking it I sometimes take a 3 day break at beginning of month.

I then had a small bleed, bit confused about if I was starting a 3 day break or not - I am feeling generally confused for various life reasons! -and then stopped HRT altogether as panicked a bit and thought may as well let the bleed come without messing around with prog (obvs stopped oestrogen as well). A bit complicated by being abroad, but contacted GP and have 2 week wait gynae referral in progress and appointment set for before Christmas.

Was feeling OK without HRT after a week, then got to 10 days and wham back to feeling really awful so am restarting today. I am wondering about trying the utrogestan vaginally at night and doing the estrogel at same time instead of after shower in morning. Also I will try to have a rule about not eating after 7pm or something.

I am feeling very confused, I've searched loads on here but can't seem to take it all in and come to a conclusion. I don't have a GP who has any interest in HRT; there is one person in my area but the practice has declined my request to register (against guidelines but not inclined to battle them yet). I may go and see someone privately... I feel a bit nervous about a DIY approach (maybe I should look at it as taking responsibility for my own health). However the advice on here is excellent and you people know an awful lot more than any GP I've seen so far about the nuts and bolts of HRT 

I'd be really grateful for any help/experiences, especially about the vaginal route for Utrogestan and morning vs evening etc. I've also wondered about the 12 days/month 200mg option! Thank you.

[Hurdity]

Hi Rosie

I have only ever taken utrogestan vaginally so can;t comment re the orally. However the thing about taking it without food is so give consistency of absoprtion. In fact the research that I have looked at ( and I am sure also in the product info on web) says that bio-availability is increased if taken with food - so it can;t do any harm!

Consistency is key though - because the body does react to a fall in progesterone and can trigger a bleed. Theoretically there should be nothing to shed on conti HRT if the balance is right - but that's why the 3 days break is there - to shed any lining that might have built up. This is much much less likely to occur when using vaginally - because more gets straight to the uterus where it is needed. However for obvious reasons you might not want to do this with conti HRT!

Many of us on here who take Utro vaginally are on a cycle - firslty because we prefer the well-being achieved through oestrogen alone and secondly do not want to have to put up with permanent side effects from the UTro. Sounds like you haven't experienced these anyway - but the cyclical regime is an option and would lead to a predictable bleed every 4 weeks - or possibly longer if you opt for a longer cycle - and also depends on the oestrogen dose.

I haven't come across anything about having to take prog the same time as oestrogen? Personally I would apply estrogel in the morning ( I do this with my testosterone gel) so there are no transfer issues although if you applied it early enough in the evening this wouldn't matter anyway.

You definitely do not need to go privately!!! It's a question of working out what is best for you, your uterus etc in conjunction with your doc.

No actually sure why you need a gynae referral - since by your own admission you haven't been consistent with the prog sometimes so the odd bleed or spotting is to be expected. However it would be good to see how your lining is doing and what has happened to it while you've been on this regime!

Also when you say 3 blobs of estrogel - so you mean 3 pumps -? That is quite a highish dose so also 100 mg utro taken orally may well not keep the lining thin - hence the readiness with which you spotted when the levels of prog varied.

Does this help at all? Please do ask if I haven't been clear and there will be others also who can offer their experiences.

Hurdity x

[Rosie500]

Thanks for the reply Hurdity, it's very helpful. You are very clear thinking, unlike me at present

I am going to try to be very consistent
in future and will set a repeat reminder on my phone. Life does get in the way sometimes though. I had been planning to get a (private) lining scan anyway to keep an eye on things so a gynae referral is no bad thing, it seems to be definitely indicated in my situation but I'm not particularly worried about anything sinister. I may even get to talk to someone properly about HRT for the first time; my GP situation is tricky so they may be able to give me some guidance.

Yes I do mean 3 pumps sorry, I call them blobs because they look like blobs to me (not very technical  ) I am going to have a go on 2 and see how I cope, I did try to reduce to 2 once but got a bit twitchy so went back to 3. I do like the idea of a cyclical regime, I think I'd feel "safer" bleeding regularly, though that may be irrational!

I'm very grateful for your comments, thank you for all the time you and others spend helping people on here, it's invaluable. I think I'll ask about the 200mg/12 days option and maybe give it a whirl. Although I'm not too bad on utro, I did sleep better and feel good without it, that is until the oestrogen wore off! Don't think I'll try another break for a few years... I do love my oestrogel.

[Rosie500]

Thank you for your reply, I do think I'm going to try the 12 day regime but am carrying on with 100mg a day for now. I'll ask the gynaecologist when I see them. The blurb says to take it days 15-26 of the cycle but given I have no cycle I suppose I just take the 200mg for 12 days which then creates the "cycle" for me. I am definitely going to do a calendar with reminders built in so I can't mess up easily. When I took it in the morning I out the pack next to the kettle which worked beautifully! It's just going away that gets me out of order as my things aren't in the normal place.

[Hurdity]

Yes that's just it - you make your own cycle. If it's 4 weeks then it's easy as it's always the same day of the week you start. Some find a monthly regime easier so eg take the utrogestan on the 1st of every month for 10-12 days whatever you've been prescribed.

Hurdity x

[Rosie500]

An update in case anyone else has the same problem as I did and is searching as I did...

I went to the hospital just before Christmas and had a scan - was instantly reassured as it was 3mm so absolutely fine. I then was sent to see the gynaecologist. Great I thought, I can get some info about HRT from a real doctor (eg how best to take Utrogestan etc). The doctor was very nice and I would be 100% confident in her dealing with me surgically etc. However she had little interest in HRT and only seemed familiar with the basic nuts and bolts of treatment (as my husband had predicted to me!). She suggested that GPs would know loads and could answer my questions. Oh how I laughed  . I told her the GP who prescribed my utrogestan had never heard of it before I requested it (armed with info from this site and NICE guidelines!) and that most male GPs I know probably only prescribe HRT once a year or so since 2002 (I don't have access to the only female GP in the area with an interest in HRT). She seemed rather surprised. She did kindly offer to get the consultant to speak to me but I thought I'd just rely on MM in the future as I wasn't sure he would be interested in my questions either! However it seems a good department and I am confident if I did have any major gynae problems I would get excellent care so that's good to know.

Anyway thank goodness for this forum and the wonderful people who are so knowledgeable. I bet there are lots of women who have had their lives changed (for the better ) because of those who answer questions on here so thank you again.

I am now taking the utrogestan vaginally for 12 days a month (the frequency suggested on the PIL rather than the GP prescription). I read elsewhere on here about a poster (can't remember who) about taking it orally if she got lucky. That still makes me laugh a lot.

Just to say that if people have a scan to measure endometrial thickness, it was miles less invasive than I was expecting. I am rather hazy about medical procedures; I suppose I should have googled it but I vaguely thought it would be more like a hysteroscopy, silly of me, it was rather tame and quick in the end. Given I had thought of hysteroscopies I was initially startled by the size of the instrument