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[Rosie63]

Hi all

I'm just coming to the end of my first month of Estrogel/Utrogestan regime. It's been tough and not sure it's going to be the one for me but trying to stick it out for a bit longer. I decided to do the first 2 weeks Estrogen only and then add in the P. I'm on the 8th day of P. and have started to bleed. I'm not sure whether to carry on taking both or whether to stop P. now. Looking at other posts, I think this might have happened because I've increased to 4 pumps of Estrogel but only taking 100mg Utrogestan. Please may I have your advice?

Thanks as always.

Rosie x

[Dotty]

Hi I take 4 pumps Oestrogen and 100mg of Utrogestan for 25 days each month.  I had  bit of breakthrough bleeding but just carried on taking both and the bleeding soon stopped.  Bleeding is normal for first 6 months.

[Rosie63]

Thanks Dotty. As you're on the same regime as me, would you mind if I ask you a few questions please? Can I ask if you have a few days break from the Utrogestan each month?  Also, did it take long for things to settle for you and is it working well for you? I know this is my first month but I've had a lot of discomfort in my back, stomach and down below.  I'm also getting palpitations which when they come on can make me feel nauseous and light headed. I'm also feeling very tired with sore eyes.  I hope you don't mind me asking.

Thanks.

Rosie x

[Rosie63]

Just to explain a bit more, Dotty, I was Prempak C up to about 6 months ago until it was discontinued and I've been trying to find something else that suits me since then.  I was on it for about 13 years.   I thought I might be intolerant of the P. but even when only taking the Estrogel for the first 2 weeks, I still had the discomfort so I'm thinking it's the type of Estrogen.  I appreciate some women are against the way the Prem estrogens are obtained but I'm tempted to give Premarin a try with a separate prog. 

Any views would be appreciated please.

Thanks.

Rosie x

[Dotty]

Hi I take utrogestan for days 1 -25 and then start again on the 1st of the next month so have about 5 days off. This is my 2nd month so I can't say if I will bleed or not. I'm happy with the regime. I was on tablets for 4 months and they did nothing for me. The Oestrogel seems to be working .

Perhaps you are getting too much oestrogen as 4 pumps is a lot although I seem fine on it.

[Rosie63]

Perhaps, yes, although less doesn't seem to help with other meno symptoms. I have another appointment with my consultant on Weds. so will talk it through with him.  Thanks for your help.

[Hurdity]

Hi there - yes 100 mg Utrogestan especially when taken orally is way less than the licensed dose and unfortunately there are no different doses of utro given for different oestrogen doses. I would suggest that the licesned dose is on average what is recommended orally to protect the endometrium for a medium dose of oestrogen - so this would be say 2 pumps gel and 200 mg orally for 12 days per 28. I thoink you've hit the nail on the head if you are using 4 pumps of gel and only 100 mg utro orally for 10-12 days per month. This could well account for your early bleed. I would carry on and take the whole course (if taking orally) because of the protective effect on the uterus while taking it.

If you are feeling nauseous taking it orally ( if you are that is) then maybe try vaginally - and then you may well get away with less in dosage - although 200 mg is still ideal if you are having that much oestrogen.

I think you need to give your body a bit longer to adjust to the different oestrogen but no reason why you can't try premarin with the Utrogestan if that's what you are used to. If you are older or plan to take HRT long term then it is better probably to continue with the estradiol though- as it is bio-identical.

Hurdity x

[Rosie63]

Thanks Hurdity. I did take the Utrogestan vaginally for the first couple of days but because I felt so uncomfortable I couldn't bring myself to take it that way so then changed to taking it orally. I thought I was probably doing the wrong thing though. I will do as you suggest and carry on and finish the course.  I'm 63 Hurdity so know really that taking HRT in gel or patch form is preferable at my age.  I'm going to try and stay with this regime a bit longer to see if it settles but when I go back to see my meno man I think I should probably speak to him about the progesterone dosage whether I stick with the gel or change.

Thanks again for your helpful and knowledgeable advice.

Rosie x

[Hurdity]

I understand Rosie63 - I am almost the same age as you and yes probably wise to keep to the bio-identical hormones as we age and if we intend to stay on HRT long term. Do let us know what your consultant says and hope your visit goes well

Hurdity x

[Rosie63]

Hi, had my appointment with consultant. Unfortunately I was having a bad day and ended up in tears so didn't feel able to explain myself as well as I would have liked. Anyway, he suggested I try Premarin 1.25mg as Estrogel didn't seem to be dealing with my symptoms.  I started today and I'm to take alongside the Utrogestan. However, I'm not sure whether to start taking the Utrogestan tonight or whether to just take for the last 12/14 days of the month as I did last month when I was taking the Estrogel. I'm not sure if the 100mg will be enough for the Premarin dosage. 

Your thoughts would be appreciated please.

Thanks.
Rosie63 x