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[Blue Kingfisher]

Ok, trying to keep some perspective on this but struggling.

I'm only on day 2 of taking Utrogestan 100mg oral capsule at night inserted vaginally. I've had 2 doses. Had to go to bed at 8:30 last night & have just forced myself out of bed at 7:30am. Feel like I'm in a complete coma & just want to sleep!

I don't understand why I can tolerate the Utrogestan 200mg pessary a lot better than the 100mg oral Utrogestan (again taken vaginally) when the progesterone is supposed to be double the amount ??

Wondering if I should go back to the 200mg pessary or stick it out with the 100mg progesterone tablets for longer. If I'm experiencing over whelming progesterone symptoms now on the tablets after two doses......I'm wondering if this is likely to improve with time or get worse with the progesterone building up in my body?

Ive been moved from 7 days on the pg 200mg pessary régieme onto continuous HRT with the 100mg tablets (used vaginally) but I'm already beginning to wonder if I should at least go back to the pessary. I'm feeling so bad I'm considering starting the 200mg pessaires tonight & then worrying about how long I should take this for when I feel l can function! Is it even worth asking the gyne if cutting the pessary in half for continuous HRT is an option?

Now I know why people say they feel they can't drive etc when having this progesterone coma!! I do NOT feel human!! 

[pepperminty]

Hi Blue Kingfisher,

if the other regime suited you better you can always go back to it. Why dd you change, if it was working well? You haven't been on the new regime  very long and it might settle in time? But that is no consolation when you feel so crap. I wouldn't cut the pessary in half as you may not get enough in the dose. I hope you feel better soon. Someone may come along who has been in the same position soon.

Peppermintyx

[Blue Kingfisher]

Hi Pepperminty & thank you so much for replying. I felt good for half of my cycle on the 7 days 200mg Utrogestan pessary routine with 5 pumps of oestrogel but terrible with crashing fatigue from day 5 of my cycle through to day 15 of my cycle. I say ‘cycle' having no idea if I still bleed naturally as only 50 years old but been on HRT for about two years. I count day one of my cycle on the day i start bleeding (was always 3 days after stopping the progesterone).

Having looked around at other posts it looks like an option could be to take the 100mg tablet vaginally every other day & consider increasing my oestrogel back to 5 pumps daily (gyne suggested I start by reducing the oestrogen dose to 4 pumps). I absorb oestrogel badly which I why I have been on 5 pumps daily.

Not sure whether to try:

A) sticking with 100mg daily & increasing oestrogel back to 5 pumps
B) taking the pg every other day & staying on 4 pumps oestrogel
C) taking the pg every other day & increasing oestrogel back to 5 pumps
D) going back to 200mg pessary & 5 oestrogel pumps immediately & then reviewing

My concern with taking pg every other day is will it just confuse my body even further & I won't know if I'm coming or going? This morning I tried option A) 5 pumps oestrogel as opposed to 4 & I ‘think' this is slightly more comfortable but it's early days & I could crash & be back in bed within half an hour for all I know so I will just have to see how the day pans out. One things for sure though, I feel under extreme pressure to get this sorted. I don't feel well enough to work & if I lost my job it would be financially disastrous & affect my whole family. I couldn't work last week due to hormones, trying to fix this now with this continuous régieme & terrified I'm going in the wrong direction.

[CLKD]

You said it yourself "Confuse my body further".  The body doesn't get where it is suddenly so it stands to reason that any HRT will need to be absorbed to improve symptoms.  Which may take a while. 

Maybe keeping a diary would be helpful to chart feelings and any progress?   This fatigue needs to be investigated, unless it is absolutely related to the HRT.  Thyroid function, low VitD levels can cause associated tiredness.  Make sure that you keep well hydrated.  And be kind to yourself 

[Blue Kingfisher]

Thank you CLKD, I think you are right of course. I'm not being rational at all. I will try taking the 100mg pg earlier tonight say 6pm in the hope that the side effects have worn off a bit more & I can go to work! I just don't understand why I feel ok on the 200mg pg pessary & not the 100mg tablet taken vaginally. But like you say, I didn't get here overnight so I can't expect to be in a better place overnight. Will keep persevering to try to get to a more comfortable place xx

[Blue Kingfisher]

The 100mg is an oral tablet. It's spherical. The gyne (I'm under the Studd clinic) was very specific that I should use the oral 100mg oral tablet vaginally. He said they find it works better for patients. I think I'd rather try a 100mg pessary though as I do ok when on the 200mg version. Perhaps the oral version are absorbing too well for me despite it being half my usual pessary dose??

[Blue Kingfisher]

Stella Jane, are you saying you can get pg 100mg in pessary form? If so this might be the answer for me. I feel so much better on the 200mg pessary than the 100mg oral tablet taken vaginally! But that was just taking pg for 7 days so for a continuous routine which has been suggested I try...the 100mg pessary might be better.....

I HAVE to try the 200mg pessary tonight, I can't even explain how BAD I feel!

[Tc]

Hiya ladies. I didnt know there was a pessary.
I had trouble with thec100mg oral pill falling out when I used it vaginally, probably because i wee so much during the night.
I've had to stop it altogether now after 5 months continous oral without even the 3 day breaks. Its built up so much in my system its intolerable.

I'm intending to restart on a 14 day cycle which will mean 200mg doses. I had assumed that meant taking 2x100 pills. Do ladies insert 2 of the 100 pills vaginally. Do you know if the "pessaries" are different to the "pill" and whether they are NHS available please.? They might not "fall out" as easily and I dont fancy taking 200mg orally.
X

[CLKD]

How much do your own hormones interfere with the HRT though?

[Tc]

In my case they dont interfere at all as I've lost my ovaries. You would think that makes things simpler wouldnt you? Apparently not so 

[CLKD]

I think that hormones are also produced from somewhere else when ovaries are gone  .  Wouldn't it be nice to have see-through bodies so that we can actually watch what is happening  ..... it would solve so many issues 

[Tc]

It sure would. Adrenals and fat cells produce small amounts but I guess its individual as to how much. I've often wondered if the reason  some ladies fair better on no or low  hrt after ovary removal is because their adrenals are functioning better than others.

Stellajane thanks. Dont worry I can easily confuse myself all on my own!!
Shame the pessary isnt available. I wouldve liked to try it.  When I put the pill in vaginally I found it on the toilet floor completely whole the next day. Just glad the cat didnt eat it!!!

[pepperminty]

Hi BlueKingfisher,

as you also changed the dose of estrogen, it may be difficult to know whether it is a combnation or that alone. It is horrible worrying about your job. Can you work from home if you need to? Most good employers should be supportive whilst you are adjusting medication.
It can take a while getting it right. If you feel that trying regime at the moment is too stressful, perhaps go back to what you know, although not perfect, and re group mentally. Can you explain to your employer that you are having to adjust you medication and this may cause a few issues, so you may need a bit of support? Do you have an occupational health department ?

Trouble is you don't know what works and what doesn't until you try and then it can be variable until your body adjusts. Also tell your family that you need a bit of support too.

Crap isn't it!

Anyway, once you find what works, please update on your progress.

PMX

[Blue Kingfisher]

I've been on the 200mg progesterone pessary for HRT for approx 2 years. Was prescribed this under the Studd clinic. I feel good whilst on the 200mg pessary but terrible on the 100mg pg oral tablet used vaginally. They've put me on the 100mg pg continuous routine as I felt terrible on days 5-15 of my menstrual cycle so we are trialling if I need a continuous dose of pg. I might indeed need more pg but I can't tolerate this oral tablet version at all! Back to the 200mg pessary for me tonight & will take it from there. I'm still not clear if you can get a 100mg pg ‘pessary' does anyone know?

I think the way the pessary dissolves or absorbs is much more tolerable for my body.

[Blue Kingfisher]

Having looked around, it looks like there is either 100mg progesterone oral tablets (these are spherical) which you can also use vaginally OR 200mg vaginal pessaries which come with vaginal applicators. The 100mg tablets (taken vaginally) feel disastrous for me, I feel like I'm loosing my mind! I had no idea that the 200mg pessaries weren't normally prescribed for HRT.....! The side effects are significantly less for me.