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[DownDillie]

I've been on Sandrena gel 1mg along with Utrogestan 100mg 25 days out of 28. I don't tend to take all the 1mg of Sandrena, usually about half or 3/4 of it.

I am currently on the 3-day break from Utro and I've realised yet again how much better I feel mentally without it. The feeling of lethargy and apathy has lifted. Perhaps this is psychological because it's happened so quickly. I still have a dull headache which seems to be semi-permanent these days.

I also feel that generally throughout the month, while I feel emotionally on an even keel, it's almost too even, there are no ups and downs. I never look forward to anything, I am never excited or particularly happy, just .... plodding along. I have other cr@p going on in my life but generally I feel mildly depressed, and I'm wondering if the Utro is causing this.

Prior to starting HRT, I was a complete mess mentally, very down, depressed, weepy, anxious etc. I am 55, last period in 2011, started HRT in June 2016.

So I've been toying with the idea of either a) coming off HRT completely for a while to see how it goes or b) taking Utro vaginally.

With b) we arrive at the subject of this post - how does it work when taken vaginally - i.e. how does it get absorbed? Is it meant to work its way into the uterus? Apologies if this is a daft question  .

The reason I ask is that I have recently had two attempted biopsies of the womb lining - neither could actually get in through my cervix which is apparently clamped shut tighter than Fort Knox. I had a hysteroscopy before the first biopsy, and that did get through because they had the camera for navigation, though it was a bit of a struggle.

So I'm wondering if I take Utro vaginally, will it get absorbed? Also does it make VA worse?

Thanks for listening 

[Sooze]

DownDillie,
I'm on 1mg of Sandrena too and I've done some experimenting with the Utrogestan. I started trying it every day orally, then switched to vaginally. Neither suited that well, orally the taking on an empty stomach, bonkers dreams, slightly flat emotions vs local irritation and feeling even flatter emotionally with the vaginally I decided to switch to vaginally alternate nights.  For the first 4 months or so after I switched to alternate nights I had erratic  spotting, nothing heavy though so I wasn't concerned as otherwise I felt much better. Now I've just had a check up and my uterine lining is very thin, so I think I have the doses right for me and my gynaecologist is happy for me to continue.

My understanding is that you get a higher dose vaginally, and as long as you're on a low to medium dose of oestrogen, alternate nights is enough to keep the uterine lining thin (as long as your lining is OK to start with- no fibroids etc)

This is the best I've felt for years (testosterone helps too) and I'm really glad I ploughed on through the spotting, as it did settle within the 6 months after changing to alternate nights.
HTH,
S

[Traceylr]

hi there,
I have been using utrogestan 100mg caps vaginally for nearly 2 years, i use them continually ( no 3 day break) as that I believe is the recommendation now for post meno. Oestrogen delivery is 37.5 mcg patch. If you swop to using vaginally dont  be surprised if you do get spotting or bleeding, which i did , i got checked and all was fine. i find it much better usiing it this way for me . It is absorbed by the surrounding vaginal tissues and doesnt need to actually get past your cervix, but do try to put it in as high as you , i use an applicator that is usually used to administer vaginal oestrogen , but the caps fit perfectly in the end of it. Also be aware that utrogestan isnt licenced for use vaginally in the uk ! so your gp unless enlightened may no be supportive . good luck and hope it works for you 

[DownDillie]

Thanks both for your replies, interesting.

I started back on the Utro last night after a 4-day break (I ran out so had to go 4 days instead of 3). Today I had a migraine aura and I've had a headache all day, not migraine-level but bad enough. I am inclined to blame the Utro for this because I was fine all weekend.

I think I'll taking it vaginally for a while and see how that goes. If it doesn't work out, I am going to try stopping HRT altogether I think. I'm also (after this weekend, I'm away all weekend) going to have a bit of a revamp of my diet and exercise regime as well. I could do with dropping a stone  .

[juliemargaret]

Hi sooze..are.yoi post or peri? X

[Sooze]

Very post

[Nannyneet]

Hi,I was advised that if you are post meno you should take the utro daily with no gaps,the dose I'm on is 100 msg daily, This is only day four for me so I realise it's early days but I feel ok so far

[Ladybt28]

Nannyneet - the general perceived wisdom amongst health professionals is that post meno you "should be able to take utro continuously so that you don't bleed" but...and it is a very big but - quite a few women cannot tolerate progesterone even in limited doses, let alone continuously, so we don't have any choice but to use it on a cycle and suffer a bleed.

When you use it vaginally it is not going through the stomach and being processed by the liver so those who don't tolerate progesterone well get less side effects or if they are lucky don't get any.  There is always a theory about how each type of hrt or system "should" work but as you can see by posts on here, the theory and the practice are too very different things  .
Its really finding a treatment and a system which works for your body.

[Sooze]

If you look at Hurdity's post re studies of vaginal use https://www.menopausematters.co.uk/forum/index.php/topic,43633.0.html there has been one with using alternate days of Utrogestan 100mg vaginally and 1.5mg of Sandrena daily.  As I'm on just 1mg of Sandrena I thought it would be worth a try. 

The scan I had last week showed the uterine lining to be very thin, therefore my GP is happy with me continuing with this and I'll continue to get regular scans to make sure everything stays OK.  I feel like the balance of oestrogen, progesterone and testosterone is pretty much perfect for me at the moment with regards to symptom control and minimal side effects.
S

[DownDillie]

Have you thought about upping the oestrogen dose a bit? You say you feel flat, mildly depressed with little interest in much. That pretty much sounds like low oestrogen to me.

Well I am taking less than 1mg sachet of Sandrena a day. A few months ago, I changed this to use the whole 1mg sachet, but not long afterwards I started getting some bleeding. A scan showed my womb lining was 6mm, which is a bit thicker than it should be. So I dropped the Sandrena back down again to about half/three quarters of the sachet. The nurse practitioner (who in fact didn't seem to really know a lot about HRT but generally approved of it) said that the Utro was not strong enough for the oestrogen, at least not for me.

I must admit, I was very spooked by the whole bleeding thing - you were kind enough to reassure me at the time.

Perhaps when I start using Utro vaginally, I can try increasing the Sandrena to the full 1mg sachet, which is what the original prescribed dose was in the first place.

[pricey]

Ladies,  I'm curious about this: are you taking the 'oral' utrogestan vaginally? I have read it's not licensed for vaginal use in the UK so is this why my doctor hadn't heard of it. I'm reluctant to take it orally.

Or am I totally wrong here?

[jefner]

Pricey, it is indeed licensed to be taken orally but many take it vaginally as I do and which my meno specialist advised

[Ladybt28]

Hi Pricey - No you are not totally wrong.  It is not "licensed in the UK for vaginal use" but it is licensed in Europe and the European leaflets talk about using that way and... yes that is why your doctor hasn't heard about it...but there are loads of us who use it vaginally to minimise side effects and there are loads of doctors and meno consultants who do know of using it that way- it's patchy in terms of knowledge but we are getting there.  Proper meno advice is patchy at the best of times.  I use it that way and my meno consultant recommended to do it that way.

See my post below

[pricey]

So ladies,  I'm on my first month of Oestrogel.  Day 14 today and I have been spotting for 3 days (this has been a theme anyway on Evorel Sequi). I'm going to use the Utrogestan vaginally after reading advice on here. 

A couple of questions:

The pharmacy label states 200mg days 14-28 whereas I'm reading here things like 15-26 (12 days inclusive).

Also, what about sex (what's that with all this bleeding??) - will the capsules affect my partner? Could they irritate him? And does the gel shell fully dissolve/get absorbed?

Thanks for listening.

x

[pricey]

So ladies,  I'm on my first month of Oestrogel.  Day 14 today and I have been spotting for 3 days (this has been a theme anyway on Evorel Sequi). I'm going to use the Utrogestan vaginally after reading advice on here. 

A couple of questions:

The pharmacy label states 200mg days 14-28 whereas I'm reading here things like 15-26 (12 days inclusive).

Also, what about sex (what's that with all this bleeding??) - will the capsules affect my partner? Could they irritate him? And does the gel shell fully dissolve/get absorbed?

Thanks for listening.

x