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[pricey]

Hi ladies,

I last posted on the verge of giving up on Evorel Sequi, or HRT altogether. I have been spotting off and on for 4 weeks now and this turned into a heavy bleed. Spoke to my GP who has now prescribed Oestrogel (2 pumps) which I started last night and utrogestan 200mg a day for the latter half of the month. I'm a bit apprehensive about that from everything I've read. With the job I do I can't risk feeling groggy. So what is the best way to take it? I've seen some ladies advocating splitting the dose,  one in the morning and one at night. Others mention taking it vaginally but my GP had not heard of this. Added to this uncertainty is the fact I only have 80g of Oestrogel (one pump) and 3 months supply of the utrogestan.  The pharmacist has dispensed as per script so the GP has only prescribed one month's supply of Oestrogel. As if this wasn't expensive enough!

Grrrrr.

 

Any advice appreciated x

[Ladybt28]

Hey Pricey,
So a couple of things to consider.  Firstly you do not know how you're body will react to the change of regime, so it is hard to give you definite rules as to what to do but as you have read, things to consider are feeling groggy on utrogestan.  Please bear in mind your spotting may continue although I had plenty of spotting and bleeding on Evorel which stopped on oestrogel and utrogestan.  It will take at least 2 months to settle into the new regime and you may feel a bit weird on changing over...everyone is different.  I had 6 kinds of hrt before I got to gel and utro which has been the one and only thing which has worked for me and works just fine.
Forget that your GP hasn't heard of using it vaginally, loads haven't but it is a well known method and perfectly safe. Lots of us ue it that way on the forum, myself included.

Orally utrogestan can (not for everyone, you could be lucky) have a sedative effect which some women like because you take it at night and if you have trouble sleeping its good.  However, as you have read it can make you feel groggy in the day.  It goes through the stomach and the liver taken orally and so that can increase the side effects (if you are going to get any - the only way to find out is to do it). 

Used vaginally it is absorbed straight into the uterus, vaginal lining so side effects are less or non-existant.

The gel is best put on in the morning - some ladies split the dose - I don't and unless you have any obvious problems I wouldn't start splitting it (ladies usually have come to conclusion about splitting the dose after much experimentation over a period of time) because you are just starting out - see how you get on 2 pumps in the morning - utro at night.

I knew I had problems with progesterone so I never even bothered to try my utro orally I went straight to vaginal.  The only issues I had with it was cramping during the utro phase for the first 3 months which went away and I get a little bit tearful during the utro phase.

Ref the 80gm pump, yes she has only dispensed you one month of oestrogel - not sure why? maybe it is because you are starting off an she expects you to go back for a follow up? 

[pricey]

Hi Ladyb,

Thanks so much for replying   I'm feeling apprehensive about taking the oral capsules but my GP seemed clueless about using utrogestan vaginally. The female pharmacist was clued up though! I was thinking of phoning the surgery again, but I just read on another post that utrogestan used vaginally isn't licensed for use in the UK.  What is the name of the product ladies are using? )

Thank you x

[Ladybt28]

Its not licensed for use that way in the UK but it is licensed for use in Europe and says so on the leaflet.  Just because its not on the UK leaflet or in the book doesn't mean there is a problem using it that way.  Don't let the license thing put you off there are millions of women using that way Pricey.  Some GP's and meno consultants just need educating that's all. Glad to hear the pharmacist knew about it though.

The are using Besins Utrogestan capsules vaginally.  There is one called cyclogest which is a pessary but is used in fertility treatment and not necessarily for hrt and it is usually only prescribed by private meno consultants.

To be honest no one is going to know whether you swallow them or push them inside - they will do the job that's required which ever way you use them.  The only thing will be that if you are going to get side effects you will get more orally than vaginally.

[Wooz]

Thanks for these posts which are so helpful both in knowing others are going through similar experiences and knowledge given by those further down this HRT road!

I've just started on Utrogestan oral daily & Estradiol - 1 week ago. I've had a hormone headache yesterday and today. Also feeling a bit spaced out with some gastric issues. I asked the GP about vaginal Utrogestan but she said that they only prescribe oral. Ladybt28 - can I get vaginal Ultrogestan from a GP and if so, does this need to be Besins Utrogestan? You seem to be saying that this is intended for oral consumption but can be used vaginally - is that right?

[Ladybt28]

Wooz - yep... you use the same capsules...the ones you swallow, are the ones you insert, Besins utrogestan.  There are not too different kinds.  You just take the little balls you have been prescribed to swallow and push them as far up inside the vagina as they will go!  I use an applicator from a Caneston set..seems my fingers are not long enough to get them that far up.  Other ladies use applicator from vaginal atrophy treatments.  Most people use their finger and just push 

[Dotty]

Hi I take Utrogestan orally every day and I don't have any side effects. Not everyone has side effects x

[Hurdity]

Hi Wooz

 

and hi pricey!

As Ladybt says (those pesky balls!) - and I posted about this recently on this thread all about vaginal progesterone:
https://www.menopausematters.co.uk/forum/index.php/topic,43633.0.html

There is a bit of chat at the end but my first and last post gives the info about vaginal progesterone. If you look at the link on your phone you can get Google to translate the French but I've done the relevant bit!

Hurdity x