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[Cassie273]

Hi everyone

I'd be really grateful for some of the collective wisdom that has helped me previously on this forum please!

I started perimenopause about 8 years ago at the age of 38, and some years and many battles with the GP later, I finally got taken seriously and have been on Femoston 2/10 for a couple of years.  I'm now right at the end of perimenopause and both the GP and a gynae consultant agree that I can stop having a monthly bleed and move onto a continuous form of HRT.

I've been prescribed oestrogel and utrogestan - which are obviously both a significant departure from popping one tablet every morning (vis-a-vis the femoston) but the GP was pretty helpless when it came to the details of how to take the oestrogel and the utrogestan, so I have a lot of questions.  Please do answer what you can for me!

1) When is the best time to take the utrogestan? There's some detail on the packet about 2 hours after a meal & 1 hour before, and I've seen other posts from people who take it at night. Does anyone know why it has to be taken on an empty stomach and what would happen if I took it only one hour after eating For example?  I go to bed really early so it may be a problem to take it 2 hours after eating.

2) Does the oestrogel have to be applied at the same time that the utrogestan is taken?

3) I'm assuming I take the utrogestan every day (there's nothing to the contrary on the packaging and I have 100mg capsules / tablets) -  is this correct for continuous HRT?

4) Where do I apply the oestrogel? I've heard that it should be applied on the thigh but whereabouts? Near the knee? Higher up? Front, back, side??

5) Has anyone else transitioned from Femoston 2/10 onto oestrogel and utrogestan? If so, please share your experience of transitioning - did you do at the end of one month's pack of Femoston or in the middle? Do you experience any unpleasant side effects at all?

6) Has anyone had any problems with the utrogestan? I am pretty sensitive to progesterone and am really concerned about getting depressed.  Unfortunately I can't have the Mirena coil, which was everyone's preferred option for me, so it looks like I'm stuck with the utrogestan.

Any other advice greatly appreciated!

Thanks so much!!

[westie]

Hi Cassie

I can't help with the transition from Femoston as have only ever used gel and utrogestan but can help with some of the other questions to raised.

I don't think there is a correct time to take the Utrogestan although as it can have a sedative effect, I think most of us take it in the evening before bed. If you a struggling with having the two hours after food, you can take it vaginally which means it wouldn't, have to go through the digestive transit. Many of us take it this way and it also reduces the side effects which may help you with your progesterone sensitivity, and yes 100 mg daily is the correct dose for continuous HRT.

as for where do you rub it in, upper inner thigh or you can use it on outside of upper arms, whichever you prefer. It drys very quickly so you don't have to wait long before getting dressed.

I tend to do the gel in the morning after my shower and the utrogestan in the evening but I don't think it matters how you do it.

Am sure many others will be along to help further. Good luck with it, I hope you find the new regime effective.

W x

[Ladybt28]

Cassie - I do gel in morning utrogestan at night.  If you take it orally then Westie is right it can have a sedative effect which is good if you have trouble sleeping but some ladies complain they still feel doppy in the daytime.  I use my utrogestan vaginally to avoid side effects of taking orally where it goes through the stomach and the liver.  I am also sensitive to progesterone and I will tell you it takes a while to settle.  Just for your info I do not take it continuously I take it on a cycle and I am post meno and I choose to bleed because it limits the amount of progesterone I am taking.

Regarding this regime, it is very flexible unlike tablets and patches, it is just a matter of working out how it works for you personally.  Utro can be taken continuously or on a cycle and it can be taken vaginally (although it does say so on the sheet in the UK but it is licensed that way in Europe and loads of ladies on here use it that way) or it can be taken orally.

You can end up using anything from 1 pump of gel to 4 pumps of gel.  There are no hard and fast rules, it is all about using enough to control symptoms but minimise any side effects if you are going to have any.

I slap my gel on my inner thighs and rub in - its not a precise science.  Trial and error are the name of the game on this one.
Good luck and don't be afraid  there is really no right or wrong way based around a general regime.  It's totally different from other forms of hrt. xx

[KiltedCupid]

Cassie273 - I've transitioned from both Femoston sequi and conti to oestrogel and utro and back again. I could tolerate the prog in Femoston more than utro but I'm very prog intolerant and eventually had to stop the Femoston too. I didn't have any problems stopping one and starting the other although you may have a bleed in the transition as your body settles into the new regime. I'd also echo what the other ladies have said in terms of usage.

One thing that strikes me though is why didn't your doc just offer Femoston Conti? It's 1/5 but you could double up to 2/10 by taking 2 of the conti tablets a day. If you have absolutely no problems on the prog part of Femoston, I wouldn't change it. Prog is the most difficult element to adjust to and if you've found one that suits, without side effects, then stick with it.

[Cassie273]

Thanks so much for replying to me - it is much appreciated.

One further question to those taking the utrogestan vaginally - do any of you use vagifem as well?  If so, how do you deal with both vagifem and utrogestan vaginally?  Both at the same time or different times of the day?

KiltedCupid - Femoston Conti was suggested but I need more oestrogen than I am currently getting, and the progesterone has always been a problem on Femoston as well. That's why the Mirena coil was first choice but I went into cervical shock when they tried to fit it so they will refuse to do it again now (and I don't want that experience again too!). the oestrogel should be better in terms of my oestrogen levels but i am concerned about the progesterone.

[Ladybt28]

I don't use vagifem Cassie but I know the answer to the question because its on another thread.
You use your vagifem in the morning and the utrogestan vaginally at night.

[Cassie273]

Thank you Ladybt28 - this is really helpful

[KiltedCupid]

Apologies Cassie - I didn't realise the Femoston prog didn't suit. Good luck with the utro and gel.

[Cassie273]

Many thanks