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[Ljp]

Hi all.

Today I went to see an NHS menopause specialist in my local area, I had no idea we had one! I was referred by my GP as my mirena(used alongside oestrogel, estring and tostran) needs replacing (had it 4 years) and the strings have twisted up inside my cervix.

Well, the specialist was lovely, and spent time listening to all my history of menopause symptoms, VA, Mona Lisa, and still having bladder issues.

Initially she was going to replace my mirena, then she suggested rather than replace it yet, that I try utrogestan daily to see how I get on with it, as she said mirena, although very good, isn't body identical progesterone and very little gets into blood stream, where as the utrogestan, which is body identical, will benefit my whole system, hopefully including my bladder.
If I tolerate it well, she will remove my mirena at a later date.

She has also prescribed me intrarosa to try to see if that, alongside my estring, can help bladder and VA flare ups.

I'm feeling positive, but also apprehensive about taking utrogestan, worried I might get side effects?....how do you fare? If you are on it?

[CLKD]

Also - what are you using for the VA? 

Glad that you managed to get a sympathetic medic - hang on to her ;-).  Let us know how you get on.

[Tinkerbell]

I was prescribed Utrogestan daily, i lasted 8 days, the side effects were so bad, disturbed sleep, with vivid dreams, needing to keep getting up for toilet in night, hot flushes so bad that my sheets were soaked. I had to stop as i was zombie like in the day and i had to do school run and go to work, maybe i would have got used to it but as i didn't feel i should be driving i had to stop it, i then went for the Mirena.

[Ljp]

Also - what are you using for the VA? 

Glad that you managed to get a sympathetic medic - hang on to her ;-).  Let us know how you get on.

I've been using estring for 4 years
I will be also be trying intrarosa DHEA as from tomorrow

I was prescribed Utrogestan daily, i lasted 8 days, the side effects were so bad, disturbed sleep, with vivid dreams, needing to keep getting up for toilet in night, hot flushes so bad that my sheets were soaked. I had to stop as i was zombie like in the day and i had to do school run and go to work, maybe i would have got used to it but as i didn't feel i should be driving i had to stop it, i then went for the Mirena.

Blimey that's concerning! Hope I don't suffer such side effects 😟

[Ljp]

There are stories for and against, so fingers crossed you'll be ok. I'm okish on utrogestan. It can make you feel a little foggy but you won't know till you try it. Try not to worry!
I was like a miserable, knackered old hag on the Mirena.

Thanks Birdy, I'm terrified to try it, I've been doing ok an my oestrogen and mirena, the Tostran has helped my bladder since September and all good.

But I hear what the specialist was saying regarding my age and VA and how removing and inserting mirena coils can be problematic as we age and uncomfortable (mine was very painful
being inserted)
I'm so worried the utrogestan is going to start cramps, bleeds, fogginess etc 😩

[Tinkerbell]

I love the Mirena but others hate it, same as with utrogestan, so you don't know until you try and you can always go back to the Mirena.

[Dotty]

I have no problems with Utrogestan. Try not to worry x

[Ljp]

So no to using it vaginally then

[Ljp]

I did ask the specialist regarding how best to use it, orally or Vaginally, she said orally, so feel I should do this way first.
Maybe if it all goes well and I have mirena removed, then I can ask about trying vaginally.
Although I already have estring and starting intrarosa tonight, not sure if vaginally would be wise, quite the chemical concoction 🤔😀

[Ljp]

Did you ask it just do it?
Do you insert it daily I'm on Conti
I am worried that using it Vaginally might be risky with already having estring and now using intrarosa too? Plus how it could affect my VA

[Ljp]

Hopefully Hurdity will read and reply x

[Tinkerbell]

I didn't know the Utrogestan can act as a diuretic, explains why i was up about 3 times a night whilst i took it, prior to starting it i never needed to use the toilet at night.

[Rhiner]

LJP,

When I started on Utrogestan I did it alternate days 100mg, so the body gradually gets used to it, maybe this will help, do say first couple of weeks alternate days and see how you get on.  I had a bit of headache and feeling itchy initially but soon passed. In fact my mood improved with this prog (had been on oestrogen only for 2 months first to get the right dose).

So its not all bad!
Rhiner

[Hurdity]

I've used Utrogestan vaginally on a cycle for 8 or 9 years now - Hurdity and I started around the same time. Yes, it does minimise unpleasant side effects such as sedation but for some it acts as a diuretic (which is a natural attribute of progesterone) and can tend to irritate the bladder (in some people) so you're up and down to the loo during the night. I definitely wouldn't want to be using the capsules vaginally every day. Hope that's clear now.

Yes! THis! Was it really that long ago stellajane? Now I come to think about it, was Sept 2011 when I started long cycle vag Utro having just done a few months of conti with 25 mcg patches and every third day Cyclogest, then thanks to this forum discovered utro had been licensed for hRT in UK  since I started hRT....

Yes like Marmite whoever said that - you love it or hate it (Utro that is). My experience I think I posted today on another thread?  Never taken it orally as I've always been HRT  = nil-by-mouth - most natural way to get the stuff into your body. It does give me bladder irritation as normally now I sleep so deeply ( too deeply - no proper cortisol awakening response or something) so I don't wake up easily. When taking Utro I wake in the night to pee. When I didn't sleep so deeply I would sometimes need to get up twice. I always read in bed ( actual book!) so just before I turn light out I nip out to loo so hopefully then it's only just the once!

Also it dometimes gives me labial irritation (upper labia just below the mons - becomes very itchy) - so I use thrush cream if so and despite the fact that the utro oozes out - try to make sure there is nothing tight around that area at night. Sooo much better with only 100 mg though ( but if cyclically this must be supervised medically ie with permission of your doc). also side effects so much better (or rather less bad) with 100 mg compared with 200 mg but like I said in other thread I plump up with Vagifem daily during the week leading up to vag utro and during it when I can (Vagifem in the morning 12 hours after the utro).

Gosh LJP I am wondering why you will be using Intrarosa + the Estring as well as systemic oestrogen? Problem with intrarosa is that the licensed dose is daily to give the same effect as twice weekly Vagifem 10 mcg so it's weaker. However probably in conjunction with other HRT it may well help. There is also the newly licensed Imvaggis (drum roll!) an estriol pessary made by Besins.

Foggy head? Yes to this ie I get it with Utro, but much more with 200 mg. This is the worst symptom along with fatigue and occasional migraine but I must stress it is very individual as you can see from the replies.

Don't think I can add anything further except to agree with all the excellent replies . Research shows that for a given dose more gets to the uterus when used vaginally than orally as it goes straight to where it's needed. Orally there are more metabolic byproducts. I think the effect of it will vary according to where you are in menopause and perhaps your general hormonal "milieu" not just HRT. As I said I sleep too deeply so can do without the extra sedative effect. If you are generally hyped up and over-stimulated it may well have a calming effect before it gets to be too much and have the depressive effect - so maybe this accounts for the differences?

Sorry I'm rambling - had my Fri night tipple and not enough sleep last night due to momentous events 

Hurdity x

[Ljp]

Thanks Hurdity and all for your replies.
I'm definitely feeling very confused and anxious about all this change, and unsure of safety etc.

My mirena is still in,had it 4 years although they now say 5 years is ok for meno use.
I think the specialist saw this as an opportunity for me to try utrogestan, but I'm worried about  my liver taking it orally, and wouldn't want to use it vaginally due to my VA and bladder issues.
I do have moderate to severe VA at 55 😩 and specialist suggested I try intrarosa alongside the estring to see If it might help the Labial irritation I still get at times, and the urgency and urge incontinence I still get, some dats worse than others though, tostran has helped I think.

I'm just in a state thinking about it all, how to take, what to take,....thought I was doing okish on my oestrogel/estring/mirena regime 😥