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[pricey]

Hello ladies,

Bumping this up again for advice. Having read around the last few days, I'm considering trying the vaginal 100mg alternate days on a continuous regime. I was thinking of doing the 25/28 day regime to allow for a bleed if the lining builds up, but is this 3 day break necessary or practical on an alternate day schedule? I seem to absorb and tolerate utrogestan well vaginally but at 55 (and on HRT for 5 years) I would welcome less/no bleeds if that is achievable. My own cycle still kicks in from time to time on sequi  and has done so again this month.

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My last trial.of a conti regime didn't go so well, but Oestrogel and Utrogestan (200mg vaginally for 12 days) seems to be suiting me   I very occasionally have slight breakthrough bleeding at the time my own cycle would be due - this was relentless on other therapies.. As I'm 55 now and have been on HRT 4 years, I'm wondering about trying the continuous approach again..My doctor was happy for me to experiment with this. If so, what dose of Utrogestan vaginally would you recommend and would this be every day or alternate days?.Also,  I've seen recommendations of 25 out of 28 days  - does this mean using Oestrogel only for 3 days a month and why would that be?

It's all quite complex!
Thanks in advance.


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[Sid]

Hi Pricey

Like you, I am 55 and am currently on Oestrogel and Utrogestan 200mg (taken for 12 days vaginally). I recently tried to move to a continuous regime over 25/28 days (Utrogestan 100mg orally for 25 out of 28 days).  Unfortunately, the continuous regime did not work for me and I had breakthrough bleeds.  I think this is due to the fact that I don't seem to absorb Utrogestan very well orally.  When first on the sequential regime I took the Utrogestan orally and had breakthrough bleeds until I changed to using it vaginally.  I would really like not to have monthly bleeds, but it is not really practical to use the Utrogestan vaginally all the time, and so I think I will have to stick to a sequential regime (not keen on Mirena).  Really hope you have more success x

[Sid]

By the way, forgot to mention that you use the gel every day x

[Hurdity]

Hi pricey

It depends on your oestrogen dose what dose of Utrogestan would work. Like Sid I wouldn't want to use Utrogestan continuously vaginally. The licensed dose is 100 mg Utrogestan for continuous use (or 25 days out of 28). Every other day is recommended by some private consultants but it's best to start with the licensed dose and see how your body reacts and if you continue to get any breakthrough bleeding. It works best ( the alt day regime ) on low to medium oestrogen doses because the prog is likely to be insufficient to protect the uterus with higher oestrogen doses. The research on this was carried out on low-medium oestrgoen doses if I recall correctly.

Actually thinking about it - rather than conti, if you are still having some sort of slight cycle then 25 (days of 100 mg) out of 28 would be better than completely continuous Utro...

Hurdity x

[pricey]

Hi Hurdity,

Thanks so much for replying.

Yes, my own cycle seems fairly persistent (but not every month) and I think the withdrawal bleed is worse. I'm on 2 pumps of Oestrogel (is that low/medium and would 100mg utrogestan be appropriate with this?) which seems to be pretty much controlling my symptoms. I tried extending my cycle to 6 weeks using 12 days of utrogestan and this worked beautifully for two cycles. However, this cycle I started to bleed (and with symptoms that suggest it's my own cycle kicking in) at around 4 weeks ie. just before I was due to start the utrogestan. As I've been bleeding, I haven't started the utrogestan (as I use it vaginally, I felt there would be little point). So I'm thinking a trial of the 25 out of 28 days regime might be worth a try so I can have a bleed if there has been a build up (likely) but the continuous utrogestan might just keep my cycle in better check? My quandary is when to start this? I seem to be coming to the end of my bleed.

Thanks for your help?

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