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[Pauline b]

I have just changed from taking my ultrogestan 100 from oral to vaginal. I have been doing this each night but I have just read some information on this site from Louise that says vaginal is alt evenings. I am confused which is correct?

[Hurdity]

Hi Paulineb - the correct (licensed) dosage is as given on this site and is for oral use:

Perimenopause: 2 x 100mg daily at bedtime for 12 days per 28 days (days 15-26 inclusive)
Post-menopause: 100mg at bedtime from day 1 to 25 of each 28 day cycle

https://www.menopausematters.co.uk/to_progestogens.php

In practice most doctors allow post-menopausal women to take it continuously rather than with the 3 day break. The other thing is that this is a standard dosing irrespective of oestrogen dose but in practice on higher doses of oestrogen a higher dose of progesterone may be needed - especially with utrogestan which is more unstable in the body taking it as part of hRT.

Vaginal use is licensed in other EU countries but (absurdly) off-licence here. In these countries it can be taken vaginally at the same dose as oral use and you can do it this way in UK too as research has shown that in fact more progesterone gets directly to the uterus where it is needed, than the same dose taken orally ( where much is lost in digestion and metabolism through the liver).

The alternate day dosing is a regime recommended by some menopause specialists and there is research from one or two small studies ( which I and others have posted on here) showing this is effective - using low to medium doses of oestrogen ( up to 50 mcg patch if i recall correctly).

Here is the extract from Louise Newson's page:

"How is Utrogestan taken?

Utrogestan is given as a 100 mg capsule. There are two ways of taking Utrogestan.

    For women who have still had periods in the last 6-12 months, the usual recommended dose is two 100mg capsules, taken together each evening, for two out of four weeks, on a repeating basis.
    For women who have not had a period for over a year, the usual recommended dose is taking one 100mg capsule every evening, without a break.

The dosage information that comes with the medication differs slightly to this, but it is far more straightforward to take it in this way and easier to remember. It is completely safe to take it in the way we have described.

Utrogestan is a natural sedative so can cause drowsiness in some women. It is therefore recommended you take it at bedtime. It is best to take Utrogestan on an empty stomach because eating food can actually increase its absorption.

Some women use the progesterone vaginally rather than taking it orally, which can be associated with less side effects. Evidence has shown that using 100mg progesterone vaginally alternate evenings as a continuous (no bleed) preparation or 100mg progesterone vaginally every evening for 12-14 days each month as a cyclical (leading to periods) preparation is safe.

Many women use the oral Utrogestan capsules vaginally or some women use Cyclogest pessaries (these contain 200mg progesterone and can be cut in half). Progesterone is not licensed to be used in this way but there is evidence to support that this is safe. Women who use it in this way should seek individualised advice from their doctor."

https://www.menopausedoctor.co.uk/menopause/micronised-progesterone-or-utrogestan
Hope this helps

Hurdity x

[Pauline b]

Thank you Hurdity ,

I feel shocking little sleep headaches I think I am sensitive to the ultrogestan. I was fine taking it orally but my breasts were sore so a trial l vaginally was advised. I think I am absorbing too much now and perhaps alternate days may be an option for me. I am waiting for an appointment with my practitioner ( currently on a waiting list!)

[Hurdity]

Bump for jaylou

Hurdity x

[Jaylow]

Thank you