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[lizziejt]

Hi, I am still trying to find a progesterone regime that I can live with. I'm on 75mcg patch. Oral utrogestan made me feel ill so I tried the vaginal route. It has been up and down - I used 100mg every night but after a while I had continuous spotting so I have had a 10 day break during which I had a proper period. Now back on it. So my question is for sequential utrogestan and a not too heavy period (I have very low ferritin), how many days per month should I take 100mg vaginally? Is 20 days a month ok, or could I take it for just half the month at this dose? Thanks

[Cassie]

I take 100mg for 12 days per month vaginally and have a normal bleed each month.

[lizziejt]

Ok thanks Cassie - what dose of oestrogen are you on?

[Cassie]

I take 1 pump of gel per day

[lizziejt]

Ok thanks. So my dose is a lot higher which probably means I need more progesterone. I may have to see a private meno specialist as I'm not sure what dose I need.

[Hurdity]

Ideally you should start with the licensed dose if using sequentially which is 200 mg for 12 days per 28 day cycle. See how this controls your bleeding and then if necessary reduce from this amount. Research has shown in some small studies that when used vaginally less progesterone is needed to protect the womb because more gets straight to where it is needed compared with the same dose given orally - but this is off-licence, as is vaginal use for HRT (which is ridiculous!). Once you know how your womb is behaving then you can experiment with reducing the dose safely. However taking 100 mg vaginally for 20 days per month is not much less than thr 25 days out of 28 oral dose which is licesned so you may well be OK with this. You will need to do all this under medical supervision and endure that any abnormal bleeding is checked out.

However the utrogestan licensed dose is given as a blanket one dose fits all dose - which is clearly not sensible since the amount of progesterone needed to protect the womb is dose dependent ( on the oestrogen dose).

Hurdity x

[lizziejt]

Thanks for your advice Hurdity. I am doing it without medical supervision - clueless GP and NHS meno clinic discharged me. I guess I will need to get a private appointment then. I am aiming get a scan annually to check womb lining.