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[ConfusedAboutHRT]

Please help! I was prescribed oestrogen patches (50mg) plus utrogestan 100mg for days 1-25 by my doctor.  Taking for around 5 months.  I was having signs of progesterone intolerance so switched to vaginal delivery every other day for days 1-25, 100mg. Dr Louise newsomes website said to take alternative days but doesn’t specify for how long. Not sure if this is just for people taking it continuously. Now with a new doctor who is saying it’s off license and wants me to stop both to allow my body to reset. I’m worried about doing this. My doctor is looking into it but won’t have a response for me until Thursday. What I want to do at the end of the 25 days is stop the progesterone until I have a period and then restart the progesterone again - but perhaps for the last 14 days of cycle every night. (Local pharmacist says this is often prescribed this way). That might mean I’m without progesterone for 2.5-3 weeks. I’m not sure if this is dangerous. I know some people with irregular periods only take prog for 14 days in every 3 months (nhs website) so it seems it wouldn’t be dangerous for me to miss 2 or 3 weeks. (When I say dangerous I mean womb lining getting too thick). I just don’t know what to do. Very worried. Any advice greatly appreciated.

[CLKD]

Hi!  Clear as mud this HRT regime at times 

Hopefully someone who takes it will be along. In the meantime,  - browse round.  Make notes.

Often regimes are covered by regular scans of the uterus to check the thickness.  Then appropriate measures can be advised.

[ConfusedAboutHRT]

Thank you CLKD.  Yes, it’s clear that many women are confused and lots of doctors don’t know much about menopause treatment.
When you mention “regular scans” how regular is regular?

[helenc]

Sorry to hear about the confusion - if it helps - I was moved from sequential patches (I had been on them for 10 years) to continuous HRT a few months ago - the oestrogen was a gel that I had to apply once every day and the progesterone was by way of a pill taken off licence - vaginally, every other day - as soon as I switched there have been awful problems - sore breasts and now they have had to do further tests due to a 6 mm endrometrium thickening - my GP has been very blase about it all and I am fed up - the off license use of the tablets is fine - it wasnt for me though

[Hurdity]

Hi confusedaboutHRT

 

First - it depends where you are on your menopause journey as to whether you take Utrogestan cyclically or continuously. Continuously is for post-menopausal women who have been without a natural period for 12 months though this would be different for those who don't have periods but not post-meno ie on Mirena or POP or hysterectomy.

Continuously includes the days 1-25 which is the licensed  post-meno dose (to allow a bleed in those whose womb lining has built up) though many women are prescribed it every day.

Cyclically the licensed dose is 200 mg utrogestan orally for 12 days per 28 day cycle although there are often minor variations and tweaks of this and many women take it vaginally. Cyclical regimes are for peri-menopasual women and post-meno by choice ( those who dont like taking progesterone).

Yes your doc is right alternate day vaginal use is off-licence and should not be taken like this without medical supervision and in any case would only be recommended for low to medium oestrogen doses and in post-menopausal women.

You don't have to stop oestrogen at all despite what your doc says but if you are still very much early peri-meno and having your own periods then you maybe will have to adjust your utrogestan cycle as you are suggesting ( even though you're not necessarily peri).

There is no problem wih going without progesterone for that short a time - after all the cycle itself is 28 days and the "normal" gap is 16 days without prog. Not at all dangerous!

It is only in off-licence regimes that regular scans are recommended - and at least until you know how your womb lining behaves on that regime.

Do tell us where you are in menopause and we can advise further and...

Hope this helps

Hurdity x

[CLKD]

Morning Hurdity >wave< 

[Hurdity]

Hi CLKD

[ConfusedAboutHRT]

Thank you for your reply.
To clarify, I’m perimenopausal. Was having irregular periods before starting with hrt 5 months ago. 

My doctor has now said I can pause the progesterone, wait for period and then restart prog on days 14 for the two weeks. She said to take 200mg per day, either orally or vaginally. I questioned if taken vaginally it should be half dose (due to higher local absorption rather than systemic absorption) but she said no, must be 200mg daily.  Hopefully I’ll get a bleed within a week after my pause and then restart the regimen two weeks after that.  She confirmed that it isn’t harmful to not take it for 3 weeks. If I don’t have a bleed after a week, she said to count two weeks from then anyway and restart.  I don’t have a lot of faith in what gps say, so would appreciate confirmation from someone who knows their stuff.

Thank you.

Hi confusedaboutHRT

 

First - it depends where you are on your menopause journey as to whether you take Utrogestan cyclically or continuously. Continuously is for post-menopausal women who have been without a natural period for 12 months though this would be different for those who don't have periods but not post-meno ie on Mirena or POP or hysterectomy.

Continuously includes the days 1-25 which is the licensed  post-meno dose (to allow a bleed in those whose womb lining has built up) though many women are prescribed it every day.

Cyclically the licensed dose is 200 mg utrogestan orally for 12 days per 28 day cycle although there are often minor variations and tweaks of this and many women take it vaginally. Cyclical regimes are for peri-menopasual women and post-meno by choice ( those who dont like taking progesterone).

Yes your doc is right alternate day vaginal use is off-licence and should not be taken like this without medical supervision and in any case would only be recommended for low to medium oestrogen doses and in post-menopausal women.

You don't have to stop oestrogen at all despite what your doc says but if you are still very much early peri-meno and having your own periods then you maybe will have to adjust your utrogestan cycle as you are suggesting ( even though you're not necessarily peri).

There is no problem wih going without progesterone for that short a time - after all the cycle itself is 28 days and the "normal" gap is 16 days without prog. Not at all dangerous!

It is only in off-licence regimes that regular scans are recommended - and at least until you know how your womb lining behaves on that regime.

Do tell us where you are in menopause and we can advise further and...

Hope this helps

Hurdity x

[ConfusedAboutHRT]

Hi Helenc

Thank you for your reply. Sorry to hear you’re having trouble and some lining thickening.  And sorry to hear your doc is so blasé.  I just think most gps know virtually nothing and medicine is basically misogynistic. We are women, they don’t care.   Thankfully it’s gaining more focus and people are starting to take notice, but it says something about the state of things when women have to ask each other on forums because gps know so little.

Sorry to hear about the confusion - if it helps - I was moved from sequential patches (I had been on them for 10 years) to continuous HRT a few months ago - the oestrogen was a gel that I had to apply once every day and the progesterone was by way of a pill taken off licence - vaginally, every other day - as soon as I switched there have been awful problems - sore breasts and now they have had to do further tests due to a 6 mm endrometrium thickening - my GP has been very blase about it all and I am fed up - the off license use of the tablets is fine - it wasnt for me though