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[Masmeno]

Can anyone help please.
I am on 300mg of Utrogestan 2 weeks of the month, I need the higher dose to stop breakthrough bleeding.

If I want to take this vaginally I am confused with what the dose would be…I know it is half the oral dose but not sure how to spilt the 3 tablets for vaginal application 

Thanks all!

[CLKD]

HI! MayB put the product name into the search box on the Forum to see threads?  Make notes ;-)

[Masmeno]

HI! MayB put the product name into the search box on the Forum to see threads?  Make notes ;-)

Yep I did that first, couldn’t find anything.

[CLKD]

Ah.  Hopefully someone will be along. 

[sheila99]

The dose is only half according to Louise newson, the manufacturer thinks the dose should be the same regardless of the delivery method. Perhaps you could try 200mg vaginally first? I haven't heard of anyone on 300mg. Are you still peri as you're on cyclical hrt? Perhaps your own cycle has got out of step with the hrt one (my body is always stronger). Have you been investigated in case you have a polyp or fibroid that's causing it?

[Masmeno]

The dose is only half according to Louise newson, the manufacturer thinks the dose should be the same regardless of the delivery method. Perhaps you could try 200mg vaginally first? I haven't heard of anyone on 300mg. Are you still peri as you're on cyclical hrt? Perhaps your own cycle has got out of step with the hrt one (my body is always stronger). Have you been investigated in case you have a polyp or fibroid that's causing it?

Yes I had a scan 2 weeks ago and been fully checked there is nothing wrong with my womb, it is because I am on a high dose of oestrogen (100) I was finding the progesterone was not high enough to prevent constant breakthrough bleeding, this quite common and increasing the dose of progesterone to 300mg if the prescribed oestrogen is high is advised by the bms. See link.

https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf?fbclid=IwAR3FZqPo4qCjYhEQ9YZuDDwB4JfHaHnwAfLT1TpovqcEcTuNSr3INBQsLks

I am peri so on cyclical regime. Just not sure if I should do 2 a night as can’t really half a pill 
Prob have to call the doc.

[Hurdity]

Hi Masmeno

Just to be clear - you have been taking Utrogestan orally for 2 weeks per month and this has resulted in breakthrough bleeding but you want to take it vaginally?

Thing is why not just take 200 mg vaginally for a couple of months and see how you get on because more gets to the uterus when used this way? Also if you are wanting to follow what the BMS says then you should really take the prescribed dose.

What Louise Newson says is not licensed. There is no licensed dose for vaginal use. There have been some small studies suggesting that half the oral dose can be used when taken vaginally but as you say it is not one size fits all and on higher doses of oestrogen more may be necessary anyway.

You should ideally follow what you have been prescribed to start with especially as you have been having breakthrough bleeding - start with that (300 mg daily for 2 weeks) and then if you feel you can reduce safely you could try it eg alternate 200 mg with 300 mg.

Hurdity x

[Masmeno]

Hi Masmeno

Just to be clear - you have been taking Utrogestan orally for 2 weeks per month and this has resulted in breakthrough bleeding but you want to take it vaginally?

Thing is why not just take 200 mg vaginally for a couple of months and see how you get on because more gets to the uterus when used this way? Also if you are wanting to follow what the BMS says then you should really take the prescribed dose.

What Louise Newson says is not licensed. There is no licensed dose for vaginal use. There have been some small studies suggesting that half the oral dose can be used when taken vaginally but as you say it is not one size fits all and on higher doses of oestrogen more may be necessary anyway.

You should ideally follow what you have been prescribed to start with especially as you have been having breakthrough bleeding - start with that (300 mg daily for 2 weeks) and then if you feel you can reduce safely you could try it eg alternate 200 mg with 300 mg.

Hurdity x

yep to be clear I don’t want to reduce my dose I just was asking about taking the same amount vaginally as I have had some intolerance to Utrogestan in the past and was a bit anxious about taking 3.

Anyhow the first few nights have gone ok so will carry on orally for now.

[Hurdity]

OK great! Hope it continues to be OK for you

Hurdity x