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[Pleasantlyblew]

I’ve had problems with progesterone intolerance for over a year. I finally discovered I can now tolerate Utrogestan orally which I’ve been on for around 2 months. I’ve been bleeding continuously for many weeks. Not heavily, but enough to be annoying. I recently had a review with a dr from Newson who doesn’t seem concerned about the continuous bleeding. She said to increase to 200mg orally after a month on 100mg orally. I took 200mg every day for about 3 weeks but there was no change in the bleeding but towards the end I began to feel very depressed. She said if the bleeding didn’t settle down it could be that my body isn’t ready for a continuous regime and to swap to cyclical. So a few days ago I made the decision to have a break. It’s now day 3 and the bleeding has increased to a heavier period which I’m presuming is a withdrawal bleed. The question now is whether or not I should have a two week break or a 3 day break? Am I right in thinking if I do 2 weeks on, 2 weeks off that I should take 200mg but if I have a 3 day break I can take 100mg? I’m concerned that if I have to take 200mg that I will become mentally unstable with depressive episodes. But likewise is the 25 days of 100mg with a 3 day break considered more of a continuous regime? I need to decide whether or not I should resume taking the progesterone tonight or start again when the 2 weeks are up. I just want to stop bleeding! 😩 What would you do?

[joziel]

That sounds really difficult.

In terms of what to do, with the bleeding, the just 3 days off a month, is considered continuous. So you could use 100mg with that.

If you do 2 weeks on, 2 off, then that is sequential and you'd need 200mg. Have you tried using it vaginally and does that reduce the progesterone side effects for you? You could take 100mg orally and 100mg vaginally to get your 200mg - and then could be on a sequential 2-on, 2-off, with that in terms of progesterone.

I can relate as I am peri-menopausal but, due to endo, I'm on a continuous HRT. And I've no idea what that is going to mean in terms of bleeding patterns and what's acceptable and so on...I am just going to get unscheduled bleeds all the time and is that going to freak doctors out? I might end up having to schedule bleeds somehow, but not with a full 2 weeks off which would give me too long with unopposed estrogen and would stir my endo up. Anyways....

Have you thought about the Mirena coil? It is often useful for women who suffer systemic effects from progesterone because it's a local dose delivered where it needs to be. But not everyone wants it. (I don't!) And some women (small %) do still get systemic effects.

[Dotty]

Hi the 3 day break is the old continuous regime which has now changed to every day. x

[joziel]

That's true Dotty, but it has changed to every day to stop breakthrough bleeding which happened when the progesterone was stopped for those 3 days.

But if someone is bleeding all over the place and needs to schedule it somehow - without resorting to a sequential regime - (in a sort of 'taking the pressure off so you don't get breakthrough happening') it might still help as a protocol....

[Pleasantlyblew]

Thank you for your replies. Unfortunately I have had a nightmare trying to find the right form of progesterone. Initially 3 years ago when I started HRT, I took Utrogestan orally but it made me have uncontrollable mood swings so I took it less often than I should. I was only on 0.5mg of Sandrena at the time and my oestrogen levels were below 100. 18 months ago my symptoms started coming back so I was gradually increased to 2mg and my symptoms went away. Around that time due to me having difficulties with the Utrogestan (both orally and vaginally) giving me awful mood swings, I was swapped to Cyclogest pessaries. For the first few weeks I felt great on it but because I was waking up to a greasy mess I decided to try it rectally. Within a few days I had a really bad adverse reaction to it with left me with a rash, breathlessness, flu like feeling and sweating constantly from head to toe. It took several months to recover and three months after, my hair, lashes and brows began falling out due to the shock. I waited a while and tried to go back to taking it vaginally but my body reacted like it was poison. A while after, I decided to just go back on Utrogestan vaginally and I reacted in the same extreme way to that too. I was told to have a 3 month break from all progesterone to allow my body to recover and then try Lutigest instead. I took Lutigest for a month but developed such a terrible cough that I became incontinent (who knew coughing was a possible side effect?!). So I was told to come off it. I was told my options were now very limited. Have a Mirena coil, have a hysterectomy which was not recommended as I have a healthy womb, or come off HRT all together. I have never liked the idea of a Mirena and the thought of implanting something in my womb that contains something I may have an adverse reaction to filled me with fear. I don’t want or need a hysterectomy and I don’t think I could entertain giving up my HRT! I reluctantly booked in to have a Mirena privately but got Covid a few days before so had to reschedule. I still felt that the Mirena was maybe not a good choice for me, so in the few weeks I was waiting for my appointment I decided to have one last attempt with Utrogestan but orally instead of vaginally. To my joy and amazement I’ve been able to tolerate it this way for 2 months now, so cancelled the Mirena. My problem is that I’m not sure where I am with my meno journey. Initially because I went 360 days without a period they assumed I was post menopausal but then last November I began bleeding more and more regularly until I wasn’t able to go a week without some form of bleeding. Either light spotting or full on period. I have now been bleeding non stop for about two months. I assumed it was due to the unopposed oestrogen for so long but now that I’m tolerating the progesterone the dr from Newson is not overly concerned and said it may take up to 6 months to settle. I’m reluctant to try Utrogestan vaginally again in case I mess everything up again! I’m now 52 so was hoping the periods would be over by now but I’ve recently read that women with PCOS often have periods for around 2 years longer. I think in light of what has been said, I will try 2 weeks on, 2 weeks off for a while and see how that goes. Thanks for your help ladies x

[joziel]

It might be worth getting referred for a scan, just to be on the safe side. That will also tell you if you're bleeding because your lining is too thick - and if so, more progesterone should help.

[CLKD]

Morning.  We are in menopause after 12 months without a period: however, Mother Nature can throw in the curved ball if ovaries decide to have 1 last fling! Then 1 begins counting again 

Progesterone upsets many ladies