Hi ladies, I’m confused about the utrogestan dosage. I’ve been on cyclic utrogestan orally 200mg 14 nights per month for 2 years with 2 pumps of Oestrogel.
Since January I’ve been told to up to 3 pumps of Oestrogel Then continuous utrogestan at 100mg per day, which didn’t improve my bladder issues and made me experience severe anxiety after 6 weeks. (Blood test showed 159 estadiol after 2 weeks of being on 3 pumps).
so I asked to up to 4 pumps. Dr said yes but I’ll have to double up my utrogestan dose.
So my question is, is that right, 4 pumps or more need double utrogestan dose?
I’m proving intolerant due to increased anxiety, so I’m stuck.
My bladder issues started last May. At first vagirux worked but when I went to twice daily it came back within 48 hours. I then did every other day for a few months which worked until November when I’ve had continuous daily bladder problems and external burning. I’ve used ovestin nightly for 3.5 months. Still no change.
I’ve come off utrogestan on a long 13 week cycle with provera for 2 weeks at 10mg in 11 weeks al to rule out progesterone intolerance due to horrendous panick attack on continuous at 6 weeks.
Still got bladder and external burning at 3 weeks in.
Hi SaraUK - I'm not clear what you mean about your cycle? Do you mean you recently stopped Utrogestan altogether and started a long cycle of Provera for 2 weeks? But you said in your frist post on the thread that you've been discussing increased utrogestan?
For the record - the licensed dose of Utrogestan is 200 mg for 12 days per 28 day cycle or 100 mg days 1-25 (or continuously in practice). However no dose of oestrogen is given to match this progesterone dose.
The amount of progesterone required to protect the uterus from over-thickening through oestrogen stimulation is dose-dependent ie as a rule of thumb higher doses of oestrogen require higher doses of progesterone - on average - though obviously individual women will vary in their response.
The trials for utrogestan were carried out, as far as I understand, with low to medium doses of oestrogen as these were the standard doses for post-menopausal women that Utrogestan was seemingly, originally intended for.
https://www.medicines.org.uk/emc/product/352/smpc#gref . More recently and especially in UK I think ( though I don't know) women are being prescribed higher doses of oestrogen but there has been no change to the licensed progesterone doses. If you look at the HRT menu on this website for example, eg at some of the tablet HRT which use norethisterone as the progestogen - when the oestrogen dose is doubled, so is the norethisterone dose.
Hence the guidelines from BMS have allowed for the fact that progesterone at the licensed dose may not control bleeding and have suggested increases as Bandango stated.
Re what your doctor said - if you do want to continue with utrogestan but are not able to tolerate 300 mg, then are you able to suggest to your doctor that you are scanned after a few cycles to check the lining, ie whether it is overthickening on the higher oestrogen dose when you are keeping to the same utrogestan dose? You would need a scan immediately after the withdrawal bleed. If you are still peri-menopausal then the lining will vary with your natural cycle as well.
The fact that your oestrogen levels seem low (notwithstanding the inaccuracy of spot testing of estradiol as Penguin says) could indicate that you're not absorbing and that your womb lining may not therefore be overthickening.
Also be guided by what your bleeds have been like?
Hurdity x