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[Bandango42]

Hi

I have a couple of questions regarding taking utrogestan for the latter 2 weeks of a cycle. For the last 2 months I have started bleeding early, on around day 7-8 of taking utrogestan. My question is do I count the first day of a bleed as day 1 and stop the utrogestan as I've started bleeding already? (I have done a search of this and whilst there are many similar posts it seems there is no conclusion!) or do I continue with the full 14 days and count day 1 after that? which means my own cycle and hrt cycle will be out of whack (have tried hard to sync them and was successful until 2 months ago). Last month I counted day 1 as the first day bleeding and stopped the utrogestan (on day 9) but I don't know if its safe to keep doing that? There is nothing in the leaflet about bleeding early. I have tried to speak to my GP but can't get an appointment for another 2 weeks. If anyone can shed any light on the best way to proceed I'd be grateful x

[VanillaLover]

Hello,

This is such a common thing and it seems ludicrous that there isn’t any official guidance on what to do in this situation!

Personally I carry on taking the utro 2 weeks on 2 weeks off regardless. I have been on HRT nearly 18m and my bleeds carry on regardless. I don’t think it would be possible to get them in sync as they are not very regular (16-60 day cycles!)

Other people do keep trying to sync them I know though.

FWIW I did speak to a consultant about this and he said that as long as you are bleeding regularly, your own cycle or via utro withdrawal, then all good.

I do worry about what will happen when my own periods fizzle out though…

Have you found the HRT useful generally?

[Bandango42]

Hi

Thanks so much for your reply. I agree it seems very common but there doesn't seem to be a definitive answer at all! Very frustrating because it was going so well, cycle wise. I was just having the withdrawal bleed/actual period after the utrogestan had finished 🤦‍♀️ now its all gone to pot! I'm really not sure what to do. I'm worried that if I keep taking it, my own period (which I'm guessing I'm having now) will end then I'll have another bleed when I stop the utro? But if I stop the utro, am I getting enough? All massively confusing.

I've found my hrt journey to be, well, meh if I'm honest. Feel better than when I started but not brilliant by any stretch. Most physical symptoms have gone but I'm still suffering with hair thinning, low mood, low energy, joint aches/pains. I'm currently on evorel 75 patches too. My recent review with my GP, he doesn't want me to increase to 100 yet as he says I'm only 43, once I get to the 100 patch there's nowhere else to go so to stay on 75 as long as possible. Which I understand. There are many women suffering way worse than me so I'm not complaining, I can live with it 😂 sucks to get old though. Wish I still had my old energy levels.

Thank you for asking though x

[sheila99]

I found it better to keep then in sync so weather or not you stop utro now if you still have a fairly regular cycle of your own I would start counting again from day 1. I personally stopped the utro because once I'm bleeding I doubt the utro is doing anything and it makes me dopey. Are you able to tell when you ovulate? If you can you can start utro a day or two later and it will keep them on step.

[VanillaLover]

If you stop taking the utro it shouldn’t stop your own period.

I find that when I stop taking the utro it doesn’t trigger a withdrawal bleed. Nor does taking it stop my own period from coming.

If you find that stopping utro does start another bleed off, yes you might find you are having two bleeds in quick succession sometimes. Although I guess in that case it should be light as not much time to build up lining.

I am amazed that there isn’t any guidance on this in the product leaflet. I guess they expect that the utro will just override everyone’s menstrual cycle and that’s that. As we’ve seen it’s often (usually?) not the case though. 

I understand your GP not wanting to go to a higher patch yet ….but bear in mind that absorption of these products vary so you may not be getting as much oestrogen from the patch as another woman might. A specialist can prescribe more than the 100 but there will obviously be a (long) wait time for referral.  In this case they might check blood levels to see whether the oestrogen is getting through first before going above the 100. It’s hard to check levels in peri though due to massive fluctuations going on anyway. So there are options open if you are struggling. A change of delivery method to gel or a different brand patch may be worth trying also down the line.

I find HRT has been helpful but I still have some symptoms that fluctuate. So it’s raised the baseline, which I’m grateful for, but not a panacea for all ills sadly.

[VanillaLover]

Should add seeing Sheila’s post that I personally don’t mind taking utro, it makes no difference to me whether I take it or not. If you have side effects like sleepy etc then you can minimise them as she says by stopping once your own bleed has started.

[Bandango42]

I have thought about absorption rates. The problem I have (or what most women have I would think) is that I have nothing to base it on. What I mean is, how am I supposed to feel? Amazing? Or is this it? Is this normal?! Does that make sense?
My GP is very much 'its not a miracle drug' and women of a certain age are not ever going to feel wonderful. So I'm on HRT, it's replacing the lost hormones, but this is just how I will feel going forward 🤷‍♀️ if we knew hrt was 'most definitely' supposed to make you feel great, then I would say mine is not working. But it's eliminated 'most' of the 'standard' menopause symptoms so I'm guessing it's doing something!

Sorry, I'm not making much sense 😂

Sheila - thanks. I'll count today as day 1 then and stop the utro. Quite heavy so like you say, it probably wouldn't be doing much anyway if my lining is already shedding and I do really want to try and keep the cycles in sync 👍

[wherearemyslippers]

I have thought about absorption rates. The problem I have (or what most women have I would think) is that I have nothing to base it on. What I mean is, how am I supposed to feel? Amazing? Or is this it? Is this normal?! Does that make sense?
My GP is very much 'its not a miracle drug' and women of a certain age are not ever going to feel wonderful. So I'm on HRT, it's replacing the lost hormones, but this is just how I will feel going forward 🤷‍♀️ if we knew hrt was 'most definitely' supposed to make you feel great, then I would say mine is not working. But it's eliminated 'most' of the 'standard' menopause symptoms so I'm guessing it's doing something!

Sorry, I'm not making much sense 😂

Sheila - thanks. I'll count today as day 1 then and stop the utro. Quite heavy so like you say, it probably wouldn't be doing much anyway if my lining is already shedding and I do really want to try and keep the cycles in sync 👍

I recently decided to stop my Utro early as my bleed was coming a few days before the end of my 14 day course, but it really messed things up for me 😬 I had a breakthrough bleed before my next Utro course even started, which freaked me out (I'm an anxiety queen, HRT sadly hasn't helped with that😂) , although my consultant wasn't worried. I've gone back to completing the full 14 day dose regardless of whether my bleed comes a bit early (as clearly early bleeding does seem to be a common trend). Going for a scan as well as it's been a few years since my last one. Hope this is useful x

[Bandango42]

My cycle did eventually rectify itself for a few months but I started having erratic bleeding last summer so started continuous hrt in September 2023. I haven't had a period since December x

[wherearemyslippers]

I'm starting to like the idea of continuous tbh. My consultant always brings it up, but I've resisted for years. But I might have a rethink. No bleed sounds so nice 🥴

[Bandango42]

I feel so much better on continuous, mentally anyway. It just suits me. I did have quite a bit of bleeding for the first few months so I increased my progesterone from 100mg daily to 200. That seemed to work and since December I've only had brown spotting intermittently but no full bleed. The spotting has now stopped too. My GP did state that bleeding was to be expected up to the first 6 months but I've just hit the 6 month mark and it's all stopped. I hate bleeding so I'm keeping my fingers crossed that going forward I'll be bleed free xx

[GraceM]

Utrogestan is prescribed for a certain amount of days per month for a reason and therefore should be taken for the prescribed amount of days regardless of periods.  I have been on continuous and cyclical utrogestan and had periods on both regimes.  Taking utrogestan continuously doesn't necessarily mean the bleeding stops.