Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Willow79]

Hi all,

Just wondered if anybody has any advice on side effects of utrogestan. i was on evorel sequi patches which were great for a while and then it felt like they had stopped working so i was switched to estrogel 3 pumps and Gepretix. The Gepretix gave me the most horrific nightmares so was switched over to utrogestan. The problem i am finding is that they make me feel really drowsy which does help with sleep but i still feel drugged on waking. I am also having an upset stomach and another weird one which i think is trouble breathing. I am asthmatic and had trouble breathing last month but didn't link it to the utrogestan. I took one last night and feel like i have an elephant sat on my chest today. I think i am really sensitive to medications and feel like the menopause is seriously messing with my life. I have ups and downs with mood, super tearful and irritable around period time which takes forever to get going and am just at a loss with what to do. I have seen 4 different doctors with one who just wanted me to come off HRT and try antidepressants hence i declined! Is there any other combinations of hrt i could try? I don't want to go down the coil route as the mini pill gave me migranes from hell. I would just love to feel human again.

[Dotty]

Hi are you taking the Utrogestan on an empty stomach ?

[Willow79]

I am taking it at bed time so yes on an empty stomach but when i get up in the morning my stomach is really off. I was wondering can it be taken 1 tablet daily instead rather than 2 daily with the break?

[bombsh3ll]

If you tolerated evorel sequi but found the dose too low and can't tolerate micronised progesterone, you could consider using an additional half or full patch of evorel sequi, or if you are under the care of a specialist they MAY agree to just adding extra estradiol.

Have you tried the micronised progesterone vaginally? That is sometimes better tolerated.

Another option if you are ok with norethisterone which is in the combination patches, would be to take norethisterone orally.

It is available on its own in a progestin only contraceptive pill. You might need to take 3-5 of these daily depending on the dose you require.

PS I just saw your last post - yes of course you can take one every day, as long as you take the same overall quantity. You MIGHT get some irregular bleeding, however this is not pathological and may be worth it if it makes your chosen treatment tolerable.

[sheila99]

Using it vaginally should avoid stomach issues but it still makes me dopey. I find one a day is just as bad as 2 so for me sequi works best, at least I get some time to feel normal. If they'll let you use 1.5 patches that would solve the problem, or you could try provera. I don't think oral noresthisterone is licensed for hrt? They wouldn't let me use it. If you still have a cycle of you're own and you use a conti regime it's very likely you'll bleed. I would take advice from your gp befors going down that route. The conti patch has enough progesterone for the amount of oestrogen in the patch so if you add only oestrogen you should have regular scans to check you'd lining isn't building up.

[Willow79]

Thanks i never thought of splitting the patches it is a pain that they don't make a higher dose. I feel like menopause is taking over my life and causing me to feel like a depressive lunatic and Gps just seem to have no clue.

[Pink68]

Hi sheila99, do you mean you feel dopey when you use it vaginally? I have just started using it vaginally 200mg pessary as oral route didn’t work for me .

[sheila99]

Yes, whichever way I take it I end up like a zombie by day 8  .

[bombsh3ll]

Oral norethisterone isn't licenced for menopause treatment however that doesn't mean it can't be used in the hands of a knowledgeable clinician.

Another option is two 75mcg desogestrel pills daily - again not licenced but increasingly popular as it also provides menstrual suppression and birth control to boot. Most women don't bleed at all on this.

Cyclical is often prescribed because you"might bleed" on continuous, however you almost certainly WILL bleed, every 4 weeks, on cyclical.

Some people "might" get a headache on estrogen but you don't go and bash them round the head to jolly well make sure they have one, every 4 weeks!

The decision should be based on patient preferences, not paternalistic beliefs about what bleeding pattern a woman ought to have.

[sheila99]

Cyclical is often prescribed because you"might bleed" on continuous, however you almost certainly WILL bleed, every 4 weeks, on cyclical.

Sorry but that isn't true either, it depends on the individual and how far into meno you are. In the early stages it's very likely you'll bleed, later on some women bleed infrequently, others don't bleed at all. I bleed approx 1 in 3 when my own hormones aren't doing anything. And when I have a bleed because of hrt it's short, light, no pmt and no pain.
 Not sure you can say this medical advice is down to paternalistic views. After all they encourage you to go on conti a year after starting hrt when most aren't meno and often the body isn't ready for it.

[Penguin]

Cyclical is often prescribed because you"might bleed" on continuous, however you almost certainly WILL bleed, every 4 weeks, on cyclical.

Sorry but that isn't true either, it depends on the individual and how far into meno you are. In the early stages it's very likely you'll bleed, later on some women bleed infrequently, others don't bleed at all. I bleed approx 1 in 3 when my own hormones aren't doing anything. And when I have a bleed because of hrt it's short, light, no pmt and no pain.
 Not sure you can say this medical advice is down to paternalistic views. After all they encourage you to go on conti a year after starting hrt when most aren't meno and often the body isn't ready for it.

I didn't bleed every month on cyclical hrt either. In some cases I don't think my estrogen built lining up enough. NHS use the words 'usually' but my GP said it is hit and miss and dependent on what your own cycle is doing underneath.

[bombsh3ll]

What I mean is that artificial withdrawal bleeding confers no health benefits (other than possibly in some POI cases where natural conception is still hoped for).

It is not medically necessary, doesn't treat or prevent any disease, and the recommendation for cyclical first is not due to there being any safety concerns with continuous.

Therefore for a particular individual, taking the progestogen continuously may be preferred above cyclical even if they are not 12 months out from their last menstrual period.

They may be happy to accept the possibility of some bleeding because for example the progesterone helps them sleep so want to take it every night, or they might be sensitive to fluctuating ups and downs and just feel better on a stable dose every day, or may find the lower dose in continuous more tolerable than the higher dose in cyclical.

Conversely someone who is well into postmenopause may have a personal preference for cyclical, perhaps because they don't feel their best on the progestogen and like a break from it, and this to them is worth having withdrawal bleeds and in the long term a slightly increased risk of hyperplasia.

In my view this should be a shared decision between the clinician and patient, rather than flow chart based prescribing that considers bleed pattern to be the sole determinant of who gets cyclical and who gets continuous.