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[jacig1957]

I’m kind of wondering about utrogesten ? I’m 66 and post menopausal.
I’ve just had a scan showing my thickening is at 10mm.
I’m currently using 1 pump eustrogen daily and using utrogestan vaginally cyclically for 12 days, every 3 months.
I understand that’s probably too long and not the suggested method nowadays.

My GP has suggested I start to take double the dose 200 mg of utrogesten EVERY night. That’s a huge difference and tbh my GP does not seem to be very helpful. The list for menopause clinic is over 2 years in my area 😱
I have horrible side effects when using utrogesten and just can’t bear the thought of taking it every night.

Can any of you ladies already on a cyclical programme, tell me what works for you?

[joziel]

If you're post-menopausal, you shouldn't be taking it cyclically (unless you really have to, and have explored all other solutions) - ideally you are taking 100mg every night, continuously. You can also take 200mg every night if needed. (I take 300mg every night, because I like the effects on sleep and I'm on quite a high estrogen dose.)

If you've been scanned to have a thickened lining you need to increase your progesterone use because you are at increased risk of endometrial cancer and if you can't get that lining down, you'll end up having more scans, biopsies etc etc.

You can take the utrogestan vaginally - have you tried that? Many women find that it is not absorbed systemically and they can use it vaginally when they can't orally.

If you can't take it vaginally either, you might want to consider having a Mirena coil fitted which will keep the lining thin without any utrogestan at all... Many women love it for that reason. It has a tiny amount of a progestin in it, but hardly any is absorbed systemically - it stays mostly local to the uterus.

Or, there is the option to go for the Evorel Conti patch which has a synthetic progestin in. It has 50mcg estrogen in, though - which would be an increase from your 1 pump of gel. (It's the equivalent of 2 pumps.)

[jacig1957]

Hi Joziel
Thank you for your reply.
I’ve been on utrogestan for years and tbh it makes me feel awful. I was glad when I was told I could use it vaginally and cyclically.
Due to thickening they’re now saying I need to use it every day.
I feel 200 daily is a massive dose compared to what I’ve been using.
Whilst I understand I need to up the dose I’m just wondering what the lowest dose I could safely take with only 1 eustrodol pump.
I have tried all the others you kindly suggested over the years and finally managed really well on the regime I’ve been on.
I’m very prone to horrendous migraines and need to be careful xx

[bombsh3ll]

Your scan showed a thickened endometrial lining.

I agree 200mg every night with one pump of estrogen gel would be a high dose for MAINTENANCE i.e. to keep a thin lining thin, however that's not where you're at. 

The 200mg every night that you have been prescribed is likely to be intended as a TREATMENT dose i.e. to make a thick lining thin.

Once this has been achieved it is likely you can negotiate a more appropriate maintenance regime with your doctor.

[joziel]

Have you really really tried all those options? What went wrong with the Mirena coil idea?

I think you are looking for a way out of something there isn't a way out of. You need to get that lining down FAST. Follow your doctor's advice...

[jacig1957]

Have you really really tried all those options? What went wrong with the Mirena coil idea?

I think you are looking for a way out of something there isn't a way out of. You need to get that lining down FAST. Follow your doctor's advice...

I’m really not trying to get out of it. I’m just trying to find a way to tolerate the dose now that I need to take it daily.
The GP actually prescribed the dose a few days ago before I had the scan. I went to her with a dirty discharge and she suggested I should now Bo on daily dose and told me to take 200 mg nightly or every second night.
What’s the difference ….im so confused

[jacig1957]

Your scan showed a thickened endometrial lining.

I agree 200mg every night with one pump of estrogen gel would be a high dose for MAINTENANCE i.e. to keep a thin lining thin, however that's not where you're at. 

The 200mg every night that you have been prescribed is likely to be intended as a TREATMENT dose i.e. to make a thick lining thin.

Once this has been achieved it is likely you can negotiate a more appropriate maintenance regime with your doctor.

Thank you for your reply. My GP suggested this new regime due to my age and a dirty dish charge. This was a few days before my scan yesterday so I’m not sure .
She looked up the dosage in a book?

Sorry for sending this reply using the quote but I couldn’t find the reply button, to reply directly to your message. I couldn’t see it anywhere.
I’m really not techi minded and find this site so helpful but very very difficult to navigate 😩

[joziel]

jacig, there are standard utrogestan doses. They are either 100mg every single night for women who are post-menopausal or 200mg for the last 2 weeks of your cycle, for women who are on sequential and are peri-menopausal and still cycling.

After 5 years research shows it is safer (better endometrial protection) to be on continuous every night at 100mg than sequential, and most women would be ready for that after 5 years anyway...

It's not clear what you mean by 'using utrogestan cyclically for 12 days every 3 months', but this doesn't sound sufficient if you're only using utrogestan every 3 months. That is less than either option.

Whilst some women can get by with less utrogestan, they need regular scans to check the lining isn't building up. You have had a scan which shows your lining has built up, so this doesn't apply to you and you can't reduce the standard dose.

On the other hand, some women need a higher dose than the standard dose if they still have a thickened lining on the standard dose. This may well apply to you.

Either way, you need to increase your utrogestan by a lot and if you feel unable to do that, you should return to your GP to discuss other options. If you really have tried all the other options in the past, then you simply won't be able to use HRT unless you have a hysterectomy - because you won't be able to protect your endometrium against the effects of estrogen.

[bombsh3ll]

I would continue on the 200mg until your follow up scan - I assume one has been arranged to recheck your lining after 3 months or so.

If you can take it vaginally this sometimes makes it easier to tolerate and also delivers a more concentrated dose to the uterus.

If your lining has thinned down after your next scan you could probably get away with either 100mg every night if unmonitored, or 100mg alternate nights if you were going to be scanned periodically - you may have to pay privately for this.