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[janeyg73]

I'm peri and on 1.5 sachets Sandrena and 100 continuous Utrogestan.  I've been on continuous for about a year and have increased from 1mg Sandrena to 1.5 about a month ago which has helped some returning symptoms.

GP review today said that I should be on 200 Utrogestan continuous.  I was hesitant to increase as I'm feeling good as I am, so she suggested instead that I take 100 one day and 200 the next, and alternate daily like that.   Does this sound ok?  It kind of makes sense to me that over the month I'd be increasing my general progesterone levels, but by a lesser amount than doubling the dose every day.  Does anyone else take a different amount each day? Should this be ok or should I be questioning it with GP.??!

[CLKD]

What does the GP judge her suggestion upon?  If U feel OK then personally I would stick with what works for now.

Thinking back to your discussion with her, was there anything that you suggested that gave her the idea to increase?

[janeyg73]

I told her I was feeling good and no odd bleeds or anything.  She said that the 1.5 sandrena dose meant that I should be on 200 utro continuous (which I don't think is right anyway, so that's why I queried it with her and her compromise was to tell me to take 100 one day and 200 the next.  sounds crazy to me?!)

[bombsh3ll]

In the absence of any bleeding your progesterone dose is likely to be adequate.

If you wanted to continue on the lower dose you could always book a private scan every so often to check your endometrium remains thin.

[janeyg73]

is there any reason though why I shouldn't try her suggestion of 100 one day and 200 the next?   If i feel ok on that then would that be ok too or is there any reason why I shouldn't do that?  I'm confused!!

[bombsh3ll]

It's just a compromise.

You are happy with 100mg daily, GP feels more comfortable if you take 200mg based on primary care guidelines and not wanting to take any risks around endometrial hyperplasia (although these are frequently overestimated by non-specialists).

If 100mg/200mg alternate days works for you it's absolutely fine.

[Dotty]

https://thebms.org.uk/wp-content/uploads/2024/06/01-BMS-GUIDELINE-Management-of-unscheduled-bleeding-HRT-MAY2024-G.pdf

Have a look at page 16. This gives the progesterone doses.

1.5 of Sandrena is a moderate dose which is 100 Utrogestan continuously.

[Cassie]

100mg continuous is correct. You should be fine on that.

[Hurdity]

I'm peri and on 1.5 sachets Sandrena and 100 continuous Utrogestan.  I've been on continuous for about a year and have increased from 1mg Sandrena to 1.5 about a month ago which has helped some returning symptoms.

GP review today said that I should be on 200 Utrogestan continuous.  I was hesitant to increase as I'm feeling good as I am, so she suggested instead that I take 100 one day and 200 the next, and alternate daily like that.   Does this sound ok?  It kind of makes sense to me that over the month I'd be increasing my general progesterone levels, but by a lesser amount than doubling the dose every day.  Does anyone else take a different amount each day? Should this be ok or should I be questioning it with GP.??!

Back in the dim distant past maybe 2010 or 2011, after stopping HRT for 3 months and symptoms returning a went back to half a patch and together with someone on this forum, we worked out through a rough calculation that taking progesterone every 3 days would be sufficient. (This was cyclogest before utrogestan was available/prescribed for hRT). I had no particular side effects, no abnormal bleeding and my womb lining stayed thin. Admittedly a very low dose (a 200 mg pessary) but considering I really do not like progesterone I thought I would notice the dips and troughs especially every 3rd day  (because progesterone breaks down quickly in the body) - so it can be possible, depending how sensitive you are.

[later symptoms returned so I went back up to 50 mcg patch and then needed to take more prog so went back to a cycle]

Hope it works for you

Hurdity x