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[PollyH]

Hello everybody

Just an update on taking 50mcg estradot patches and 200mg utrogestan capsules. This is the second month of this regime taking utrogestan on day 15 to 26. No bleed last month and felt ill on the the utrogestan last month. I am now on month two and started a bleed on day 7 of the utrogestan - not a lot but noticeable. Should this happen? I am wondering whether the dose of progestogen is too high. I still don't feel right - Brain fog and feeling depressed. I am due to see the doctor tomorrow and he did say he would ask his gynaecologist friend if I could use it orally, and  also if I don't feel right I can be referred to a endocrologist as my T3 is on the low side or should I be seeing a gynaecologist as well. Just want to feel normal. Hip pain, back pain groin pain -feel like I'm dropping to pieces, and get tired easily.

Thanks for listening

Polly H
Xxxxx

[Hurdity]

I am taking the same as you PollyH although I have a longer cycle - I am well post-meno so choose to have a 6-8 week cycle.

Re the bleeding - it depends on your cycle. If you are still peri-menopausal, which I presume you are, then your own cycle could break through and cause bleeding at the "wrong" time.

I'm a bit confused by your post - because using it orally is the usual ( and licensed) way to take Utrogestan, so you shouldn't need to consult a gynaecologist to take it this way. It is sometimes recommended to take it vaginally if you experience side effects from oral use. In your case you may well feel worse if you take it orally though, if you are getting side effects from vaginal use.

Most private gyanes and meno-specialists would generally prescribe a lower amount vaginally than orally (from what I've read on here and meno friends have told me) - because more is getting to where it is needed ie the uterus. Therefore it could be too high for you to use 200 mg vaginally for 12 days monthly. Also the dose is more consistent from vaginal use, because it doesn't have to go through the system and the hormone is unstable when passing through the digestive tract.

Re the actual side effects - some brain fog is par for the course I'm afraid, and will be more lilely to have this effect if you suffered pms for a week or two before your periods. I've just come through mine (utrogestan cycle) and feel a completely different person now my head has cleared!

Hopefully you will see a gradual improvement so that the times when you feel rough, decrease.

Re the T3 - definitely get this investigated and treated if necessary as well. Aches and pains, and feeling tired are all symtpoms of this too, I understand.

Hurdity x

[PollyH]

Hi Hurdity

I have been going through the menapause since I was 40 and am now fifty and my gp has said my blood results show I am post menapause about two years ago. I choose to take sequi hrt because I am intolerant to the progestogen part.

I Feel such a fool - I meant to say my gp was asking his gynaecologist friend if I could take it vaginally and if so what dose. Maybe I should opt for a longer cycle the same as you - if i do this what dose do I take vaginally and for how long. Of course I would need to have a bleed. Or maybe I could take 100mg vaginally on days 15 to 26. Omg don't know which to try - my bloody fogged brain I can't make a decision.

Thanks for the reply Hurdity will reply back when been to docs.

Polly H
X x x x

[Spangles]

Hi Polly
Sorry to hear that you're not getting on too well with Utrogestan.
Like you I have just finished my second cycle of Utrogestan, the first month I used it orally and the tiredness etc floored me, I took 200mg for 10 days as i didn't think I could tolerate the whole 12 days.
My period came a couple of days later and was fairly light.
The second cycle I used it vaginally after advice from MM members, again I used it for 10 days.
My period came immediately after I had takes the 10th tablet, again light but painful.
My question is regardless of how long the period lasts for do I still count 12 days from day one of my period before I start to use it again? If so it will mean my periods will be a bit irregular (nothing I'm not used to).
Have I made sense, I'm a little confused!
I must say that by using vaginally I did not feel as tired but I guess only time will tell and I will have to wait until next time to be sure.
Hope you feel better soon.
Shellb
xXx

[Hurdity]

Hi PollyH - OK I get it! I thought it was a bit odd!!! Hopefully your doc's gynae friend will OK it for you. The answer is yes you can take it vaginally but the dose isn't licensed in UK but it is used in France and on continent like this. The French product information gives the same dose to be taken vaginally as orally (in the case of oral side effects) but research shows that sufficient protection can be given with a lower dose vaginally because the hormone goes straight to where it is needed before it is broken down (progesterone is an unstable molecule).

I would suggest you could try 100 mg vaginally for the same time that you normally take it orally ie for the 12 days. It is probably better to discuss a longer cycle ( or shorter course of progesterone) under medical supervision, since closer monitoring of the endometrium is advisable when you use less prog than the recommended dose.

Several members on here in the past have reported all sorts of different regimes - usually under specialist gynaes - and including some at meno clinics on NHS.


Hurdity x

[Hurdity]

Hi Shellb

This counting is awkward isn't it? The main thing with HRT is to keep the 28 days going regardless. The idea when you start is to sync with your own cycle, but of course we all know that these become irregular when you are peri. When you are post-meno - I just count the first day of the oestrogen as Day 1 and take it from there (but I have a long cycle anyway so it's a bit immaterial). Or you could count say 1 as the prescribing info says above so that Day theoretically is the third day after you stop the progesterone, and might be the first day of your bleed but might not. So I would not re-start the Day 1 on the bleed unless your cycle is predictably out of sync by the same amount each month if you see what I mean.

Hope that doesn't sound confusing - to recap - keep on with the 28 day cycle so that you always take 12 days of prog within the 28 days (ie day 15 - 26), unless it becomes obvious that your own cycle is doing something else. Glad to hear you are not so tired using it vaginally. I can't comment as I've never taken it orally!

However you may find you don't need 200 mg when using vaginally - but again depends on your cycle and whether you are ovulating. The extra progesterone may help to shed the lining and hopefully avoid the very heavy periods and clots some women experience during peri - when periods are missed because ovulation doesn't occur, but the lining continues to build up.

Hurdity x

[Spangles]

Hi Hurdity

Thanks for your reply. I'm sorry but I'm still a little confused! Would I be right to count 12 days from day 1 of my bleed then start the prog on the 12th day? (This is hat I have been doing).

Many thanks

Shellb
xXx

[Spangles]

OK I feel silly now!

I re read your post Hurdity only to realise that I have been taking my Utrogestan on day 12 of my cycle and not day 15 as prescribed! It doesn't take much to confuse me at the best of times let alone throwing menopause into the mix!

Shellb
xXx