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[Frankie3030]

Hi, I am 47 years old and have just started taking HRT.  I am totally confused by my gynaecologist as I walked out of the meeting with my prescription and what he said to me in the meeting, and what was written in his letter which arrived two  weeks later is slightly different.  I have tried to get hold of him for 3 days to no avail.  So I hope maybe someone here can help me.

I am taking Sandrena gel daily and then Utrogestan 100 from day 15 of the cycle.  In the meeting he clearly said I was take Utrogestan for 12 days and then off for 12 days.  In the letter it says from day 15 to day 28 of the cycle which would mean 14 days. I presume it is 12 days rather than 14. My next query is do I take Utrogestan literally on for 12 days, off for 12 days etc etc or do I start it day 15 after each cycle for 12 days (regardless of when a cycle starts i.e. some cycles may be on time, earlier or later)?
 
So far this is what I have done: I started Sandrena Gel on 13 June, I started Utrogestan on 15 June (as this was 15 days after the cycle which started 3 June).  I stopped 12 days later. My recent cycle started 3 June which would mean 15 days after is 15 July.  Or do I take it on 7 July which would follow the pattern of 12 days on 12 days off?

I also emailed my gynaecologist, but his colleague replied to my above questions, just saying take Utrogestan for 14 days in each 28 day cycle and repeat. 14 days seems rather long and again it doesn't explain the cycle part of it.  What if a cycle is longer or shorter than 28 days?
 
Confused?  I am!

[Hurdity]

Hi Frankie3030

If I haven't done so already, this is to say 

Regarding your query - actually the standard licensed dose of utrogestan taken cyclically (ie to induce a withdrawal bleed) is 200 mg orally for 12 days in a 28 day cycle. here is the info:
http://www.menopausematters.co.uk/to_progestogens.php

This says take it Day 15 - 26 (if 12 days). You should then bleed approx somewhere between Day 28 and Day 2 - although women do vary in this respect! You then just carry on with the days so Days 27 - Day 14 would be oestrogen only. Yes you carry on regardless of when your cycle starts although sometimes if it gets completely out of sync women decide eventually to adjust slightly to suit.

So - I am confused too! If you are taking a very low amount of Sandrena, then maybe the gynae feels that 100 mg will be enough. Also if you are taking it vaginally also less may well have been prescribed. Are you in the UK and what have your periods been doing before you started the HRT?  Is you gynae private or on NHS? Some women who are still having regular periods but being prescribed additional oestrogen, are also (it seems) sometimes prescribed less progesterone because they are still producing their own which may well be sufficient to produce a proper bleed and shed all the lining monthly.

Re the 12 days on and 12 days off. This is a mistake as you will see from the above. All cycles are by default 28 days. It may well be that your gynae has prescribed it for 14 days because you are taking a lower dose ie 100 mg.

I hope this helps and clarifies what you should do  according to the licensed amounts - but your gynae may well have differed from this.

Hurdity x