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[Waterdaggers]

Hi,

I've been prescribed 200mg utrogestan to be taken orally for 12 days. I was just wondering can these tablets be used vaginally instead or do I need to get utrogestan pessaries? I don't like the idea of taking them orally as always suffer with digestive problems. Also if i do take them vaginally can I reduce the dose to 100mg as absorption will be better via this method? I am really nervous about starting them as I had a bad reaction to the progestin in my evorel sequi patches. I need to start them tonight 

Thanks in advance 

[Hurdity]

Hi  - they are the same tablets/capsules. Utro used to come as 200 mg as well as 100 mg - for oral use for HRT, and now only come as 100 mg. As far as I know the 200 mg version is still available for fertility treatments for vaginal use - same stuff. Limited research shows that more is absorbed vaginally than orally and this means that half the amount could be used for the same effect - but this is unlicensed. The French product info gives vaginal use as an alternative to oral use if side effects from latter, but at same dose.

You could build up gradually ( is what I've started to do now I am on the 2 x 100mg ) - so two days of 100 mg, then 8 days of 200 mg followed by 2 days of 100 mg and see how you go. Ideally you would want docs approval to vary from the standard dose and if necessary ask for scan to check your lining is OK on this regime. I didn't get on with Evorel sequi and although feel tired on this prog it is far far better! Had a headache the first 3 days (in the morning - but cleared) but not since ( currently I'm on my 12 day course). Hope this helps.

Gtg

Hurdity x

[Waterdaggers]

Thanks Hurdity. I'm going to try them vaginally with a little build up like you say. My doc doesn't really seem to know a lot about them as they are not what she usually prescribes. She wanted me to have a mirena fitted but I didn't like the idea of not being in control of it if it gave me side effects. I can handle a little tiredness (although far from ideal) and I often get headaches anyway but there is no way I could handle the effect the evorel sequi had on my mood! It took all my enjoyment out of my life. I am just using evorel 50 patches on their own now (plus the utro).

[Waterdaggers]

Well I felt like a zombie with a sore head all day yesterday and last night I woke up with my heart racing after an awful nightmare. Feel dreadful again today. Just wondering does it get any better? I am only taking 100mg and not the full dose I was prescribed! Do the side effects wear off over time or get worse as it accumulates in your system? I'm really tempted to just take 100mg and hope that covers me. I don't think I can last for 12 days of this either. I feel so fed up. I never expected at 42 to never feel good again  xx

[peri]

Warerdaggers I use 100mg vaginally (can't tolerate it orally).  This month I had every intention of taking it for 12 days but got my period after 8 days.  This seems to be the longest I can go because after that side effects build up and I feel terrible, I've been on this regime approx 2 years now and this had never altered, so to answer your question I don't think it gets better (or it hasn't for me anyhow).  I did have an hysteroscopy last year which showed everything was normal, so my guess is the dose is overprescribed to err on side of caution, I'm not advocating this just saying it has worked for me.  I have to say I have tried several hrts and it's the best regime I've found so far.  However I do have an appointment at the menopause clinic this week to explore any other possible options as I'm fed up of having periods and feeling ill for 7/10 days per month (the rest of the time I'm fine).  Hope this helps x

[Waterdaggers]

Thanks for replying Peri... it helps to know I could probably get away with taking 100mg. Do you know if its ok to skip a day? I have minibus training next week and I don't think I should be doing it feeling like this. As well as just feeling half dead, I feel really jittery and shakey. My training is next thursday morning if I skip wednesdays nights utro will I feel better for the training? Its for a new job so I really don't want to mess them around because of a HRT issue.... doubt it would go down well. Wednesday night would be day 7 of the utro. I don't know how you have coped with this for 2 years and maintained a normal life! xx

[Hurdity]

Hi Waterdaggers

It is obviously different for everyone although there will be some similar patterns. I am just at the end of my 12 ( well actually it's gonna be 14 days because of the 2 x 100 mg taken at the beginning and end) day cycle. As I mentioned the first 3 days this time I woke with a headache and stiff neck and thought I was getting a migraine - but fortunately each time it cleared (took an ibuprofen to help it on its way). I have to work too - but nothing that could cause anyone danger if I'm not quite 100 % - but have to stand up in front of groups of people and be on the ball and enthusiastic - delivering a type of training. Hopefully you will also get used to it. I am amazed at how I have got used to it this time. Sometimes my head gets foggier as the days go on but this time - I do feel very tired in the mornings (even more than usual) but my head is not foggy! Hallelujah!!! Plenty of caffeine helps I think.

Absolutely do not miss a day! You could feel worse the next morning as the progesterone withdrawal symptoms could kick in and make you feel very pmt-ish. Also it is very likely to trigger a bleed.

The progesterone changes the structure of the lining that has built up from the oestrogen (to get ready for a pregnancy) and when the level drops, your body thinks - there is no fertilisation so don't need this lining any more, and away it comes as a bleed. if you only miss one day - then this does depend on how thick the lining is and how long you've been taking the prog - but is quite likely to happen randomly! Once you've started the prog  - do try to finish the course. All the time you are taking it as well - it is stopping the lining from growing again under the influence of the oestrogen you are still taking.

Make sure you eat properly and don't go hungry - especially don't eat too many empty carbs like sugary foods  (sweets, sweet drinks, biscuits, cakes etc) - either slow release carbs and/or lots of protein - so you don't get jittery due to blood sugar fluctuations.

I am sure you will feel better after a few days - hopefully anyway - let us know!

Did you say you were post-meno? If so you might be able to stretch the cycle a bit...

Hurdity x

[peri]

Hi Waterdaggers, like Hurdity says don't miss a day, for me it would trigger a bleed and mean certain pmt, and that's the last thing you want if you've got a big day ahead x

[Hurdity]

Having said that I last took 200 mg (vag Utro) on Thursday night, then 100 mg on Fri night and nothing last night and haven't started to bleed yet - and I am on a long cycle! No doubt it will come with a vengeance tomorrow or Tues ( when I don't want it as working with important engagement.....mind you when we had natural periods they just came when they did and we just got on with it - it's only when one is choosing to do it that it seems really annoying and especially inconvenient!!!

Hurdity x

[Waterdaggers]

Ok I'll scrap that idea then! It's pretty depressing to think there is more misery to go through once I stop taking them as well! Today has been slightly better (still sticking to the 100mg vaginal dose). I think it may have helped taking it slightly earlier in the evening. I know I should be upping the dose but I think I would rather risk it and have a scan. I have to see my gynaecologist regarding follow up to another issue on Wednesday so I might see what he says. Im only early peri and not post meno yet so guessing that means I have to keep to the 28 day cycle? Oh to be a man!!  Thank you both for taking the time to answer my questions xx