Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Lizab]

Some time ago there was a thread on different synthetic progesterones where ladies were posting what worked for them when utrogestan was not their ideal choice. Does anyone recall it? I have searched and can't seem to find it. I need to get some ideas in order before seeing the doctor for annual followup soon. Something has to change as this cyclical utrogestan is not sustainable for me.

[CLKD]

Crikey - there are pages and pages and ……… maybe search 'synthetic progesterone' and pick the more recent threads?

[Lizab]

http://www.menopausematters.co.uk/forum/index.php/topic,32194.msg512448.html#msg512448

Found it!

[CLKD]

      â€¦â€¦     and is it helpful ?

[Dancinggirl]

Lisab
Whilst I quite liked the slightly sedated feeling Utrogestan gave me (I felt almost ‘high'!) I still found it more problematic than most other progesterones I had tried. I felt detached from life, had erratic bleeding and spotting and a lot of cramps.  I couldn't use it vaginally as it made me very sore around my ‘lady bits'.  I tried sequi and conti versions as well.
I think it really illustrates that we are all different - so HRT, like many treatments, is trial and error.

Dg xxxx

[Hurdity]

Lizab - what is the problem with cyclical utrogestan for you? There is always the option of a longer cycle if your oestrogen dose is not very high - but I think you are fairly young so probably would like a decent level of oestrogen? Otherwise there is the possibility of stretching the cycle to eg 5 weeks (if you are post-meno or nearly so) and slightly shortening the length of time on Utrogestan to say 10 days,  if you are monitored regularly through a scan of your uterus.

If you want to stay with separate oestrogen and separate progesterone there are only two other licensed options for the progesterone part and these are Provera ( MPA) and Mirena which are listed here: http://www.menopausematters.co.uk/to_progestogens.php

As I'm sure you know there are a various other progestogens as part of combi HRT - patches or pills listed here - but the progestogens are mostly not available separately: http://www.menopausematters.co.uk/perimeno.php

Otherwise there are the two contraceptive pills which contain estradiol - QLAIRA and ZOELY. I'm sure I'm saying thing that you know already!

I would say that if you are below the natural average age of menopause then it probably doesn't matter what progestogen you use - provided you can tolerate it and the negative side effects do not outweigh the beneficial effects of oestrogen. After this age, as a rule of thumb you start counting the years on HRT and the risks begin to kick in eg after 5 years and/or as you approach 60 so if you're thinking about staying on it long term after this sort of time has elapsed - it would be sensible to try to settle on a regime that includes utrogestan, since research is providing increasing evidence that progesterone itself is associated with less risk - and especially to the breast, than the synthetic progestogens - so for the sake of your future long term health, it might be worth putting up with a few side effects (but remaining on a cycle). As it stands there is nothing conclusive but it does make intuituve sense that a "natural" ie bio-identical substance is less likely to be harmful than a synthetic one.

The problem with progesterone of course is not the hormone itself, but the large quantities that need to be taken in order to maintain serum concentrations at the right level to protect the womb - and especially when used orally.

Hurdity x

[Lizab]

I'm taking 200 mg 10 days every 4 weeks. The first few months were a rollercoaster, so I raised the estrogen to .5 from .375. Summertime came just after I raised the estrogen, and I stretched cycles out to 5, 6, and 8 weeks to accommodate travel, but still only 10 days. I also felt very well in the summer. I still had dips but attributed those to normal blips of menopause and carried on. I didn't connect them to the progesterone at all, as I did enjoy the good sleep and calm feeling I had on progesterone days. My last two  or three cycles I have returned to a 4 week schedule, as I worried that 10 days wasn't enough on longer cycles, and I have felt progressively worse. This last round of progesterone I had an awful time starting halfway through and continuing more than a week after. I'm finally starting to feel good again. My trouble is emotional side effects. I become bitchy and irritable about 5 days in, then anxious, then depressed and weepy, and physically sluggish. This last round scared me as I felt so gloomy and was sure I was dying, not suicidal, but physically off and then worried that I was dying.  I actually had to ask friends to drive my children to and from school, which I had done last year before and starting out on hrt. It felt like a huge relapse. So during all this I decided I should ask at my followup for an antidepressant, but hated to ask for more medicine only to tolerate the medicine I'm already on. Now that the cloud has lifted, I realize that the progesterone every 4 weeks is probably the problem. Almost as soon as I recover from the last round, it's time to begin again.

I never had problems with bleeds on the hrt, other than that since I've returned to every 4 weeks my bleeds are quite heavy. Also, when I did stretch to 8 weeks the one time, I had a tiny trace of blood the day before I started the progesterone. When I started the progesterone, it stopped and my period held off until the end of it. That may have been coincidence as we were vacationing and were more active than noreal in the bedroom. Everything I read says if the bleeding is heavy, to increase the dose or length of progesterone, not an option for me, or to try a different route. The bleeding was actually lighter on the longer cycles so I'm confused about what to do.

[Lizab]

I don't know how to edit, but I should add that it's possible my estrogen has fallen lower as well, as I'm feeling a bit dry below lately. It's so hard to know what is going on with so many variables.

I didn't like Mirena as a birth control. Actually, I loved it but it gave me migraines for the first time in my life and constant morning sickness like nausea after about a year with it. I had it removed after 2-3 years and almost instantly returned to wellness.

I do appreciate you putting all the options in one place, Hurdity! I do know of all those options, but it helps greatly to have them laid out in one spot together.

[Dancinggirl]

Lisab - like you, I seemed to be fine, initially, on Utrogestan - the first couple of months were great.  I believe that for some of us, particularly if we need to use it orally, the side effects seem to be cumulative - I seemed to get more and more sedated (even on sequi) as time went on and I also developed an itchy rash around my chin and back of my head.  Utrogestan may be natural but I believe this progesterone is derived from a plant and perhaps some of us are actually allergic to this particular plant.  I can really understand how the sedative effect of Utro could trigger low mood.
If you are peri meno then you may well be needing a higher dose of oestrogen as your levels may have dropped - I also wonder if it's worth your while trying Provera which many women, who don't get on with Utrogestan, seem to find quite good.  Perhaps try the Provera before increasing the ADs???
I do think we need to accept that there may not be the perfect progesterone, so there are compromises - it's about finding the one that gives the least problems. DG x

[Hurdity]

Hi again Lizab

I agree with Dancinggirl that your oestrogen dose is still not high - I have more or less never had less than 50 mcg from late peri-menopause when I was around 54 until now (early 60's). I came off for 3 months once, went back onto 25 mcg which was too low, and 3 years ago tried 37.5 which was also too low. Now on 62.5 (unofficially!). I can't remember if you are taking utrogestan orally or vaginally. if you have no issues with your uterus ( fibroids, polpys etc) then 10 days utrogestan every 6-8 weeks should be fine to protect your uterus from 37.5 or 50 mcg oestrogen patch. I'm not sure what your medical situation is but if you are under a doc or gynae you should be able to discuss a longer cycle and a possible scan after 6 months to a year, to check the thickness before deciding on a definite regime. I know I would not tolerate progesterone every 4 weeks. Vaginally is of course the best way to take utrogestan because it gets to where it is needed and the dose is more consistent.

Just to remind you that for most of the last 5-6 years I've use Estradot 50 mcg on a 6-8 week cycle with 200 mg utrogestan vaginally for 12 days per cycle. My bleeds have not been heavy.

Stellajane also has a bimonthly cycle but uses gel instead of patches - and I can't remember what dose/route of progesterone (Utro) she follows.

I agree I wouldn't want to take ADs to counter moods caused by the progesterone! That does seem to defeat the object of it all! As I said in my earlier post below, if you are young ( as I think you are) then you should go for the prog that works best for you (provided you take it cyclically) - and only think about changing to/working with progesterone itself when you are beyond the natural age of menopause and are maybe planning to take it very long term and into your 60's.

It's a pity that dydrogesterone is not available in UK separately as it used to be because I am sure many women would be using this as almost as good as progesterone - but because smaller doses are needed perhaps maybe has fewer side effects (of the sedative kind).

I agree - for many of us - progesterone is a necessary evil - just as some parts of our natural menstrual cycle was -we just need to work out how much we can tolerate in order to function hopefully as well as we did when fertile!

Hurdity x