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[jennyr265]

Hi everyone
I have been using Evorel patches (started on 25 in October and increased to 50 in November) and 100g of Utrogestan vaginally every day until last week when I went away and forgot to take them with me. So I haven't used utrogestan since last Wednesday but I haven't had a bleed at all. I missed two days mid December and I had a short bleed then. So does this mean anything significant?! Presumably the lining is not building up very much so doesn't need to shed? I intended to start the utrogestan tonight as I am now home but am wondering if I can get away with using it less?

I am also using 1 pump of testosterone gel five days a week as my levels were very low when tested.

Thank you.

[Hurdity]

Hi jennyr265

I presume you are post-menopausal hence the daily Utro?

Progesterone does two things to the endometrium when taken continuously as part of HRT. At the right dose it prevents the oestrogen from having a stimulatory effect on the endometrium ( ie stops it growing), and if any lining has grown it converts it from proliferative ( growing) to secretory (preparing for fertilisation).

So - if the dose is right - the first will happen meaning when you stop the progesterone or the HRT completely -  you won't bleed. If some lining has grown - then the progestogen converts it to secretory (structural changes take place) and then when you stop, the progesterone level drops which signals to the body that fertilisation has not taken place and any lining is shed.

Sometimes it takes a while for continuous progestogen  to work on the whole endometrium to stop it growing - hence some women get intermittent bleeding and spotting.

Your oestrogen dose is very low so that is the explanation as you say. No lining to shed.

Some limited research showed that on low to medium doses of oestrogen (like you are taking), alternate day Utrogestan used vaginally was sufficient to thin the lining - so with your doc's consent or supervision this might be worth a try. Alternatively you could perhaps consider a longer cycle - giving a short withdrawal bleed every 6-7 weeks. My GP is happy for me to do this. It is only likely to work if you are post-menopausal though (longer cycle).

Are you using Tostran? I think that is quite a high dose of T for the amount of oestrogen you are taking and I presume you/gynae is monitoring this so you don't become too T dominant with associated androgenic effects?

Hurdity x

[jennyr265]

Hi Hurdity
Thanks for your reply. Yes I am post menopausal - last period was July 2014 and then I had a bleed November 2015 but nothing since.
Ok so it is worth having a chat with my GP about the Utrogestan and using it less frequently.
yes it is Tostran and I have only been using it five times a week for about a month now and so far I haven't noticed any androgenic side effects.
I think I must have been androgenic anyway in my fertile years if that makes sense. My periods were extremely irregular - maybe only three or four a year - I had terrible acne and I have always been hairy! I was diagnosed with PCOS in my twenties but luckily conceived easily. Pregnancy and Child birth sorted my cycle out and then I had a Mirena fitted but I had the third one removed early as I found it was disagreeing with me. I have never suffered with PMS particularly so again I have been very fortunate.
I went on HRT to try and help my back and hip which have been very painful for the last 2 years or so but sadly it hasn't helped so far although it's early days I guess. Although the hot flushes and the itchy skin have gone so that's a bonus.
My GP wants to increase the oestrogen but I am wary as I had huge boobs for most of my life and had a breast reduction five years ago which has been amazing and I think the oestrogen may cause them to grow again.
I think my hormone levels have been imbalanced for most of my life so I am finding it difficult now to work out how I feel on what are essentially artificial levels. Hey ho!
Jenny

[Spangles]

Hi Jenny,
I use Utrogestan 200 for 12 days, have done for around 2.5 years now. I have had occasions where I've had no bleed, I went without a bleed for 3 months once, whilst using it.
Shellb
xXx