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[Gmail_tara]

My doctor has taken me off Evorel Conti, because of heavy hairloss. (Evorel is discontinued now anyway)

I've been given Estraderm oestrogen patches, and Utrogestan pills instead.

The pharmacists label on the box, as asvised by my doctor says:
ONE x 100mg pill per day, on days 1-25 of my cycle - I don't have a cycle! I haven't had a period for years!

*BUT the Utro leaflet says 200mg is the recommended dose and to take TWO tablets in 15-25 days of cycle!*

Also the label says I will get a monthly bleed, when I expressly said to my doctor this is not what I want.
I started them both today.

Can you advise please?

[Dotty]

Hi if you are post menopause then you take Utrogestan every night ( 1 tablet 100mg ) . The leaflets in the packets are out of date. You may get bleeding in the first 6 months x

[Gmail_tara]

Hi Dotty

My doctor told me to take it for 25 days then  break, too though 

(I haven't had a period for years)

[Gmail_tara]

The EMC and the NICE website (both for medical professionals) state the same for post menopause with uterus in situ:

"Alternatively 100 mg can be given at bedtime from Day 1 to Day 25 of each therapeutic cycle, withdrawal bleeding being less with this treatment schedule"
https://www.medicines.org.uk/emc/product/352/smpc

https://bnf.nice.org.uk/clinical-medicinal-product-information/utrogestan-capsules.html

I guess if these sites state the same as my doctor and the pill leaflet, I've got to go with what they say 

[Rosie63]

As far as I know it's fine to take the Utro continuously so that you don't get a bleed.  That's what I was told by my private gynea when I tried it 

Rosie63 x

[MicheleMaBelle]

Hello. Far as I'm aware you can take it all the time. 100 mcg daily. Can be some side effects if taken orally, less so vaginally but I wouldn't be wanting to do that on a continuous basis.
See how you get on with it.

Interesting re hair loss- I've also suffered with this and continue to do so even although I'm on the more hair friendly Utrogestan. Hair thinning and loss can be made more pronounced with the testosterone based progesterones but it can still be a side effect with them all.

You should ask your doc for some blood tests ( thyroid, vitamin B, D, iron and ferritin as a starting point ) I've been to a trichologist recently and had to get full blood work done to pinpoint what was going on.

[Dotty]

Hi the new guidance is to take every day. x

[Dotty]

https://www.menopausematters.co.uk/postmeno.php

Have a look at this link. x

[Dotty]

https://www.youtube.com/watch?v=aT3aSVfjb20

Also have a look at this link.  Dr Renee Hoenderkamp is a well known menopause specialist and she advocates taking Utrogestan every day x

[Gmail_tara]

Hi Dotty

I checked the link you gave, and even that says for Utrogestan:

"100mg at bedtime from day 1 to 25 of each 28 day cycle, though taken every day is often recommended"

As my doctor isn't recommending otherwise, or the BNF or the UK Medical Council, I'm going to take the Utro for 25 days and break for 3 days.
If I should start having issues, I'll go and reassess with my doctor.

Thanks again.

[Hurdity]

Hi there

I've posted some info on the 3 day break here https://www.menopausematters.co.uk/forum/index.php/topic,43533.0.html which is info from Besins who produce Utrogestan.

Hurdity x

[Gmail_tara]

Thanks Hurdity, that's a really helpful study, with interesting benefits to the 3 day break, along with very low incidences of bleeds.

What I'm going to do, is stick with the 25 days routine and see what happens.
If as the study suggests, I don't have a period, then great! If I do get them, after month 3-4 and hormones have settled, then I'll look to take it every day. It'll really depend on how heavy the periods are, and if they are painful too.

Thanks again 

[Gmail_tara]

Hi there

I've posted some info on the 3 day break here https://www.menopausematters.co.uk/forum/index.php/topic,43533.0.html which is info from Besins who produce Utrogestan.

Hurdity x

Sorry Hurdity, I forgot to quote you when I replied earlier 

[Tc]

It would appear from the article that there are benefits to a 3 day break. I cant realy understand what they are though or what they mean practically for the patient

. I've been taking it continuously with no break for months now so not only have I been missing out on any benefits In fact I've had such profound negative effects from the build up in my system I feel it might actually have been damaging.

I would like to know how docs come to the conclusion that not having the break is better than doing something which has benefits.when  I cannot see any added benefits in taking it without a break.
Yet again I feel let down by my gynae.ive been in misery for weeks and it might have been avoidable.

[Hurdity]

I know this issue is coming up all over the place today but the benefits are stability of dosing. Some women prefer to keep exactly the same dose of oestrogen and progesterone. There will always be some element of progesterone withdrawal if you have a 3 day break so those who are happy taking progesterone may actually be able to avoid this. The thing is it is highly individual - all these studies come up with general principles that a significant proportion of the study group will haveshown. This is not to say that you will, so if you have a good gynae then some tinkering can be really beneficial. What you don't want is a medic to be too rigid. If you are being monitored than this is fine - but going against the prescribing guidelines (eg shorter prog dosing regimes or longer cycles etc) is best done only under medical supervision. I think you can safely assume that the continuous prog regime is either 25 days out of 28 as licensed or as often prescribed in practice - daily - and one of these may give better control of your symptoms or endometrium.

Hurdity x