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[Sid]

Hiya ladies

I have posted before that I don't seem to absorb Utrogestan very well (unless I use it vaginally which kind of limits me to a sequi regime).  I would very much like to move to a continuous regime as have been having awful cramps before a bleed which really do floor me (even though I never had heavy periods and the withdrawal bleeds are not any heavier). I am nearly 56 and am not keen on a Mirena.  My question is whether it would be worth taking the Utrogestan daily with food to try to increase absorption. Any thoughts much appreciated. 

[Hurdity]

Hi Sid

Now that's an idea! I would suggest as long as you take it at approx the same time each day say with the same approx amount of food, then why not give it a try?

I would be very interested to hear the outcome if you do go down this route. Also if side effects are increased?

I have often wondered why more women don't do this when they experience poor absorption. Maybe the levels fluctuate more when taken with food ie depending on the amount of food perhaps? You can but try!

Good luck and be sure to come back to us on this thread!

Hurdity x

[Sid]

Thanks, Hurdity.  I will give it a go and let you know the results 

[Sparkler]

Hi Sid

What is it that makes you think you don't absorb it well? I have wondered the same as I get cramps and usually bleed a bit in the middle of the utrogestan part of the cycle. I'm really interested to hear how it is for others.

Sparkler

[Sid]

Hi Sparkler

I absorb the Utrogestan well if on a sequi regime and taken 200mg vaginally, but if I take it orally my bleed always starts really early (on day 7 or 8 of starting it).  Conversely, I always manage to complete 12 days of Utrogestan if I take it vaginally, and the bleed usually starts about 4 days after finishing it.  I did try a continuous regime taking it orally on an empty stomach as recommended (don't think continuous use vaginally is very practical) but had very erratic bleeding.  So again I think I wasn't absorbing enough.  I really would prefer a continuous regime due to horrendous cramping at the start of the bleeds and so I am going to try taking the Utrogestan 100mg daily with food rather than on an empty stomach. Hopefully this may increase the absorption enough to stop the bleeding. Fingers crossed!

[Annies]

Hi ladies, hope I'm posting this question in the right place and not repeating something already asked loads! Apologies if so.
Am in first month of oestrogel/ utrogestan regime, but only using 100mg orally of the utrogest for 10 days, days 16-26 because I am starting off v slowly on the oestrogel, only quarter to half a pump daily to adjust.
After only 2 days on the utrogest ie cycle day 17, I am spotting quite heavily, as though I'm about to start my period. 🤨Prior to beginning hrt this month I was having  periods each month anywhere between days 20-30. This month I woukd have expected a shorter natural cycle (after a 29 day cycle last mth) had I not begun hrt, so might this be my own hormones still taking the lead and/ or an insufficient amount of utrogestan being absorbed do you think? If the latter should I just see what gives the next few days and if my period does arrive this early, consider asking gp re increasing the utrogestan to 200mg?
Thoughts really appreciated, thanks everyone!
 

[Sid]

Hi ladies

I posted back in May about the problems I have absorbing Utrogestan. I wanted to move from a sequential to a continuous regime due to painful bleeds and wondered if taking 100mg of Utrogestan daily with food would increase absorption sufficiently to stop break-through bleeding.  Well, it didn’t!  I even tried 1 month of 100mg each day vaginally but that wasn’t sufficient either. Last month went back to 200mg vaginally for 12 days and no break-through bleeding (but a predictably painful bleed thereafter).  Very frustrating 

[Gnatty]

I had a phonecall with the pharmacist at Newson Health last week. She said that women experiencing heavy periods on HRT have success with 200mg orally of Utrogestan on a continuous regime. Not sure whether I want to give it a try or not!

[NightNurse]

I had a phonecall with the pharmacist at Newson Health last week. She said that women experiencing heavy periods on HRT have success with 200mg orally of Utrogestan on a continuous regime. Not sure whether I want to give it a try or not!

Dear Gnatty, I've had several years of juggling doses and routes to try to get the best symptom control with fewest side effects, particularly hideous lengthy painful bleeding plus spotting and irregular bleeding.

I've been on 100mg Estradot patches which controls the usual perimenop symptoms brilliantly.  I was very worried I would have to reduce the dose (as Avalon says below) but I really didn't want to do that.  However, with trial and error I think I've struck gold with the current progesterone regimen!

I'm taking 200mg uterogestan orally for 14 days of the month, starting the 1st of the month to the 14th of the month. I know this is two days longer than the usual prescription but it seems to work for me. I did try 100mg daily but that was chaos! Bleeding all over the place and with a constant dragging ache and feeling bloated with headaches and low-ish mood.

I take it in the evening, 2 hours after I've last had something to eat. Your pharmacist may be right about taking 200mg daily continuous but you might want to give 14 days rather than 12 days a go first. You could get good bleeding control without too many side effects. Plus if you have to pay for it, it's only a couple of extra days on tablets rather than 30 days of 200mg.

[Gnatty]

That's really interesting NightNurse! May I ask if the 100mg Estradot is quite a high dose? I take 2 pumps of Oestrogel and was wondering whether to up the dose. Mind you I do have a fibroid so maybe that isnt quite such a good idea. Where does your period come in relation to the 14 day utrogestan? Just wondering how to change over from 100mg continuous...

[Hurdity]

Gnatty - it depends whether you are peri or post-menopausal as to when to change to sequi. If you are post-meno then you can change at any time. Just stop the utro and then go with oestrogen only for 14 or 16 days whichever you decide and then take the utro again for 14 or 12 days - or if you do it monthly rather than 18 days then tweak accordingly. 100 mg Estradot is classed as a high dose - but individual absorption varies between women.

Two pumps of gel is medium dose but you would only increase if this is not controlling your symptoms. Yes higher progesterone is required if the standard dose does not control bleeding. Unfortunately this is not catered for with the standard dosing instructions which appears as one dose irrespective of the oestrogen dose. In practice the amount of progesterone needed to protect the uterus is dose dependent (on oestrogen) and more is needed and possibly for longer duration with higher doses of oestrogen.

Hurdity x

[Dandelion]

Gnatty - it depends whether you are peri or post-menopausal as to when to change to sequi. If you are post-meno then you can change at any time. Just stop the utro and then go with oestrogen only for 14 or 16 days whichever you decide and then take the utro again for 14 or 12 days - or if you do it monthly rather than 18 days then tweak accordingly. 100 mg Estradot is classed as a high dose - but individual absorption varies between women.

Two pumps of gel is medium dose but you would only increase if this is not controlling your symptoms. Yes higher progesterone is required if the standard dose does not control bleeding. Unfortunately this is not catered for with the standard dosing instructions which appears as one dose irrespective of the oestrogen dose. In practice the amount of progesterone needed to protect the uterus is dose dependent (on oestrogen) and more is needed and possibly for longer duration with higher doses of oestrogen.

Hurdity x

Hi @Hurdity
I am using 50mcg gel and 200mg utrogestan, but it is not enough to control the bleeding.
Sorry to hijack the thread.
I'm 54 post meno.
I was taking 100mg utro conti and bleeding started, so 100mg vaginally was added, as this is better absorbed. A hysteroscopy showed nothing sinister in 2009.
All went well until six months later and bleeding started again.
Oestrogen was reduced which stopped bleeding, but six months later it started again.
Not just bleeding but dried blood, clots, bits of womb lining.
I reduced oestrogen by my self and this still did not control the bleeding.
I've been bleeding on and off for 2 months now.