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[pluto]

Hello everyone,

I've found the posts on here so incredibly helpful over the last few months as I've been deciding whether to take the plunge and begin HRT.

I started on the Estrogel/Utrogestan regime four weeks ago (slowly increasing due to sensitivity in changes in estrogen levels, which cause migraines for me. I'm at 1.5 pumps of gel at the moment). I introduced the Utrogestan last week, 100mg vaginally for 12 nights. I have found that it's immediately caused crippling insomnia - like it's switched all the sleepy circuits of my brain to "off" and the waking ones to "on". Four nights was all I could manage, I didn't take it last night and my sleeping was bit restless but very much improved.

I know that a few of you have experienced something similar. I was wondering whether anyone had found a solution to this - using a different progesterone, or taking it at a different time of day? Or even trying it orally?

I'm cautious about taking a different progesterone as I had severe low mood when I tried the pill in my youth, but am willing to give anything a go. There's no way I'll be able to carry on with the Utrogestan like this.

Thank you

[Cassie]

Utrogestan makes me feel as if I have had a major caffeine overload. It makes me jittery, palpitations, insomnia and irritability. I take 100mg for 12 days vaginally, but only every 2 months as its just too much, but I  have found it gets better after a few days, try to persevere into the 2nd week and see if you settle.

[pluto]

Thanks Cassie. I wondered whether it might improve if I persevered, but it's been so bad that I couldn't face keeping on going.

Have you found that it gets better over the longer term, or do you have the same experience each time, every 2 months?

I also wondered whether it was worth considering taking it in the daytime, rather than at night. Have you tried this?

[Cassie]

I have been on it for many years and its always worse for the first few days and then I tend to settle in and just feel generally wired but I do sleep with busy dreams. I cant use it in the day as I use it vaginally so it would fall out.

[pluto]

I did wonder whether that might be an unavoidable obstacle in taking it during the daytime 

The GP at the clinic I used has recommend I try a very much reduced dose of Utrogestan - every other day for only a few days each cycle - so I'm planning to try that and see how I get on. I might be able to cope with not sleeping if it's only for that long.

I've come across discussions here about how beneficial it would be if lower doses of Utrogestan were available, 50mg or even 25mg. I read a report today (by a panel of gynaes from Austria, Germany and Switzerland) proposing that 200mg orally for 12-14 days was equivalent to 45mg vaginally for 10 days, or 100mg every other day for 10 days (in terms of keeping the endometrium in check). If only 45mg was an option for those of us who struggle with progesterone.

[Herbies Mummy]

hello

thank you so much for posting this today because it is TOTALLY how I have been feeling too. For about the last 2 /3 months I have had horrible insomnia on Utrogestan (which is the best for me but I have experimented since Jan this year in different ways of taking it). The insomnia feels like I have drunk too much coffee - I am wide away. I have NEVER had problems with sleep before - I love Sleep!

I take 100mg of Utrogestan vaginally every other day. (and if I feel awful I just give myself a day off here and there and don't stress too much - because I reckon getting better sleep is also very important and everything's a balance).
What I am trying from today is taking it at 4pm every other day and see how I sleep..so watch his space!.everyone goes on about the sedative effect it has - and there is not enough about the horrible effect it seems to have on sleep in the opposite direction! I overdosed on it a few months ago thinking if I had two 100mg it would help sleep - I definitely now know that that is wrong for me! I went MANIC and mad in the day and still couldn't sleep! Much better now - and I won't be doing that again! Thank you for your post and I hope you sleep soon.. cx

[Wrensong]

I'm another who finds Utrogestan terrible for insomnia.  It seems to have opposite effects in different women  .  It makes me completely wired, very, very hot, with palpitations & other horrible effects.   I've tried it 4 times, both orally & vaginally & with different doses of Oestrogen but have had to abort every trial - the longest was 5 weeks.  I think probably complicated by being on 2 types of thyroid hormone.

There are other options that can be combined with oestrogen gel or patch: MPA (Provera) tablets come in a range of strengths, but are considered old fashioned & have a somewhat controversial risk profile  compared with Utrogestan.  Norethisterone tablets are also sometimes prescribed.  A progestogen releasing Mirena or similar IUD are other options some women get on well with, but perhaps not a good choice to have a device implanted if you already know progesterone gives you serious problems.  Personally I wouldn't consider an IUD for that reason - I need to have control over my HRT.

I'm currently experimenting with taking my progesterone earlier in the day as when taking it at bedtime as advised, the worst effects for me have been at night.

If you are a migraineur (as I am) you may find that an oestradiol patch gives better hormone stability than gel, which can give rise to peaks & troughs, though some migraineurs are fine on it.  The gel will give you finer control if you are building up slowly.

[pluto]

Hi Herbies Mummy & Wrensong.

I'm sorry to hear you're having sleep problems with Utrogestan too, though it's comforting to know my experience isn't totally unusual. And it's really useful to hear what happened when you tried increasing the dose, Herbies Mummy - I was considering that option as well, but think I'll steer clear of trying that for now!

Thank you for the advice about patches, Wrensong. I do get migraines, and they seem to be in response to fluctuations in estrogen levels, so I'll definitely be bearing that in mind. I did have a bit of trouble when I tried to go up to two pumps of gel a bit too quickly, but I dropped it back down again and seem to have been ok since then. I have also wanted to avoid an IUD for exactly the reasons you outline. Managing to keep on with the Utrogestan for 5 weeks is no small feat when it makes you feel this rubbish.

I'll be really interested to hear how you both get on with taking the progesterone earlier in the day.

[Hurdity]

Hi pluto

 

I'm a long term Utrogestan user (nearly 10 years) only ever taken vaginally and only ever cyclically. I have been taking it on a long cycle to minimise the amount I have, but I always have the 200 mg full dose for 12 days per long cycle which has varied from 5 - 8 weeks, currently settled at 6 ( though considering throwing in the towel!). I find its effect on me varies from cycle to cycle! This time I barely noticed it but have also started sleeping with my pillows propped up so haven't had so many headaches (fingers crossed!) and that morning fog and thick head which often led to migraines while taking the utro were the worst symptoms.

It has a mixed effect oin me. I sleep like a baby - can't wake up in the morning feeling as though eyes glued to the pillow. However i have vidi dreams while taking it and it does affect my bladder so that causes me restless nights - as it fights with the soporific effects trying to keep me asleep and then eventually I wake and need to go! However this last cycle I barely needed to get up at all - no apparent rhyme nor reason.

I only ever insert it at night - too many children and I'm far too loose  for it to stay up there at any other time  .

Re the report about dosages. If this is a new one I would be interested in seeing it? However if it is the review of micronised progesterone that came out a couple of years ago - the 45 mg that is referred to is a different product - Crinone gel and not comparable with utrogestan. These studies need to be interpreted with caution because the different trials often use different doses of oestrogen ( usually low to medium) and sometimes different preparations of micronised progesterone so the results are not universally applicable and especially not with higher doses of oestrogen.

If you are using less than the licesned dose under supervision then that's great - your doctor can monitor whether this is sufficient to protect your womb.

If you are interested in vaginal progesterone and endometrial protection ( and sounds like you are!) then I pulled together some of the studies on a thread about it so will find and bump that for you. It's here but will bump it too: https://www.menopausematters.co.uk/forum/index.php/topic,43633.0.html . I haven't checked it for a while eg whether it's still valid and current but if you have a new report or study it would be great to put it on that thread if it's not covered already?

Hurdity x

[Smokey]

Hi Pluto

Have you tried taking magnesium to help with your sleep?

I have been taking a type which have 3 different types in one capsule and they really do work , they do however take three months to start having an effect. I wouldn't be without them now.

They are premium magnesium blend with included zinc and vitamin b6  mag from glycinate mag from taurate and from malate they are also good for anxiety. They about ?15 for a bottle of 90 and you can take from 1 to 3 each day. Available from Ama**n.

Good luck

Ann x

[pluto]

Thanks Hurdity, for the welcome and the info!

That's a really good point about the different types of progesterone. I think the study I read probably was the one you refer to, the 45mg dose was Crinone gel.

And thanks Ann for the magnesium suggestion. Generally my sleep is pretty good at the moment, apart from when hormonal fluctuations mess it up. That is something I'll bear in mind though.

I was surpised and very grateful that the GP I saw (private clinic as I knew I'd stand no chance of being able to be seen my by local NHS menopause clinic at the moment, and I was feeling rather desperate) immediately suggested trying such a drastically reduced dose. She stated very clearly that there's no evidence base for it (at the moment) but it's a judgement based on their considerable experience and advice of clinicans that they trust. So fingers crossed...