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[KarineT]

I am not on HRT but if I ever feel I need I wish there could be more choices of HRT on the NHS.  Utrogestan might be the only progesterone available on the NHS.  There is more choice available privately but, unfortunately, not everyone can afford it and medical insurances don't cover menopause-related issues.

[Taz2]

Hi Karine. Why do you believe that utrogestan is the only progesterone available on the NHS? I've been on HRT for 13 years and not used Utrogestan. There is a wide choice on the NHS so don't worry about having to use private clinics to be prescribed something other than utrogestan.

Taz. 

[Wrensong]

Hi Karine, as Taz says there are many HRT products available on the NHS.  I've had oestradiol in 3 different forms: tablets, patches & gel & tried 5 different types of progesterone/progestogen: utrogestan, norethisterone, levonorgestrel, dydrogesterone, MPA.

[KarineT]

Hi,

Thanks for your replies.  This puts my mind at rest knowing that there's more choice.

Karine

[Paz23]

Many women have a Mirena coil fitted for the progesterone part of HRT -because the hormones are localised and only a tiny amount enters your general blood stream there is less chance of side effects.

[Hurdity]

Here they are listed officially - the ones that are licensed and available separately that is:

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

As Wrensong says there are others but dydrogesterone is not available separately in UK, and norethisterone is only available as part of combi HRT - although some doctors do prescribe it separately, but I don't think it's available separately at the lower doses used in HRT.

Hurdity x

[Wrensong]

Thanks Hurdity - just to clarify, the dydrogesterone I had was, as you say, in an oral combi formulation: Femoston.  The levonorgestrel was in FemSeven (back in the day when that combi patch was still available!) - the same progestogen used in the Mirena IUD. 

I have used 5mg Norethisterone tabs as a separate progestogen (with Estradot).  They are listed on Chelsea & Westminster website as an oral alternative to Utrogestan for HRT:-

https://www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/links/ProgestogenandProgesteroneRegimensinHRT130518AGREED.pdf

The relevant bit is:-

"When is a continuous progestogen or
progesterone used in HRT?
If periods have stopped for more than one year, then
a progestogen or progesterone is taken every day
with estrogen. With this regimen there will be no
bleeding. Common prescriptions are:
• Norethisterone 5mg, every day
• Utrogestan 100mg capsule, every night

When is a cyclical progestogen or
progesterone used in HRT?
If periods have not stopped for one year then there is
a risk of further menstrual bleeds occurring. To avoid
the risk of irregular bleeding on HRT a progestogen
or progesterone is taken for 12-14 days each month
and an artificially induced bleed will follow
discontinuation. Common prescriptions are:
• Norethisterone 5mg twice daily, for 12-14
days every 28 days
• Utrogestan 2x100mg capsules at night, for
12-14 days every 28 days"

Karine, to be clearer than in my earlier post: the NHS prescribable standalone progesterone/progestogen variants combinable with the various forms of oestradiol I've used are: Utrogestan (capsules, used orally or vaginally), Norethisterone (tablets) & MPA (tablets).  The other two prog variants were in combi products that were also available on the NHS.

Wx