Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Mim]

Hello I am new here but would welcome some advice.
I have been on oestrogel 3 pumps and utrogestan for 7 years. For the first two years I used utrogestan 200mg PV 12 days. I then began to get v bad migraines as the utrogestan came off.

My private menopause doctor suggested 100mg for 10 days with a USS every 6 months. This has been fine until now when I had a 3 week withdrawal bleed and the endometrium at the end of my bleed was 7mm. I am now waiting for a hysteroscopy and biopsy under GA. the gynaecologist has suggested a Mireia or endometrial ablation. The problem is my migraines have been terrible this year, requiring monoclonal antibodies. The headache neurologist has said to avoid the miriena if possible as it may make the migraine worse. I was wondering if the histology is normal whether I could get the endometrium thinned by going back to utrogestan 200mg. I need to make a decision as it’s next week and unable to get appointment with the menopause dr. Has anyone been in this situation, I would be really grateful for any advice, experience.

[CLKD]

U can of course put off any intervention.  7mm isn't very much, I think 5mm is what is expected.  No one has to undergo anything until completely relaxed about it, a few months won't matter.

Migraines can increase during peri..  I would stick with the neurologist for the while, although a Mirena coil can be removed if it causes problems. 

Hopefully someone will be along!

[Mim]

Thank you. I can barely cope with a smear nowadays so if I absolutely needed the mirena then would prefer it went in whilst under GA. Reading other threads it sounds as though it’s a bad idea for migraine. So I just wanted to know if anyone had used a higher dose of utrogestan and managed to get the endometrium back down to a safe thickness.

[sheila99]

Do you always bleed on 100mg? Are you peri or meno? Do you use it vaginally or orally? The 3 week bleed suggests there's been a build up. The only time I tried 12 days x 100mg I didn't bleed but I don't always have a bleed so it may have been coincidence. It is a known strategy to use double dose but I think that is more for a conti regime. Some of the synthetic ones such as norethisterone seem to be a bit better at it but I don't know if that would be worse for your migraines?

[Mim]

Hello Sheila99

I was 44 and peri when I started HRT 8 years ago. I have been on it since.
I always bleed on 10 days 100mg PV.
Since the 3 week bleed I have increased this to 12 days 100mg, getting a 10 days bleed (which is normal for me)

Progestogens would I think be a disaster for my migraines.

[Hurdity]

Hi Mim

 

As you have a thickened endometrium while being on the reduced progesterone dose ie less than the licensed amount for the cyclical regime - of 200 mg x 12 days per 28 day cycle - then it would seem sensible to go back to 200 mg per cycle to thin the lining down again ( provided no abnormailities have been found after hysterosocopy etc).

The presence of a bleed does not automatically mean that the progesterone dose is sufficient to keep the endometrial thickness within normal limits, ie that all of it is being shed. My endometrium was thickened on last scan (though I am on longer cycle) whereas previously it never was, when done immediately post-bleed.

I don't think increasing your cycle to 12 days would make that much diference in terms of thinning the lining though it may work as a maintenance dose once your lining has thinned to a normal level?

If you can cope with the 200 mg dose for a few months that would be my choice, since like you I don't want to use synthetic progestogens.

Hurdity x

[Mim]

Dear Hurdity,

Thank you so much for your reply that is extremely helpful and what I was hoping somebody would suggest. Now I just have to hope the hysteroscopy and histology are normal.