Utrogestan - terrible headache/stiff neck! Should I stop immediately?

[OnlyTeaForMe]

After being on Elleste Duet 1 mg for about 2 years relatively successfully (apart from a few digestive issues at times) I decided to switch to a continuous regime.

Started on Estradot 25 and Utrogestan 100mg (for 25/28 days) just 11 days ago. Thought was fine at first, but for the last 3-4 days I have had just the most awful stiff neck with pain running up the left side of my face/ headache. It's worse when I first wake up, but yesterday and today it has left me in tears.
After reading some comments on Menopause Matters I am sure this is being caused by the Utrogestan.

I can't tolerate this longer term, but I can't see a GP until next week at the earliest.
I'm not sure if I should just stop it to prevent any further build up in my system?
Anyone had anything similar / have any advice?

[PollyPerky]

I'm not sure what you have read on menopause matters but bear in mind some posters blame their HRT for everything with no good reason!

A stiff neck and pain is more likely to be something to do with your muscles OR it's a virus like a cold.

It really doesn't sound like anything connected with Utrogestan which is natural progesterone which we have all our fertile lives.

Utro sometimes gives PMS symptoms but nothing that is isolated to one part of the body.

Have you tried painkillers and maybe something warm on your neck and face - hottie bottle wrapped in a scarf?

I've used Utrogestan for 5 years, have read loads on the forums and never come across what you have. It's not listed anywhere as a side effect.

Hope it gets better soon.

[PollyPerky]

If you do stop it now you will most likely have a bleed although maybe not as you are taking a very low dose of estrogen- lower than 1mgs- why didn't you start on 37mg or 50mg patch?

[PollyPerky]

I think you need to work out if this is a stiff neck and a cold /flu virus, sleeping in an odd position, or a headache. A migraine (had them all my life) is above / behind one eye usually. It's very painful. It doesn't IME spread to the neck.

If it IS Utro, then you could try doing a cycle and using 200mgs x 10-12 days. But you should seriously think about the dose of the patch- that's tiny and much less than the 1mg pill you were on.

You may find that - odd as it sounds- using MORE Utro (200mgs) reduces side effects. Migraines tend to occur as it's withdrawn- blood serum levels fall (that's what happened to me on 100mgs continuously) but 200mgs keeps the level more stable.

You could also use it vaginally but if you have any kind of active sex life, using it vaginally, daily, last thing at night won't work.

[OnlyTeaForMe]

Polly - thanks. I also thought the neck/headache must be something else, but nothing has changed, and I haven't changed anything about my bed/pillows etc and it also seems to directly correlate with the timing of my Utrogestan - it's terrible in the morning, but by mid-afternoon is wearing off.
Migraine is listed as a common side effect of Utro - the stiffness may just be related to that?

"But you should seriously think about the dose of the patch- that's tiny and much less than the 1mg pill you were on" - that's interesting - I did wonder if there was problem with how much oestrogen I was getting compared with the balancing progesterone?
How do you compare one with the other? I couldn't find anything that says Xmg in tablet = Y microgrms via patch?

[OnlyTeaForMe]

OK, so I found some NHS formulary advice which suggests that what I've started on is roughly the same as the 1mg Elleste Duet I was taking before:

"These are a rough guide as absorption varies
1mg oral oestradiol=25mcg patch"

[PollyPerky]

There is no direct equivalent but I'm a little surprised at that NHS comparison. 25mgs is tiny considering patches go up to 100mgs.

There is no pill less than 1mg and no patch less than 25mgs generally available although research has been done on the effectiveness of 0.5mgs estradiol, so it's clear that 'low dose' is going to mean one of those.

Low dose is also a 37mg patch.
menopausematters.co.uk/treatafter.php

[OnlyTeaForMe]

To be honest, if I can manage my symptoms on 1mg tablet/ 25mcg patch then I'm not sure why I would go higher?

It's the progesterone part which I think is the problem. Have been thinking about this more today and I'm wondering if the headache is the side effect, but the neck stiffness is being caused by the fact that the Utrogestan is making me drowsy/ sleep heavily at night, so perhaps I am not naturally moving about in my sleep and staying in the same position all night? That would make sense.
The headache has now worn off - which it has done for the last few days - about 14-15 hours after I take the Utro.

[PollyPerky]

If you feel ok on 25mg patch that's fine but it could be that the utrogestan is dampening down the effectiveness of estrogen. Some women on other forums who used estrogen gel said they always upped the gel on the utro days (of a cycle, not continuously.) Why not try it as a cycle and see how that goes? 200mgs for 12 days. But on such a low dose of patch you could probably do 10 days. I use 1.5mgs gel and my consultant says 10 days per long cycle is ok though I sometimes do 11 or 12 days to be sure.

[OnlyTeaForMe]

Thanks, but there's no way I could risk doubling it (I'm currently taking 100mg for 25 days).

I think I might try a conti patch instead. I was tolerating the Elleste Duet quite well, but just wanted to go down a transdermal route.

The lowest dose one is 50mg though, but perhaps I could just use half? I want to see if I can wean myself off HRT longer term anyway.

[PollyPerky]

I understand what you are saying and if you want a no-bleed type then a conti type is best. But do bear in mind what I found- 200mgs as a cycle gave me fewer side effects than 100mgs daily.

[Jedinak]

Hi,

so interested in your comments about migraine and Utrogestan. I seem to be having more frequent migraines since being on Oestrogel 2 pumps and Utro 100g. I had just assumed that it was the Oestrogel that was to blame not the Utro. I seemed to be ok when I went up to 3 pumps and one capsule of the Utro but then had breakthrough bleeding and was told to drop down to 2 pumps. However, a specialist at the Menopause Clinic said I should increase the Utro to 200g which agrees with your point. Can I ask how you know all this and do you think increasing the Utro would help? Many thanks