Utrogestrone pessaries + Oestogel

[Peaceonearthplease]

Is anyone using Utrogestrone pessaries + Oestogel as HRT? Interested to hear about experiences. Is taking progesterone vaginally safe mid/long term?

[PollyPerky]

Yes and yes. But what do you mean by 'safe long term'? In what context?

[Peaceonearthplease]

In the context of pessaries v oral tablets. I understand that there is blood clotting risk associated to Progesterone, does the way we take them impact this?

[Peaceonearthplease]

I’ve read posts on another board that Utrogestrone pessaries are v messy and that some women use them anally Anyone been there done that??

[PollyPerky]

I have never read anything about the risks of blood clots with micronised progesterone (Utrogestan.) If you do some research I think you may struggle to find anything. It's usually estrogen that is the issue, when in tablet form, and then it's very very rare (more of a risk with the OCC.) If the risk is mentioned on the patient leaflet, that is because all HRT leaflets carry the same leaflet - even vaginal creams.

Can you link to where you found this risk out of interest?

The capsule is not messy- it's tiny and yes, some women mention slight 'seepage' the next day but nothing that can't be dealt with by using a panty liner.

In France they also use them as suppositories but that's a culture thing, nothing to do with risk.

If you can find the stats for blood clots with Utrogestan, do post as I'd be interested. Never ever been mentioned at all by my consultant (Harley St) in all the years I've used it.

[Peaceonearthplease]

I don’t have any online info about blood clots, my gp mentioned it verbally. It was in a converstation about general HRT risks & he mentioned that Progesterone which is ingested in tablet form can increase the risk. He did not say that Ugesteone specifically carried a risk.

[PollyPerky]

I think he is mistaken. I think he meant estrogen.

There is no other type of progestogen (apart from Utrogestan) that can be taken any other way except orally. The risk with a change in lipids is with estrogen used orally.

If you go back and ask again about HRT I'd question him on it.

Since you posted I have looked online and there is nothing.

[Peaceonearthplease]

Mmmm...i’ll bring it up again in conversation when i see my doc again. Receiving the prescription soon, he said 2 pumps of gel daily + 7 days of Ustrogen pessaries. Previously I have used Progesterone for 12 days a month. Why the reduced time using these pessaries?

[PollyPerky]

I hate to contradict your dr (but there are so many making mistakes with HRT as shown by posts here.)

Is he a GP or a consultant? (Makes a difference.)

Utrogestan (not Utrogestrone) Is also used in large amounts with pregnant women as a treatment and also for fertility. It does not come with any clotting warnings.

Are you in the UK? In the UK Utrogestan is not licensed for vaginal use, so a GP saying use it that way is not working within the guidelines. HAVING SAID THAT (!) it IS licensed for vaginal use in Europe and my consultant gave me the choice - orally, vaginally, or as a suppository - because privately, they can prescribe in a different way. It's the same capsule for all methods. In the UK there are women using it vaginally because how would their GPs know, anyway?!

There is some research showing that used vaginally it is more effective and the dose can be reduced slightly.

So...what dose has he given you? 7 days is not the licensed amount. That is 200mgs for 12 days each month. Women who use less than the normal 12 days do so under supervision where they can access a pelvic scan if there appear to be any problems.

Sorry this is so long but felt you needed the whole picture. :)

[Peaceonearthplease]

Hi Polly, thanks for this. No, I am not in the UK and HRT is not readily available where I live. However, a new GP is sympathetic & active in treating menopausal women so working with him to sort out my treatment/meds. In think some info has been lost in translation and I will go back to clarify dosage, method of taking the utrogestan.

I have not yet got the meds and a bit confused by what I will receive.. you mention that the same capsule can be taken orally and vaginally. Does this mean popping an oral tablet up one’s fango?? I’m assuming a suppository will be waxy in texture and can be used in vaginally or analy?

Oh the fog of HRT!

[PollyPerky]

I had the impression you weren't in the UK by a) the timing of your posts and b) what your dr prescribed.

The 7-day dose of Utrogestan is normally only for women who are very progesterone intolerant (after trying it and other types.) There is a risk with a low dose that it won't be enough which is why it's advisable to have a scan now and then (and not available in the UK on the NHS as 'routine'.)

Utrogestan only comes now in 100mg capsules which have a soft waxy coating and are quite small. They used to come in 200mgs sizes but in the UK this has been discontinued (unless for fertility when I think you can still get the 200mgs.)

The same capsule is used whichever way you want to use it, so yes, you push it up your fango or your bum, or swallow it.

[Peaceonearthplease]

Thank you for clarifying! Which is your preferred method & why, if you don’t mind me asking? Would up the fango help with dryness or is it just the oestrogen which helps with this?

I’m hoping I receive the Utrogetran that you describe otherwise I’ll be back on MN muddling thru the fog of information with more questions

[PollyPerky]

I take it orally but only because I have a very sensitive bladder and in my normal fertile cycles my own progesterone used to give me worse urgency and frequency so I've not risked it vaginally. if you can tolerate it that way it's better as you may have fewer side effects and it seems more effective. (Some trials say using 100mgs vaginally is okay.)

No it won't help with the dryness at all. If that's an issue ask for Ovestin (estrogen cream) or Vagifem (small pellet) as well as the gel.