Bio identical hormones and dosage

[Dorje]

Hi everybody,
Wondering if you could help me with my dosage for bio identical hormones.
GP who was a bit useless TBH has prescribed 12 days of utrogestan progesterone and 2 pumps of oestrogel daily.

I've read gynae consultant Nick panays website and he suggests 7 days progesterone.

Anyone any ideas which protocol is best for perimenopausal HRT, moderate symptoms.
I'll take it up with my GP but wanted to see what you're all taking first. TIA

I understand that 12 days of progesterone is the recommended dose for those who tolerate it well, and I take this. I'm only 2 months in but doing well. Mine was prescribed by a menopause clinic.

Thanks dramaqueen.
I'm glad you are doing well on this.
I started today so am hoping it will make a difference !
I'll start to take the progesterone in two weeks. Did you start like this?
TIA

I take progesterone on days 1-12 of each month, and started a week into the oestrogen. The progesterone certainly helps me sleep but it takes a few days.

Good luck, I'm sure you'll find it takes several weeks to stabilise but it's certainly worth it.

Hi dramaqueen,
How are you getting on?
I've been very happy on the transdermal oestrogen gel so far and am sleeping much better, no hot flashes and improved mood.
I cannot believe I didn't think of hrt before... I actually remembered why I married my DH!

Are you taking the progesterone with the oestrogen at the start, or did you do 16 days of oestrogen first, then o plus p for 12 days?
Also (possibly tmi) are you taking your progesterone orally, or vaginally. sorry for the tmi questions.
My GP wasn't sure of the protocol. TIA

Oh sorry I've just clicked what you said.
So you took o on it's own for one week then p for 12 days?

Have you had a withdrawal bleed... When will that arrive do you think?
I'm arranging mid term break and don't want to be on. TIA

You use oestrogen every day (think that's what you are doing) and progesterone as well for 12 days, usually from days 15-26. To be honest, it won't be a disaster if you delay it by a few days or bring it forward a few days so that you bleed earlier or later. You should expect a bleed 2-3 days after the last progesterone capsule but it's not always that precise- you might bleed slightly earlier even when you are still taking the progesterone.

If your own oestrogen levels have been very low and you've not had a natural period for ages AND you only use a low dose of the gel, you may not get a bleed at all to start with for a month or more, so don't be worried if that happens.

Vaginally or orally is your choice though vaginal use is 'off label' in the UK and GPs don't prescribe for this use (in legal terms) but they can't really monitor what you do with it.

You can use it on days 1-12 of the month (eg 1 May) but this only really works if you've been using the gel for a while beforehand (eg if you started it 17 April as a random example!) You have to set a 28 day cycle somewhere and some women use the 1-12 month purely for convenience so they remember when to use the progesterone.

If you've been using the gel from the start of May it makes sense to add in progesterone from the 15th (-ish) so you are mimicking a natural cycle where the progesterone would normally be in your system from mid month to the end of the month then you'd have a period.

Did that make sense Dorje? I know you weren't asking me specifically but after 7 years on this I thought it might help!

Just seen this now, thanks!