HRT - utrogestan

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I'm on my first month of HRT - estrogel gel, one pump morning and night and then 10-12 days of utrogestan in the second half of month for the progesterone. Feel great so far, no side effects.
I was told that stopping the utrogestan would trigger the bleed but on day 8/9 I began what feels like a normal period. Looking on other forums this doesn't seem anything untoward. But just wondering what is happening in my body as presumably the progesterone hasn't dipped so what is triggering the bleed.
I'm 52 and last period in January. Just curious what is happening, anyone know?

Hi there Two possibilities: first is it's your natural cycle as you are maybe still peri- only 5 months without a period.

Second is this is your bleed because Utrogestan is poorly absorbed; it sometimes drops to a level which promotes a bleed before you get to the end of the 10-12 days. (Are you doing 10, 11 or 12 days?)

I'm afraid I can't predict when my bleed on Utro will start. It can be as early as day 9 or as late as day 12 (I use it for 10-11 days) and if it starts early and I take it for another day or two, the bleed is usually light then picks up once I've completed the course.

This is a different experience to when I used Norethisterone for almost 5 years because then I could almost guarantee the bleed would be 3 or 4 days after the last pill.

Hope this helps- it's nothing to worry over, but you do need to be prepared.

Thanks Polly. I'm doing 12 days. When you say poorly absorbed do you mean the absorption decreases with time? Just trying to understand as I presume if I am not peri then I am not producing my own progesterone. So it's he HRT that is giving me the cycle and the progesterone needs to dip at some point to allow bleed. I find it all fascinating!

'poorly absorbed' means that some of it is lost in digestion and this varies from person to person. Bleeds start (natural periods too) when progesterone levels fall. The cycle with HRT mimics your own cycle, except you use oestrogen daily whereas in a natural pre meno cycle oestrogen peaks at ovulation then drops right back from days 14-28.

I meant that if it's only 5 months since you had period you might get a natural one thrown in for good measure if you ovulate and it overrides your HRT regime. Peri is until you have gone 12 months with no natural period. I've known friends go 11 months with no period then have another one.

I'm also confused about the absorbance of Utrogestan. My gynae told me to take it 2 hours after food so that's what I do- but then was told by someone on this thread that the opposite is true, and not to take on an empty stomach!

I suggest you stick at it with Utrogestan 100mg , generally speaking I take it at night on an empty stomach it really works for me better than Provera (Mediprogesterone Acetate 5mg ) I found the Provera not as effective ,

I also take Zumenon 1mg as other synthetic Oestrogens ,have caused dizziness

if it helps the Utrogestan made me regain my mojo , but suggest you reduce your calorie intake

I take my utrogestan 100mg for 10 days up my vagina at night.
No side effects and it's absorbed locally with no absorption loss.

I get a withdrawal bleed about three days after the last one.

Maybe ask your specialist if this might suit you too.

Dorje the dose is 200mgs x 10 days. Have you been advised to use less?

I am on 100x14 days,it works but most people here seem to take a higher dose but shorter time.Im loath to change as it is month 3,no side effects/break through bleeding and bleeding starts 2 days after last tablet.Also take just before going to bed.

Hot- who has told you to do 14 x 100mgs?
The licensed doses are 200mgs x 10-12 days, or 100mgs x 25 days (or can be every day to avoid any bleed at all.)

Thanks Polly.
My GP prescribed it.I read the leaflet with the pack but thought nothing more if it as it seems to work re bleeding.
I have an appointment Tuesday so will ask her.
You would have though the pharmacy would have picked it up when they type the instructions for the pack.
Still trying to find the right patches but I can get them to stay put consistently.How does gel work?

Had my appointment,staying on 100mgx14.Apparantly it's the lowest dose that works so as long as I have the withdrawal bleeds that's Ok.
I am only just peri,had all Meno symptoms but still having mostly regular periods some of which went on a bit.On these I am predictable and no side effects.Patches work well.

It's not and I don't know why your GP says that.

www.medicines.org.uk/emc/medicine/19895

The dose is as I posted above.

Some private consultants allow patients to do 7 days @ 200mgs if they are intolerant on the proviso of an annual scan (or thereabouts.)

It would be more reassuring if your GP said they were fiddling with the dose for some specific reason but it's a bit worrying that they think this IS the standard dose.

As you are peri it's most likely ok as it seems as if your own hormones are still doing something. But I'd still ask your dr why they think this is the 'right' dose when the leaflet linked shows something different.

Hi hothead, and Polly.
My GP is happy with her prescription for me.

I have regular scans and regular withdrawal bleeds. I'm in peri.

I think the dose is 200 mg p.d /14 if you ingest it, and aren't making hormones yourself.

I'm pretty intolerant of progesterone- the mini prog only pill gave me migraines for eg.

No need to diagnose on the internet Polly!
My GP is happy, I'm happy.
Be happy for me, go on

I'm not diagnosing
I linked to the info on the leaflet. That's all. But it's not advisable to suggest women deviate from the licensed dose, either, unless under supervision.

The GPs you refer to are not saying the same thing as my gynae consultant.

There is some research that half the amount may be okay if used vaginally. Another poster on another forum linked to that research.