Uterogestan Take one days 1-25

[TripTrappedNow]

Just back from GP. I am 45 /peri/menopausal, been on hrt for 6 months. Evorel 50 very successful for the oestrogen part.
Provera tablets less happy with for the progesterone so i saw GP today and asked for Uterogestan instead.
GP suggested eldest duet/duo and said my blood tests had been inconclusive and she would have not actually prescribed HRT despite the debilitating hot flushes I should have waited a year of no periods and tried something else for the flushes instead. I was flummoxed as I have gone through the NICE guidelines with another GP before.
Anyway GP decide to give me what I asked for but now looking at prescription it says 30 capsules take 1 a day days 1 to 25. This does not sound right to me.
I can't find the right NICE guidelines section to check this now. Help.

That prescription is for women whose last period was at least a year ago, so post meno.
Blood tests are notoriously unreliable in the peri stage as levels fluctuate so much, so she should be going by your symptoms. Pleased you were aware of the Nice guidelines...she obviously isn't up to date on them.
We had a great HRT friendly doctor at our surgery, sadly she has left and I haven't been impressed with the others I have seen... Last one I saw told me I wasn't using my Estrogel right ( meant to run into shoulders or thighs) she said it was meant to used vaginally I put her right on that one!

There is a lot of confusion on HRT coming from GPs (as shown on here.) Some don't appear to know the basics which is really bad.

HRT is for women with symptoms. You DON'T have to be post menopausal. Why on earth does she think you have to be?

You can take cyclic HRT at any age. You can take continuous if you've not had a period for 12 months. I am 8 years post meno and have chosen (on advice of my consultant) to continue with cyclic HRT (having a 'period') every few weeks.

You don't HAVE to take conti HRT post meno. There are pros and cons around it. Briefly, the pros of conti are no bleed, and slightly less chance of hyperplasia (uterine lining building up too much.) The cons are some women feel terrible using progesterone / progestogens daily. (I did.) There is some research which shows the type and amount of progestogen used ( might just be the synthetic versions) is what can trigger breast cancer.

Unfortunately most GPs are unaware of this research and I'm only 'educated' about it after many discussions with a consultant.

So- if you want to use Utro, you can take it for 10-12 days a month. 12 is I think the recommended dose but some women find it makes them sleepy, so you could cut back to 10 days. This is 200mgs so 2 x 100mg capsules.

I think you should go back to your GP and discuss. I'm sure the leaflet in Utrogestan says it can be used either way- sequentially or continuously.

Thanks that's helpful I think I will have to phone the surgery and ask a different doctor to review the prescription.

The GP did imply it was't really a specialism. I didn't think to read the script before I came out or I would have queried the frequency.

This explains the two ways to use it.

www.netdoctor.co.uk/medicines/a8720/utrogestan-capsules-progesterone/

You could just follow the instructions - you don't have to start on day 15 of a cycle if you aren't having regular cycles. You can start on Day 1 of a month and carry on the first of each month.

Polly I was disappointed in the GP (who has been good at other problems) and glad I was familiar with the guidelines - mostly due to your posts actually

Separate side issue Mirena had been going to be my progesterone source but they were unable to fit it due to physical exam findings. Suspected fibroids. So the uterogestan is the [my] backup plan for now.

That's a shame about the Mirena if that is what you wanted.
Any chance you could get a 2nd opinion on that one? You might find it depends on the expertise of the dr. I'd have thought it was only a real issue if there was a large fibroid nr the entrance- and if you've not had a scan, how do they know?

They are on the whole excellent, though having read the NICE guidelines has been essential, and did refer me to gynae when mirena fitting failed and gynae examined then arranged a scan - its in half an hour I am currently guzzling water in readiness - already crossing my legs and looking longingly at the toilet door.

Gynae will have a go at mirena if findings are in my favour for that.
Wish I was not relying so heavily on the nhs at the moment it seems to be a time of life thing.

Prob too late for this now but they get a much better image with a scan if they do a TVS- transvaginal- dildo type thing. I was a bit freaked out when offered it but gave in and you don't need a full bladder- quite the opposite.

Hope you get on ok.

All done external and internal, both uncomfortable but soon over. Limited info given I have to wait to see gynae for full report but yes there are fibroids was as much info as I could get.

Hope it's a non-serious case. Will try to put it to the back of my mind until apt comes through.

Thanks for your advice, has been really useful.

Most women have fibroids- I do and never knew till I had a scan.

Hope you get on okay :)

Hi trip, and polly, I take 100 mg utrogestan vaginally for 12 days, and have a withdrawal bleed no problem.
I use the oestrogen transdermal gel on upper arms and inner thighs, two pumps every day. No oestrogen cream on my labia needed as after a few days of using the gel on my arms my oestrogen level came up to normal, and vag atrophy disappeared.

This level of progesterone is fine for me and I've no problems with low mood, tiredness or dizziness. I used to get pretty bad pmt, had a wonderful pregnancy and had a horrible time after giving birth with low moods- hormonal pnd.

I've also had a TVS and had to empty my bladder. I've got a water filled cyst that comes and goes, and sometimes a cycstic ovary, but no fibroids. I'm booked in to have regular gynae scans, and breast scan next year.

Glad your scan went well Trip. It's hard to hold in the pee when they press down - I actually prefer the internal scan as it's more comfortable than the pressing down on a full bladder feeling! Also it's a bit messy with all that gel everywhere on your tummy, no matter how much of that roll they use.

Doesn't oestrogen make fibroids grow?

Hi Dorje

Do you feel well in your self?

I have to say I feel like a new woman this morning 4 days into the uterogestan - major side effect = feeling ten years younger - hope this continues! My loss of 'focus' that I was suffering daily really for the last few years, thought it was depression(maybe still is/was) seems to have vanished over the last 36 hours. Libido back too (tmi maybe but true).

Gynae apt next Monday so will find out what is lurking fibroid wise then I guess.

Apols for the ineloquent stream of consciousness - rushing 'cause at work.

T x

I feel fantastic thanks trip.
I agree there's a cloud that lifts and you didn't even realise you were stumbling along in the half light until it does.

I now wonder how many of the grumpy cahs on MN actually are low on their hormones?
With myself I know I was a bit grumpy before and can see the change clearly like a line in the sand before hrt and after, but only now after I take it I realise that I probably needed it years ago actually, and definitely needed a oestrogen boost after the birth of my baby...

Like when you go on holiday and realise how dark and miserable the weather was at home, and what the sun is again!

Glad you're coming up for air with it. Enjoy the sunshine 🌞 and everything else!

Well I did feel well until I got the scan results yesterday.
It turns out I have a 12 cm ovarian cyst and I was shipped off for blood tests looking for tumour markers and a ct scan was requested (waiting for date).

Apparently due to the size weather sinister or not the cyst and ovary will have to come out soon. So in a few weeks I have gone from gearing up to cope with a mirena fitting to who knows what

sorry to hear that. Hope it all goes ok whatever you need to have done.

Than goodness for scans Tripp.
Sorry to hear you might have something going on unexpectedly.
Knowledge is power and early detection of cysts lumps bumps tumours and growths gives us plenty of options for fantastic outcomes.

Years ago to hear a cyst or a growth was present used to frighten us half to death.
Not anymore.
I have fluid filled cysts that come and go. I'll not lie and say I wasn't worried the first time the doctor said "oh, what's this" but once you realise that inflammation and water cysts and bumps and lumps can occur all over then it's just the norm, especially in the ovary.

They can remove ovaries laparoscopically if it comes to that, so recovery is quick, not like years ago when abdominal surgery was a big deal and recovery was slow.

Ovaries produce testosterone as well as the other hormones, so if you have to have it / them out, it might be worthwhile asking for a testosterone gel to replace that lost hormone too.

I'll be thinking of you! Fingers crossed your cyst is just fluid and transient.
Not easy, but try not to get bogged down with 'what ifs'!

Keep us posted, ok?

Just to agree with Dorje.

Don't assume you HAVE to have an ovary removed- it might be a case of removing the cyst. The rule with cysts is remove if they are over 5cms and causing side effects or if they look suspect. But simple, smaller fluid filled cysts can be left alone and they often just go away (mine did.)

I'd ask lots of questions- if it's fluid filled they could maybe drain it and leave your ovary. Find out!

Thanks both of you for your guidance.
I have calmed down a little. DM and MIL were both well ... it's probably fine and I was in a panic.

Anyway CT scan is on Friday so they are gathering evidence for the decision.