Why would i be on Conti regime in perimenopause ?

[Discoisabelle]

Hello ladies, just got back from my 3rd month review after having taken Femoston + 1 pump of Oestrogel day for 3 months. I asked meno lady to put me on a different regime : to increase to 3 pumps a day with Utrogestan 200mg for 12 days. She agreed that it would be A good way to go on. She then asked me if i had bled on Femoston. I said no. Some mild period pains maybe every now and then. She suddenly decided to change her mind and said she should put me on conti as no period on Femoston. I told her that i had a period every 3-5 weeks before HRT so i know i am still peri, but she insisted. I panicked as i haven't studied or read enough on conti regime so obviously was not able to argue the point. However i am not a Yes Girl so i did say i wanted the oestrogel & Utrogestan for the next 3 months then re-assess with her after. Why does she want to put me on conti if i am still peri ? Wouldn't it mess up my natural body cycle ? Is there not a good reason for putting ladies on sequi for peri and conti for post ? Your answers and experiences much appreciated.

sounds as if she's a bit confused.

Between 10-15% of women don't bleed on sequi. No reason, they just don't. Something to do with the estrogen receptors in the uterus.

Sequi HRT (with a bleed ) resets your cycle so you have a withdrawal bleed. NOT bleeding on sequi doesn't mean you are post meno because that's classed as not having a natural period for 12 months.

Looks like she is confusing / conflating no-bleeds on sequi with no bleed= naturally post menopause. Doh!!!!

In theory there is no reason for anyone ever to take conti HRT. There is a slightly higher risk of endometrial hyperplasia/ cancer with sequi but this has to be balanced with the risks of using a synthetic progestogen every day (which appears to increase breast cancer risk.)

If you want to take any type of conti then Femoston would be the best of the lot because the progestogen in it is (it appears) less risky re, breast cancer than others (but not Utrogestan.)

BTW this is all in the NICE guidelines in various links and references (the small print) or you can find research papers on 'breast cancer risk and type of HRT/ progestogens'.

Polly thank you, glad i wriggled out of her suggestion ! I have another question : she gave me Utrogestan x 2 for 12 days to insert vaginally, i looked in the box tonight and these look exactly like peas, same round size (without the colour!), but there is nothing to help me insert the 'peas' , so obviously i will need to use my finger/s but how far in the vagina do i go ? Sorry if i am being too graphic , i was thinking allowed tonight at dinnertime about it all and DH said between Vagifem, estriol cream and Utrogestan it's like being at the chemist down there !

Interesting that she said ('did she?) to use them vaginally. This method isn't licensed in the UK ( though IS in other Euro countries) but of course no one can check up! My consultant gave me the choice but that' s privately not NHS.
Sooo- as far as you can is the answer! Right up to your cervix so it's absorbed well. yes- won't be much room for much else some days
Some women say they buy a thrush pessary and use the applicator for Utrogestan.

how hilarious !!

Yes she actually suggested vaginal utrogestan and i was surprised as i only read it on forums and never in articles or instruction booklet.

Thank you for your interest in my posts Polly, each time you have helped (and you REALLY have) i feel i should pay you a fee or take you for a bite to eat as a thank you !

ha! Pleased to have been of some help :)

" I have another question : she gave me Utrogestan x 2 for 12 days to insert vaginally, i looked in the box tonight and these look exactly like peas, same round size (without the colour!), but there is nothing to help me insert the 'peas' , so obviously i will need to use my finger/s but how far in the vagina do i go ?"

I agree they are bloody minute - much smaller than peas and much more annoying to insert than the 200 mg capsules which used to be supplied as part of HRT. As PollyPerky says you just poke 'em up but sometimes I almost lose it in between getting it from the packet and doing the insertion!

However the good news is that if you want to there is a 200 mg vaginal version available - exactly the same as the HRT version - but is used for fertility - and some doctors prescribe this instead. If your doc has actually suggested vaginal utrogestan, if you prefer you could ask for these - and I think they often come with an applicator too. The only reason I haven't asked for them is that I ease myself into my Utro cycle gently with 2 x 100 mg for two days either side of the 200 mg doses so the rise and fall in prog isn't quite so dramatic