Gel and tablets dosage

[reup]

Reading another thread when dosages of theses were mentioned I wondered what people started on?

I have been given one pump a day of oestrodose. The dose is 1.25g - it’s 0.06% gel (0.75mg of
Oestriodol) .

The tablets are one a day of utrogestan (progesterone 100mg). But inside the packaging it says to take 2 a day for half a cycle!

After trying tablets and patches with various problems I really want this to work!

The dose is 2 pumps = 1.5mgs estrodiol. But you can start with 1 pump and work upwards,

If you are 12 months without a period you can use Utrogestan daily - 1--mgs - and this is called continuous HRT which is no withdrawal bleed.

If you are not post menopause it's usual to follow cycle of 12 days Utrogestan per 4 week cycle. So that's 200mgs from days 15- 28 usually.

Around 2-3 days after the last capsule you will have a bleed usually.

100mgs daily = continuous. 'scuse typo.

Thanks for that. I still get irregular periods - the dr said they would stop with these tablets. I think I’ll call them to query dosage.

Using continuous HRT during peri is no guarantee of periods being 'controlled'- your own cycle may override the HRT . Have a read of the site Menopause Matters under treatments/ HRT for more info.

Hi Reup - i am on the gel and use 2 pumps each morning. (i am 46 and peri - with irregular periods), i found 1 pump didnt work. As Polly says i take 2 tabs on day 15 for 12 days.

I recently had a natural period before the day 15 and now i am having a semi light tablet induced bleed. not ideal but there you go.....

i feel much better tho (as we have discussed on previous threads) x

Thanks everyone.

I’m glad it’s going so well for you Kalifornia.

I’ve left a message with the drs querying dosage. I have been taking tablets daily and for the last couple of day I’ve had a weird foggy headache but I don’t know if it’s them or I’m coming down with something. I’m not sure how I’d sync it with my cycles as the last two only had a 14 day gap.

Do you just spread the gel over a wide area to dry?

I’m so tired of all this - this is 4th type of hrt I’ve tried and now if the dosage is wrong it will be a while before I can get them to change it.

If you have a supply of utrogestan you can change the regime from conti to sequi yourself. It ought to tell you the dose in the leaflet, but it's 200mcgs a day for 12 days. You need to reset your cycle, and one way to do this is to start the Utrogestan on the 1st of the month for 12 days, each month.

And Reup - please dont give up - i have been trying different HRT since July, seen 5 different GPs, really had to argue my case, (thank you, Polly, for the wisdom!), spent a small fortune on prescription charges, been misdiagnosed amounts, thus creating more prescription charges, never mind the stress and time in the bloody doctors.... BUT it has been worth it. I now feel much more stable. It isn't a magic pill but i am grateful for a calmer state of mind.

Try the gel. I put 1 pump on back of my arms, allow to dry, then another pump. i find between the thighs takes too long to dry, but it's ok for the excess on my hands. dont forget to wash hands! write down in your phone calendar day 1 of cycle and take it from there. I take 2 utrogestan tablets in the evening as they're supposed to make u sleepy (they don't me). If insomnia is an issue take an anti histamine (my GP recommended that over sleeping tabs). 2 tablets is 200mg. check your packet.

let us know how you get on xx

Thanks - I saw the drs again today and she said one tablet a day is the right dose and I’ve got to have 1 pump a day for 3 months and then they will look at upping the dose.

Kalifornia - did you feel any change on one pump of the gel? If I feel slight improvement on one dose they might up it but if none then I think they’ll stop it.

I explained about both instructions on the meds boxes being so different. I already changed practices in the summer because of this (my last gp gave me tablets on a low dose and when they didn’t work gave me anti depressants because I didn’t have hot flushes).

My sleep has been a bit different - groggy for a couple of mornings with a fuzzy head in the day then I barely slept last night. So at the moment I’m just feeling worse!

Your GP is wrong. 100mgs a day is for continuous HRT. Unless you are post menopause this is not the right dose. Most GPs are clueless over HRT. But when the dose is on the box I'm baffled why they insist on giving you the wrong information!
This is the info online:

The recommended dose is 200 mg daily at bedtime, for twelve days in the last half of each therapeutic cycle (beginning on Day 15 of the cycle and ending on Day 26). Withdrawal bleeding may occur in the following week.

Alternatively 100 mg can be given at bedtime from Day 1 to Day 25 of each therapeutic cycle, withdrawal bleeding being less with this treatment schedule

[This is the post menopause regime for women who have not had a natural period for 12 months or more].

The side effects of feeling groggy are due to using Utrogestan daily. I tried for 3 weeks (and I was post meno) and went back to a sequi regime.

You should also be using 2 pumps of gel as that is the starting dose. If there are reasons why this is not medically suitable for you your Dr should explain why.

I’m not really sure what to do - if she’s not willing to follow the instructions in the box she’s not going to listen when I’ve said I’ve read it on the Internet.

I can’t change GPS again - I don’t have any leave left at work for the endless blood tests and checkups that entails. She runs the well woman clinic and is meant to be the resident menopause/hrt expert there.

I suppose I’ll try her regime for January and if there’s no change I should have enough to follow the med instructions in February ( I was meant to be given 3 months worth). And if that works I can go again and argue for more in March. I couldn't be bothered to take either last night as I felt so crap about it all.

Have you actually said to her that the 100mgs a day is the continuous regime for women who are post meno? Also, the continuous dose is not daily, it's 25 tablets as shown on the leaflet.

There is a lot on the Menopause Matters website about when to use conti HRT. here is the link

menopausematters.co.uk/postmeno.php

My guess is she simply doesn't know the difference; you need to have this conversation and not be bossed about! No need to be aggressive but have a conversation with her.

OR there is no need for her to know you are using the sequi regime. You will have enough Utrogestan to do 200mgs x 12 days = 24 tablets.

You should also be using 2 pumps of gel. 1 pump gives you less than 1mg of estrogen. That small amount PLUS the daily progesterone is the reason you feel rubbish with it all. The leaflet says that the starting dose is 2 pumps. I'm sorry but your GP seems clueless.

I said some of that yesterday I’m not sure when my cycle is now as it’s been fortnightly recently.

I would have enough tablets but not enough gel.

I feel like I’ve been fighting this for so long and have endless appointments for that and other health issues , dental issues and my sons both have health / sen issues that take up lots of time and mental energy. I just don’t think she will listen to me if she took no notice of the medication instructions.

I have no idea of your circs or where you live but to be honest with treatment like this you'd be better if you could pay for 1 private appt with a menopause gynae and they would write to your GP with the dose etc they advised. It makes me so angry to read about women like you being given rubbish treatment on something which is well within the grasp of a GP.

You could send an email to Dr Currie at menopause matters for £25 and she would reply ; you could show your GP.

I don't want to sound aggressive but have you actually asked her why she says 1 pump when the dose is 2 pumps? I'd be asking lots of questions at the appt, because you need reasons why she thinks this regime is best (when it's not the dose.)

I was instructed by a consultant to start with 1 pump and see how it helped and if not to increase until it did. I upped the dose after about 2 weeks, but it was left to me.

The point is with you, the daily Utrogestan is actually negating all the benefits of the gel.They need to be balanced.

I think she was thinking of upping it to 2 if it didn’t work.

I’m not sure how many tablets to take if I change it to half a cycle as I’ve been taking it daily since Saturday (but not last night)

Thanks for all your responses I’ll have a think about it all and what I can afford. I’m in west London.

It's unlikely to work if you are also taking Utro daily. Some women on other forums said they upped their gel to 3 pumps during the Utro cycle.

I can see why you would start with 1 pump to see if it helped, BUT it's more usual to say try that for a few weeks and then increase if needed without having to see the dr again . Most women get 3 months' worth, not one month, because medical advice is a 3 month trial of any kind of HRT.

I’ve got 3 months worth of one pump dosage (basically one bottle) and then I was meant to go back and see her and then decide whether to up it. I can change my tablets to the dose on the box without having to make a new appointment but if I up the gel by myself I’ll run out after 1.5 months.

No you've not got that amount!

The pump has 32 applications (@2 pumps a day) so that's 64 days @ 1 pump daily. That's 2 months.

One bottle is supposed to last one month (32 days.)

Thanks - that’s quite good then so I’d have to go back earlier to get more then anyway even if I’ve followed her instructions exactly.

Everything Polly said.
and in answer to your question -
My GP suggested trying 1 pump but it did nothing - 2 pumps works.

Keep trying Reup
x

Forgot to add - i added a little extra yesterday (more than 2 pumps) as i've been flushing a lot.
i'm not dead yet.

Thanks Kalifornia - when you were recommended anti histamine if the tablets wouldn’t let you sleep did your go say how much?
I didn’t think my sleep could get any worse (I’ve been waking up btw 4 & 6 for several years) but now I can’t get to sleep either and wake up a lot- neither of which I did very often before.

I’m not quite sure if I start taking 2 tablets a month for half a month - instead of one a day should I take a 2 week break before or go straight into it?

I tried 2 lots of gel the last 2 nights.

It doesn't matter when you take 200mgs Utrogestan if your cycles are irregular. Bear in mind that after the 12 days you may have a bleed, (starts 2-3 days after stopping) but as you are only on 1 pump gel (or were) and have been taking Utro daily till now, there may not be a thick enough lining to come away yet, so you may not get a bleed till your next cycle.

I wouldn't worry too much about when to start taking it, just take it and your cycle will reset itself.

BTW Woman's Hour today was about menopause and HRT!