HRT advice- am in a panic re Ultrogestan.

[SirVixofVixHall]

I've started taking HRT, after six or seven months without a period. I've been using the oestradiol gel, and now I have to take the progesterone tablets for ten nights. I forgot about having to take them at least two hours after food, and I ate supper really late. I suppose I need to leave it until tomorrow? I'm v anxious about the tablets, partly because they are tablets, rather than transdermal, and partly because I'm frightened of getting dizzyness, and migraines. If you've taken this were you ok on the tablets? is there not a transdermal alternative? I did have natural progesterone cream for a while , from a different clinic, but my Gynae says that it has to be the tablets as the cream can't give a high enough dose?
I'm just having a big wibble- hate tablets, as I've had reactions to things in the past, and I hate feeling dizzy or faint, for similar reasons - I need some HRT hand -holding!

I've been told by my dr that it really makes no difference when you take them. The leaflet seems to be designed to give a 'standard' method of taking and taking with food actually increases absorption which is a good thing re. the lining but may give some people slightly more side effects.
I always take mine with food- a tiny snack before bed - and take just after. Been doing this for 5 years.

You may feel a bit dizzy that's why you take them before bed.

You can also use them vaginally- just push them up last thing at night.

You'll be fine. :)

I use Oestrogel and Utrageston. I echo exactly what PollyPerky says it will be fine and you can use them vaginally. I must shove mine up my fanny now.

I can pop them inside me? ! !? The normal tablets?? Are there fewer symptoms from that then? How are they absorbed? Should I check with my gynae first? Am seeing someone experienced in menopause.

Nothing one can get that does the job in cream form then? I had bio-identical progesterone cream for a while during peri, but stopped over a year ago.

On the plus side the tip to whack them up the nethers has made me laugh through my terror...

I was told today by my gyno who specialises in meno that it DOES matter when you take the tablets; they have to be taken on an out stomach otherwise they are not effective.

As I’m fond of a snack before bed this is too much of a hassle for me so will be sticking with my Minerva which I can just forget about and it does the job nicely!

Oh. Was about to take them, but maybe I should wait a day? Find the idea of vaginal intake a bit less scary, but don't know if I should double check with my Doc.

I have taken then with food, it made no difference they still worked. Yes the normal tablets can.be used vaginally as well. I now always use them vaginally.

Yes PollyPerky and I have been on this regime for a long time. We both have gynaes who are Meno experts.

If use Utrageston for fertility rather than HRT purposes you do use them vaginally.

What's Minerva? Is it a coil like Mirena? (I would have a Mirena but the mere thought of having one put in makes me feel green and faint, anyway Gynae didn't mention it).

Mirena was awful for me. Utrageston is fine the best progesterone.

Around If you don't believe me, or my gynae who is an expert , do your own research. Look online. It says that Utrogestan taken with food 'enhances the bioavailability'. This means more is absorbed.
Here is the link. www.ncbi.nlm.nih.gov/pubmed/8513955
Here is the summary
Absorption of micronized P was enhanced twofold in the presence of food. Both absorption and elimination were dose-independent, dose proportionality being confirmed. Bioavailability of the oral P was approximately 10% compared with intramuscular P

Sir In France, using Utrogestan vaginally or even as a suppository is the norm. In the UK it's only licensed for oral use but all over Europe they use it more vaginally. Your GP is unlikely to know this.

What are the benefits of taking them vaginally?

(I currently swallow mine at night and invariably i have had somethng to eat just before haha)

I find less side effects. Eg sore boobs

It's very individual. Some women find it makes then wee more and they need to get up at night, others are fine.

I found that I was weeing more when I first used transdermal progesterone cream, but after a few weeks it stopped. I took the capsules orally last night, kept waking up but otherwise fine. I get aura migraines so I'm scared of that being triggered, I feel slightly muggy today, as though I might get a migraine, but I didn't get them when starting on TD progesterone, or when pregnant, so fingers crossed.
I haven't seen my GP at all re meno stuff, am seeing someone privately who was suggested by a good friend. Clinic in Dorset.

Are the capsules the same whether one uses them vaginally or orally, or should I ask about vaginal pessaries? Does vaginal have less of an impact on the liver?

Oh and Polly, maybe you know- I'm also taking thyroxine, which I'm used to taking at night too, is that ok with the Ultrogestan ? Doc didn't mention it.

Should be fine. I cannot see any reason why it would not be.

I don't see why it should be an issue- thyroxine is putting back what you would have anyway. There is always a list of contraindicated medicines on the leaflet in the box, and also online.

Sir I suffer from migraine and sometimes get one during the few days when the progesterone levels are falling- so at the end of the days when it's used. But I used to get that with a normal period anyway.

It can be a bit sedating and that's a known side effect.

There are no other capsules to use vaginally- the 100mgs is IT. They phased out the 200mgs ones about 2 years ago, so it's a case of using 2 tablets not one now.

Yes using vaginally avoids first bypass through the liver.

So they would just dissolve in the vagina? (they are such tiny little balls, don't they creep back out?! ). I don't get migraines very often so I haven't noticed a hormonal pattern, although I had a spate of them at one point a couple of years ago, and I did sometimes get one when progesterone would have been dipping, when I was using the cream and had forgotten a day or two. Seems a bit brutal for the body to have a high dose suddenly and then suddenly stop again, I wonder why they don't do an ease in/tail off again dose?

Yes they just dissolve. You use them before bed so they ought to have almost gone by the next day. Obviously if there is any 'action' going on under the duvet you can't really use them this way.

I suppose there is nothing to stop you tailing off the dose yourself; if you are using it for 12 days you could spread that over 14 and use only half the dose on day 1 and day 14.

I'm supposed to have them for ten days each month. Last night I felt a bit green and this morning I feel urggh and have the runs. I really don't want to feel like this for ten days out of every thirty. Maybe it will settle down? Maybe using them vaginally would stop the gut thing? I'm just loathe to use them in a different way without checking with the doc (I'm very rule abiding!) My capsules are small round things like pearls, are they the standard ones? I'm supposed to have dds friend round to play today (they're 10) and DH isn't here. I feel too green to get off the sofa. Almost feel as though I might throw up.

Your GP is unlikely to a) know or b) sanction it if they do because it's not licensed for vaginal use in the UK except for fertility treatment.
I'm not sure how to reassure you further other than say that many women in the UK do use it this way and it's the 'default ' way in Europe.

The digestion issues may settle down and they may reduce a bit if you take it with food. Progesterone usually causes constipation rather than the runs, so maybe this is just a one-off for you?