Utrogestan intolerance?

[collywobble]

I started taking HRT 3 months ago Sandrena gel 1mg and ustrogestan 100 mg vaginally for 12 days ( I know I'm intolerant to it after a bad experience with the mirena coil) initially felt really not much difference. I felt slightly more energetic and happy when taking sandrena so my gp increased my sandrena to 2mg gel . This month however when I started taking the ustrogestan I have felt 10x worse than I normally do leading up to my period. My boobs are painful , my mood is horrible, I'm tearful and argumentative and my partner although supportive has said I'm much much worse on the run up to my period than I was before taking HRT . I'm assuming this is my intolerance to progesterone rearing it's ugly head again as I do feel better during the estrogen phase but as I wanted HRT to help with my mood I don't know what I can do . I've always been very hormonal . Any suggestions? Is a hysterectomy the answer ?

I was on 100mg vaginally for 7 days a month (I attended Studd clinic) - after much tweaking of doses this was the lowest I could be given and I had a heavy period every month regular as clockwork. I was also having annual scans.

I can only imagine that I would have been suicidal on 200mg x 12 days. The Mirena made me feel terrible.

Like the OP I felt good on oestrogen (in my case Oestrogel) and 0.5ml Androfeme too.

I initially attended the clinic due to PMS - I suspected I was peri but I was only 42. In the end I had a hysterectomy because I was so intolerant of progesterone (my own as well as Utrogestan!) I really did try so many other things, too many to list over the years. I also had a really healthy lifestyle (exercise, diet, sleep etc)

I was able to go private and I appreciate not everyone can do so. For me it is life-changing to have my periods and PMS (probably qualified as PMDD) finished forever. I continue to take Oestrogel and Androfeme.

@Lollypoppyflop No one needs to be qualified to know any of this- it's all online in scientific research papers if you want to spend a few years reading them - look up Utrogestan dosage- as I have. This is partly for my own use as I've used HRT for 12 years (Utrogestan for 7 years) and my meno consultant is one of the top handful in the UK (and not Studd who I don't rate.) They answer all my questions.
I also write health articles for the media (websites , print) and have to talk to medical experts for information.

You don't need to be medically qualified to know that GPs can only prescribe within the guidelines. Any GP who deviates from that is putting their professional integrity at risk.

Studd's website is out of date anyway.

It wasn’t a criticism. I’m sure you’re knowledgeable.

I’m sorry to ask a question on your thread op- I hope it’s ok?

I’ve been directed by my doctor to take 2x 100mg of Utrogestan per night (so 200mg) orally for 14 days and then have 14 days off.

In conjunction with this she also prescribed me 4 pumps per night of Oestrogel ....I’ve already reduced this to 2 pumps per night as it was way to much ...the oestrogel is to be taken every night continual.

On the Utrogestan, I am bleeding approx day 10 and I feel pretty awful. Can I adjust how often and how long I take it without limiting the benefits?

ok :) @Lollypoppyflop

It's worth reading this leaflet from the C&W hospital. There is a section on progesterone intolerance. www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/links/ProgestogenandProgesteroneRegimensinHRT130518AGREED.pdf

What is says is that any deviation from the standard dose should be done under supervision from a specialist. This means that GPs are not really supposed to read a specialist's website and start prescribing what they do :)
That is because within the NHS there is no Plan B is something goes wrong.

When I first started using Utrogestan I was concerned about using a lower dose (I use the 200mgs x 10/11 days but not every 4 weeks.) Therefore I paid for private scans roughly once every 18 months costing £300 a time. This was for my own reassurance.
The NHS won't offer that.

So although I think it's fine to go outside the prescribed regime, you do need to be aware of the fact your GP can't monitor it, refer you for scans and tweak the dose, in the same way that a specialist is allowed to.

Thank you @Lollypoppyflop

That’s really helpful!

@JinglingHellsBells I felt I was in good hands with Mr Savvas at the Studd Clinic and it's too late for me to try anything else anyway as I've had a hysterectomy, but I'm intrigued that the Studd clinic regime has been discredited.

Can you speculate as to what else I could have tried for my PMDD? What do other clinics recommend? I feel like I tried all the other options! Thanks

@hippospot Mr Savvas is not Mr Studd :) I'm sure he is good. If you are now sorted, I can't see any point in speculating over what may have helped.

The point I was making was that a GP is on dodgy ground adopting the regimes suggested by a controversial specialist who's prescribing regime is at the far end of what's considered safe.

Imagine the scenario...
a woman is sent for investigations for odd bleeding and found to have cancer.

The questions asked are' what regime of HRT did you use?'

The woman replies that her GP had followed some online dose she'd seen a specialist write about on his website.

Can you imagine the professional consequences for the GP for prescribing off-label and it resulting in a patient being very ill?

I don't know how the GP is comfortable with that. She ought to refer her patients to consultants if they need a different dose and then at least they are covered by the consultant's expertise.

I was using HRT patches and Provera but had side effects. I am giving the HRT another go due to lack of sleep. I've just started taking Utrogestan with the patches.

Does it start a bleed even if you have irregular periods? I think mine are about finished.

Sorry OP, I've butted in with my question

I had a hysterectomy for progesterone intolerance

I meant to thank @JinglingHellsBells 🙏

Oh thanks :)

Hi my gp has prescribed utrogestan 100mgx 2 daily day 1to 14, on the leaflet it says day 15 to 26? Is this right, does anyone know? Thanks

If you are still having periods, it's better to try to take it mid-cycle (day 14 ish) when your own progesterone is rising.

If your periods have stopped, you can take it any time as long as you stick to 14 days in every month and keep to the same day each month.

So if you start on 20Jan, you'd start it again on 20Feb, etc.

Thank you for replying 😊so I am still having periods......very occasionally! So if I start my first patch on Monday - changing twice weekly then on day 14 I start the utrogestan - for 2 weeks? Then I should have a period? Thank you