utrogestan continuously if still having periods?

[ladygindiva]

Prescribed estrogel and utrogestan; former daily and latter to be taken 12 days of cycle etc. Feeling relief from some symptoms ie heartburn, general mood, aches and pains , unexplained fatigue, all these vastly improved, all good. However my main symptom that has been driving me CRAZY for a couple years on and off is insomnia accompanied by a rumbling tinnitus during the night that keeps me awake. Alot. Could be pulsatile tinnitus, I don't know. Its like a vibration in my ears. Its worse as soon as my period is over and can last about 10 days, which can mean 10 consecutive nights with barely any sleep. Thats where I'm at right now; 8 nights with just the odd hour here or there. I'm on my knees. However; the 12 nights I was taking the utrogestan I had THE BEST SLEEP EVER and I felt ok too; contrary to other peoples experiences on progesterone treatment. Pre hrt my worst time of the month was the classic 10 days beforeand during my period but now those days are my best! My query is can I, as a still ( slightly erratically) mentruating perimenopausal woman choose to take 1x utrogestan once daily for 24 or whatever days of the month instead of having it 12 days only? I'm thinking it would mean twice as many days of possibly sleeping better. Or is this system of taking utrogestan purely for women who have ceased mentruating entirely? My period still arrives monthly, though I was missing the odd one pre hrt and the cycle varied from 27 to 50ish days if it did arrive.

@over50andfab There is a paper from 2005 written by Campagnoli (and others) on progestins and progesterone in HRT and breast cancer risks. NCIB publication online.

There is also the French research paper E3N which concluded the same (and this may also be included in the above research.)One criticism of that research is much of it was observational. There is also a Danish study which was carried out over 8 years and showed similar stats. I think it was done on HRT and heart disease but BC was part of the stats overall.

There is very little that is more recent for users with more than 5 years' use. You will find that data in the Lancet report but it is limited to 5 years' use and says no additional BC using Utrogestan for that timescale. Louise N mentions it on her site and it may link to the actual research.

One reason for lack of research is so few women (previously) using Utrogestan and lack of investment / interest in it from pharma companies. I am not aware of any ongoing research although I know consultants are asking for it!

BTW Most consultants are using the figure of 4 extra cases per 1000 women per year but this is based on the old data and does not differentiate between progestins and progesterone. There is also a reference on L Newson's website under HRT/ BC where the authors say there is no absolute proof of a cause-effect with HRT but neither can they be sure there is no link.

The latest message from consultants is that in some women, HRT causes the growth/ acceleration of an existing cancerous cell, but it does not cause normal cells to be come cancerous.

So if I decide to start taking utrogestan continuously do I just start today? Due to start my next utrogestan 12 day phase on 1st of the month.

Ah I think we’ve read the same studies and information Jingling (and on BC risk generally), and similarly concluded that more research needs to be done on Utrogestan. At least we know that, being micronised, it’s the safest of the progesterones to use.

I’d love to see a study done using different ways of administration. Some women in other countries use it anally though this isn’t recommended in the U.K. Any ongoing studies are more related to pregnancy and miscarriage.

@ladygindiva

So if I decide to start taking utrogestan continuously do I just start today? Due to start my next utrogestan 12 day phase on 1st of the month.

@ladygindiva you’d be best switching to continuous HRT after your period finishes, when the womb lining is at its thinnest. You might get some bleeding/spotting in the first few months but this should hopefully settle down.

But my period finished 10 days ago and I'm due to start taking utrogestan in 4 days anyway... I usually come on about 10 days after starting the utrogestan.

@ladygindiva

But my period finished 10 days ago and I'm due to start taking utrogestan in 4 days anyway... I usually come on about 10 days after starting the utrogestan.

See P.14 where it explains when and how to change from sequential to continuous HRT. www.northoftyneapc.nhs.uk/wp-content/uploads/sites/6/2017/03/Menopause-guideline-14-8-2017-APC-approved.pdf

I'm 10 days in to my first pack. My gp said take it for 25 days, 5 days off. I'm on 2 pumps of gel but can build it up to 4 if necessary over time. I was having regular but erratic periods, some heavy some just spots.

@ladygindiva

But my period finished 10 days ago and I'm due to start taking utrogestan in 4 days anyway... I usually come on about 10 days after starting the utrogestan.

Wait until you have had another full bleed then start daily with it.

Thank you all x

Has anyone switched to mirena for the progesterone bit? I take utrogestan days 14-28 but I'd be happy not to have the hassle of remembering it or periods.

@melonhead

Has anyone switched to mirena for the progesterone bit? I take utrogestan days 14-28 but I'd be happy not to have the hassle of remembering it or periods.

I’ve used the Mirena, first as contraceptive and then as part of HRT. It’s great in that it’s fit and forget for 4-5 years and it also stopped my really heavy periods and can be useful in helping with fibroids. However the downside can be not knowing if and when periods stop naturally and when we reach menopause.