Vaginal utrogestan

[Betty6]

My Dr has said if utrogestan orally makes me feel sick then it is safe to take vaginally, although it isn't licensed this way. I've read a lot of threads on here where people do that. She didn't say use less though just 100mg continuously as post menopausal, but on Dr. Newson's site it says

'Another way to take progesterone is to insert the tablet vaginally, at night time. This then works locally near your womb, where it is needed, and is not digested or absorbed into your whole body, so there is less chance of side effects. The dose of using progesterone this way is half the oral dose (so, for example, you can use one 100mg Utrogestan capsule vaginally alternate evenings). While the drug is not licensed to take in this way, it is perfectly safe to do so and there is good evidence to support its use this way'.

Is this still good guidance, 100mg vaginally on alternate nights?

Although the Newson site suggests reducing the dose, this is not widespread advice yet. some studies have been done which show it's effective but there are some issues here

1 vaginal use per se is not licensed in the UK other than as fertility treatment

2 most women in the UK don't use it that way

3 women being treated privately by Dr N and others can access scans as routine 'check ups' (for about £300) to make sure all is ok. The NHS will only do scans if there are any problems.

If you do go with the alternate day dose, you ought to be prepared to arrange a scan every 12 months or so, and be aware that you might get breakthrough bleeding which would then mean going back to your GP and saying you had reduced the dose on the basis of online info.

It is probably safe but a lot depends on the estrogen dose, how much you absorb and so on.

Thankyou Jingling, much appreciated.

'a lot depends on the estrogen dose, how much you absorb and so on'.

2 pumps oestrogel. I've just looked on Menopause Matters site and alternate nights seems quite common when on continuous utrogestan.

I'll put my name down on the waiting list for Dr Newson's clinic and also arrange annual scans but in the meantime with a relatively low oestrogel dose should I take alternate nights? Sorry I know you can't say for sure, I'm just worried I'll be getting too much progesterone.

Also my GP said stop topical oestrogen for VA but surely there'll be a few weeks crossover time as my body gets used to systemic oestrogen?

Please remember @Betty6 that Dr Newson's patients are private. They can have scans to check the lining.

I use Utrogestan vaginally from a consultant who is far more qualified and experienced than Dr Newson (she holds him in high regard!) and he's never suggested reducing the dose. I use it on the basis of the licenced dose, but a slightly longer cycle than 4 weeks.

You can't get too much progesterone. If it makes you feel terrible then you need to think again and maybe even try something else like the Mirena.

2 pumps of gel is a medium dose. It's 1.5mcgs a day.
Tablet form starts at 1mg and then goes up to 2mgs.
Patches can be lower than gel.

Your GP is wrong about stopping vaginal estrogen. I despair at times.
1:4 women need to use both, Why are they saying stop?

'You can't get too much progesterone. If it makes you feel terrible then you need to think again'

Thanks so much for this. Reassuring to know you can't get too much! No I feel ok on it so far but it's early days I'm wondering if I may feel rough at some point, or if intolerant is it pretty much from the word go that women struggle? I like it so far, seems to calm me down, I'm sleeping like a log and my heart pounding has stopped yayyy.

I know! GPs really do need to up their game here, yes they of course prescribe for a whole myriad of conditions but something as common as menopause and HRT should surely mean a comprehensive knowledge is needed.

Hi Betty6,
Came across this post researching utragestan and oestrogel continuos regime.
I am 48 no periods for 11 months and suffering from hot flushes, night sweats terrible moods , 0 libido and more .
Gp has prescribed utragestan 100 mg and 2 pumps of oestrogel , after extensive research i too came across Dr Newton advice to use utragestan vaginally on alternate nights ( mentioned it to my gp but she wasn’t aware of this ) .
As i am terrified of progesterone side effects i have just started utragestan on alternate nights but i am anxious is this ok for everybody as a first way of hrt ?
May i ask how have u felt since taking like this?
I only started a week ago and so far no benefits at all …

Having found oral progesterone to be intolerable, I"ve been to my GP to suggest trying it vaginally based on what the newson clinic says online & other's mentioning it in various forums. she said that the 100mg a day made sense to her. So she said go for it.

Have put my name down for the newson but there's a really long wait.

Who is your consultant @JinglingHellsBells ?

Hi Perichristmas, may i ask did she dismissed completely he every other night only of utragestan 100mg?
May i ask what dose of estrogen are you on
And can you remember how long after starting treatment your symptoms eased up?
Thanks

@sarafifties I have only just stated a month ago on Lenzetto - the oestrogen spray pump. I am peri & still have regular periods. I wanted to try it for various symptoms. One of which was aches in my joints & stiffness. I was completely blown away by the fact that my aches and pains felt better upon waking up after one day of the oestrogen!

I'm 46. So as I still have periods, the recommended dose i was told to take is 200mg Utrogestan for the second 2 weeks of my cycle (days 12-25). I could only manage 3 days. Felt horrendous.

So stopped taking everything. Until next cycle started last week when i have started the oestrogen pump again and will try the utrogestan from day 12 vaginally. I had seen lots of people talking about this online. Apparently it's how everyone in France takes it routinely.

I'm planning to take 100mg as this is recommended by the newson clinic, and am on a waiting list to speak to them. But my gp said she'd go with that. Surprised me actually.

I will let you know if it works!

@Sarafifties

Hi Perichristmas, may i ask did she dismissed completely he every other night only of utragestan 100mg? May i ask what dose of estrogen are you on And can you remember how long after starting treatment your symptoms eased up? Thanks

So I didn't ask about every other day. And I'm on one pump of Lenzetto - each spray contains 1.53 mg estradiol.

@PeryChritsmas,
I am on a continuos regime as haven’t had periods in almost a year and it’s only in that case that Dr Newton advocates the use of every other night as you dont stop taking it as you don’t get periods .
I use the oestrogel and done so for a week , i haven’t felt myself for over almost 2 years ( coincidentally when my periods started being irregular) , back then i thought i was too”young” to go through the changes and i was just feeling down .
At the beginning of the year i had a blood test as i was very tired , almost depressed and had more migraines than usual , gp told me i was perimenopause but no treatment was offered, it’s only now when i started having unbearable hot flushes with palpitations during the day being woken up 5-8 at nights by palpitations and night sweats ( on top of all other symptoms i was experiencing) that i decided to speak to a different gp who after looking at a almost year old blood test she said that i was full on menopausal!
After 9 days on hrt i feel last night was better only woke up 3 times and had 4-5 flushes today compared to 5-10 a day .
If i knew what i know now i would have started much earlier.
It’s great that you have started now and won’t feel overwhelmed when all tge symptoms kick in !
I looked too at Dr Newton website and she’s got a big team of Drs and nurses that work in the clinic, is the waiting list only if you want to have a consultation with her specifically?

@Sarafifties i think the waiting list is to see anyone at all.

Hello

Hi,
Reading all your comments made me feel that I'm not alone in this journey! I started hrt 3 months ago after seeing a private dr as I have been going through a lot of the perimenopausal symptoms. Was put on 2 pumps of oestrogel and 200 mg utrogestan orally for 12 nights-I felt much better straight away. Utrogestan gave me severe vertigo but made me sleep like a baby which is good but unfortunately I had to stop due to the vertigo and other unpleasant side affects. My question is this, and I know many are confused as to dr Newson's advice: my dr told me to use the utro vaginally same dose 200 mg for 12 nights, but because of the advice given by dr Newson to half the dose ie 100 mg/12 nights, I am very hesitant to do 200 mg a night! Why take extra progesterone when half is should be enough? Has anyone of you reached a conclusion? Has anyone seen a specialist and told them anything to back this? According to the Nice guidelines its 200 mg vaginally as I was told by a menopause dr on social media.

@MeemoBeemo777 If you look down through the threads, I posted on this exact topic last week. I think the title thread was Utrogestan- vaginal use/ dose.

New directive from British Menopause Society in October 2021. Another poster left a link to it which I saw.

The new directive is to use the same dose vaginally as orally. So that's 200mgs x 12 days.

Some new research has shown it's best to stick to that dose, not half.

HTH

ps I've never been advised by my specialist to use half, and I've used it vaginally for some time.

Many thanks just saw your previous post. I feel more reassured 🙏🏻

@JinglingHellsBells I’m new on here and have seen your thread about using Utrogestan100 capsules vaginally instead of orally. You’re the only person that makes me feel fine about doing this - so thank you 😊. My doctor had to refer to her little book and didn’t make me confident about it. The pharmacist locally didn’t really know and suggested I contact the manufacturer! So I’m on 2 pumps of gel a day and inserting the Utrogestan 100mg every night with the syringe I think you mentioned on another thread (the estrogen cream 1% one). I’m on one capsule per night - would that be ‘halving the dose’ to you? The other lady @Betty6 - are you on 2 capsules? Thank goodness for Mumsnet 🙌🏻 😊

Yes exactly good point!!

I’m on 200 a night vaginally for 12-14 days a month (cyclical). Been doing this for 1.5 yrs now. My specialist asked me to switch to 100 daily but these don’t have a syringe, only the 200 one come with a syringe. Any suggestions?

@MeemoBeemo777 You just insert them with your finger. The applicator isn't necessary. The majority of women using it vaginally use 100mgs as the 200mgs isn't actually licensed as HRT (although some manage to get it prescribed.)

Utrogestan taken vaginally
Is absorbed through your body & into bloodstream. Its absorbed twice as much as it dies not have to pass through your liver or into your other organs. New studies now show that many more benefits when taken vaginally.

New studies now show that many more benefits when taken vaginally.

@Seb23 Can you link to these? Interesting!

Hi ladies I know this is an old post but this is all new to me,im so anxious of starting HRT,and just by reading all the side effects of taking utragstan orally has made me not start it,my oestrogen is very low and I know I need to start HRT but I can’t risk my mental health being worse,I have the gel and the capsules can I ask is these exact ones you insert vaginally or is there another one that’s prescribed for vaginal use with an applicator? I will worry I won’t push it up far enough and it won’t be protective of the womb
thank you ladies xx