Utrogestan…really liking it?!

[jewelsandbinoculars]

Hi all

I’m 44, been suspecting peri for a couple of years now. Night sweats, but brain fog, low mood and increasingly black/bleak moods in last 7-10 days of cycle (still pretty regular). GP has been great - she doesn’t have a great deal of personal expertise but was v supportive of desire to try HRT & recommended trial of 2 pumps Oestrogel & Utrogestan (for 12 days of cycle) and monitor how I’m doing. I’m just in third month now. After all I’d read beforehand I’d expected to lurve the Oestrogel and struggle with the progesterone but it feels the other way round for me. Gel only days I feel as foggy as ever (if not worse), plus dizzy and spacey. Whereas with progesterone I feel calmer, clearer, more competent. Significantly reduced pmt, too. Ive tried to avoid being too reductive about symptoms and causation but this is third month that it feels like I’ve just flipped a switch. Anyone else this way round? Isn't this the opposite of the “norm”. Does it mean I can/should just shelve the oestrogen? And if so can I keep taking the (lovely!) utrogestan? Any thoughts or insight from those more experienced would be so appreciated.

This is really reassuring to read, we hear so many stories of how some people struggle with side effects of utrogestan.

I'm no expert and others may advise but maybe you only need 1 pump of oestrogel? I think you can go up and down depending on effects.

It’s worth carrying on with the oestrogen for the protective brain, bones and heart benefits but agree with pp that you could try reducing your dose. I also have not had any issues with utrogestan.

You can't just take Utrogestan @jewelsandbinoculars. That's not using HRT!

The main component of HRT is estrogen. Women with a womb need progesterone to protect the lining from getting too thick with the estrogen.
At 44 you may well need more estrogen. Younger women often need more.

You could experiment by dropping down to 1 pump for a few weeks, and if that heps, fine. Otherwise increase slowly to 3 pumps.

I started on sequential but when I put on weight they changed me to gel and tablet still sequential. The days I stopped progesterone were hell. I'm now taking it daily and life and sleep are much better.

I'm the same! Initially when I start the oestrogel it was fantastic but 3 months in, oestrogel alone isn't working for me. Still anxious and sleep is poor. However, the progesterone works a treat. PMT is non existent and sleep much better.

I'm not sure whether I need to increase or reduce the oestrogel? I've increased from 2 pumps to 3 in the hope it gets better?

hi,
I am so pleased to read some positive reviews.
im due to start utrogestan tomorrow-I was really worried!

I didn't get on with it at first so used vaginally, same dose, with Gp agreement. It was the oestrogen that was fab. However now, a year later, I really do like it and take it orally, no issues.

I'm the same, my doc started me on 2 weeks utrogestan and a 2 week break but on the days I didn't take the Utrogestan I literally cried and felt miserable. I lasted 3-4 days! I googled like hell and found I could take it consistently so I popped one in and within hours felt happy again. If you take it vaginally you can halve the dose.

I did notice after a year I had anxiety and again after googling I realised it may be too much progesterone, I read you can take it every other day if it's continual which seems to work for me.

I get my info from Dr Louise Newson and her Balance app. There's no point asking the GPs as frankly they are totally clueless, I've educated them more about HRT than they knew themselves and send them links to the evidence and they agree to what I'm suggesting.

Always take it at night as it helps you sleep. I have oestrogen gel alongside.

I would make sure you're not taking too much Utrogestan if you still feel anxious, see my previous post

It’s really positive to hear good utrogestron-I am really worried about taking it tonight.

If you take it vaginally you can halve the dose.

BMS now say it must be the same dose.

Take it a couple of hours after food and it should lessen any side effects.

I've seen some women in menopause matters on a higher level told to take it with food as absorption is increased several fold if they need more.

A colleague is on continuous as post menopausal and has just always taken with food and loves it as it helps her sleep (she's a snacker!)

I could have written this! I too love the progesterone days. It even clears up the awful eczema I've been having since the birth of my daughter.
I also thought I could maybe reduce my gel to 1 pump per day but I soon saw a return of some horrid symptoms.
Enjoy the progesterone but I have read that if your gel-only days don't feel great then you may need MORE, not less. I was surprised to read that younger women often need more supplementation than older women which I thought would be the other way round. I'm going to go up to 3 and see how I go.
I'm considering the mini pill also for contraception but also to try and smooth out the bumps further.

Do you know if I can sneak some progesterone in on the days I'm not supposed to be taking it? I have long suffered badly in my follicular phase. Last month I got desperate and popped a utrogestan orally for a few nights in the first half of my cycle and felt loads better. Can I do it vaginally and is there a benefit?
Also - I do take it on an empty stomach but do I really have to or is that to stop me being too drowsy> Any help much appreciated. I have a GP appointment on Thurs but I'd rather go armed with sensible suggestions that questions.

As Warrior mentioned Utrogestan used vaginally should be at the same dose as that taken orally unless under specialist advice. To do otherwise risks endometrial protection regardless of how we feel taking it.
Source is here, see bottom of page 4 thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

Bats I discussed a lot of similar things with my Gp - she suggested continuous in the summer as id been on hrt nearly a year and was having v light irregular periods. I know that's not always necessary but I've since found I do do better with progesterone. And now orally despite starting it vaginally as it made me too drowsy even 2 hrs after food.

We compromised with a 25/3 regime - she said there's a lot of playing around with what works for different women . She said even the "experts" don't always agree. I'd asked about the pill as an option to even out the ups and downs but she was as happy for me to remain on utro for that reason. I suspect she's a rare v clued up Gp though.

You can have a lot of spotting and irregular bleeding that's the only main issue. It can be doubled ti help this as per BMS guidelines for higher oestrogen doses.

@BatsAtHome if you start messing about with when you take it you’ll start getting withdrawal bleeds all over the place.
The benefit of using Utrogestan vaginally (which is off license) is for women who don’t tolerate using it orally. It helps protect the womb lining in the same way which is the point of taking it and when used sequentially induces a withdrawal bleed when stopped every month.
The reason it’s suggested to take it on an empty stomach is to prevent increased side effects, however in practice some women get more eg feeling more drowsy and for others it makes no difference.

Thanks @Over - I've had no bleeds outside of the one-per-month as expected. I only snuck a couple extra utrogestans in last month (in the first half of cycle) and had no withdrawal bleed from that. The symptoms, when I get them, are debilitating - so if it's spotting vs fatigue, nausea, brain fog, anxiety and flu-like body aches I would take the former. I just wondered if it's bad for me in any way to pop a few mid-cycle.

That's interesting!

The thing with people taking lower doses of progesterone under private doctors is that they are monitored more closely for changes to their womb. I'm worried about messing with the doses.

Thanks for all your advice ladies.
I’ve taken the progesterone tonight-we shall see.

Dr Louise Newson says you halve the dose if you take it vaginally

I think that advice has been updated and you now take the same dose.

@LetsDoThis2023 I do think that's a really important point to make. My understanding is that the 200mg for 12 days is a "catch all" dose but without scans and monitoring then it is important to "catch all".

The Menopause Society says it's important to take two tablets.