New to HRT - a few questions

[BizzyMissy]

Hi. I’m on day 26 of HRT. I use 1 Sandrena sachet (0.5mg) each day and was told to take 200mg of Utrogestan for 14 days each 28 day cycle. I started the Utrogestan on day 15 so have had 11 doses so far.

Can anyone help me with a few questions please?

1. Yesterday after 10 doses of Utrogestan I started bleeding like a heavy period (complete with period like cramps 😢). I’d been taking the same dose at the same time each day (bedtime on an empty stomach) and was not expecting to bleed until after finishing it for this cycle. Does this sound like an absorption issue?

1. I’ve read that lots of people only take Utrogestan for 12 days each cycle and not 14 as my doctor said. Since I’m bleeding heavily after 11 doses, I was thinking I might as well stop after 12 doses per the information pamphlet. Does anyone know why the doctor would say to take for 14 days when the instructions in the packet say 12?

1. The doctor said to use one sachet of Sandrena each day or “2 if needed”. One sachet a day has already stopped my hot flashes, sleepless nights but I still have some brain fog and anxiety. Do you think it is too early to try 2 sachets a day?

I’m due for a 3 month review with the GP but assuming she wants me to do the full three months before speaking with her so not sure about contacting her so early on.

Thanks for your help.

It's often quite 'normal' to bleed early on Utrogestan as the absorption can vary from woman to woman. If you take it after food, it will help to increase the absorption. The reasons they say take on an empty stomach is to minimise side effects (because more is absorbed with food) but it sounds as if that might the way for you to go.

The usual dose is 12 days although 14 days can be used if women bleed too much on 12 days. Some specialists allow 10 days but that's under supervision to keep an eye on everything.

I think some drs 'confuse' Utrogestan with other HRT (tablets) where half the pack is both hormones.

Thanks JinglingHellsBells. Any thoughts on whether it seems appropriate to increase the Sandrena to 2 sachets a day?

That dose of Sandrena is tiny.
Most tablet form starts at 1mg.
Oestrogel is 0.75mgs for one pump.

The medical advice is always use the dose you need to relieve symptoms. Otherwise, no point using it at all!

I think after a month, you know you need more.

I started taking Femseven yesterday.
I’m 61

@JinglingHellsBells

That dose of Sandrena is tiny. Most tablet form starts at 1mg. Oestrogel is 0.75mgs for one pump.

The medical advice is always use the dose you need to relieve symptoms. Otherwise, no point using it at all!

I think after a month, you know you need more.

Yes, you’re right. The GP said I should find the lowest dose that helps so has made me a bit cautious. Going to increase. Thanks for your advice.