Confused! Perimenopause and utrogestan - how do I take it?

[S2P78]

Hello,
I'm 43 and still have periods (irregular - cycle is anything from 29 to 40 days) and have been prescribed sandrena 1mg gel and 100mg utrogestan. I saw a specialist cause I have loads of debilitating peri symptoms and couldn't go on as I was...
My last period ended 10 days ago. Know I need to take 12 days of the utrogestan every 'cycle' but I'm irregular. And do I take a whole sachet of the gel?
The specialist/gp/pharmacist have all told me different things and now I'm very confused. one said start on first day of next period with both, another the first day of the month, another now!
Thank you :)

TBH it doesn't really matter for the first time.

The important thing is to stick to 12 days in a month, and that should reset your cycle so you get a withdrawal bleed at a regular time each month.

Some women use estrogen alone for a few weeks to see how they get on (this is done by a specialist) so the first few days of when to start utrogestan don't matter that much.

You can either wait till 1st May, then take it again 1st June etc, OR start on the 1st day of your next period, Or start in a couple of days when you would be nearly half way through a cycle (if regular.)

Your choice.

I thought the normal utrogestan dose was 200mg for at least 12 days if you're taking it cyclically because you're still having periods. I think you might need to check again with the specialist.

The important thing is to stick to 12 days in a month, and that should reset your cycle so you get a withdrawal bleed at a regular time each month

Exactly. Once you set up the cycle you then stick to it.

An easy way to remember is that you will start on a certain day eg Tuesday every 4 weeks. (So you can put that into your phone and get a reminder every 4 weeks).

Then you'll take it for 12 days - so you'll stop on the Saturday week after starting. So again, you can put a reminder in your phone to stop taking it every 4th Saturday

And yes - would usually be 200 if taken cyclically.

@SierraSapphire

I thought the normal utrogestan dose was 200mg for at least 12 days if you're taking it cyclically because you're still having periods. I think you might need to check again with the specialist.

That's what the OP said she was doing (I didn't expect her to say the precise dose, she was just querying when to start.)

@EarringsandLipstick One thing to bear in mind is when you 'want' the withdrawal bleed. For example, if you are busy at weekends, you might not want a bleed to occur then.

So count 12 days + 3 days, and the bleed usually follows on the 15th/16th day after starting Utrogestan.

There is a LOT more flexibility with all of this than most women know, as it's usually only discussed with a consultant.
Some women (me) use it on a longer cycle and choose the starting days each time.

Good point jingling I never thought of that.

Do you ever get breakthrough bleeding if you change the days around?

That's what the OP said she was doing (I didn't expect her to say the precise dose, she was just querying when to start.)

She said 100mg, I can't see where she says she's taking two. I've just been diagnosed with endometrial cancer, it looks like I wasn't absorbing the progesterone so I'm keen other women get it right.

@SierraSapphire

That's what the OP said she was doing (I didn't expect her to say the precise dose, she was just querying when to start.)

She said 100mg, I can't see where she says she's taking two. I've just been diagnosed with endometrial cancer, it looks like I wasn't absorbing the progesterone so I'm keen other women get it right.

To be fair, the tablets come as 100mgs. She didn't say she was taking just one, so I'd assume she was told to take 2 x 100mgs. If not, then that was negligent of the dr.

I'm really sorry to hear of your diagnosis - and you are right to query she is taking the right dose- and hope you get through it all okay

@EarringsandLipstick

Good point jingling I never thought of that.

Do you ever get breakthrough bleeding if you change the days around?

No one should get breakthrough bleeding if it's a day or so 'out' but I'm not advising that, as it's not the way the HRT is licensed. (There is always the option to continue the length of the progesterone to delay the bleed, like using the Pill back to back.)

If you think about it, HRT mimics a normal cycle, which can be anything from 21 days to 35 days ( classed as normal.) The packs of HRT are 28 days but in real life very few women have regular 28 day cycles.

There is also a tablet form called Tridestra which is an 84 day pack and has 14 days of progestin in it, so it is a 3-month cycle. This is suitable for women in peri.

@JinglingHellsBells Sorry to hear about your diagnosis - I hope you are ok :(
You are right that I thought it was 100mg a night for 12 days. Why is it that you have to take 200mg? Is there any harm in starting on 100mg since i'm not properly menopausal and seeing if htat's enough?
It's all very confusing.
Thank you

[quote S2P78]@JinglingHellsBells Sorry to hear about your diagnosis - I hope you are ok :(
You are right that I thought it was 100mg a night for 12 days. Why is it that you have to take 200mg? Is there any harm in starting on 100mg since i'm not properly menopausal and seeing if htat's enough?
It's all very confusing.
Thank you[/quote]
@SierraSapphire The diagnosis was @S2P78

You have to take the prescribed dose.

This is all listed on the very large leaflet in the pack :)

Not being fully menopausal isn't the issue. The dose is 200mgs.

Oh- sorry- names the wrong way round in the post.
@S2P78 you need to read @SierraSapphire posts, not mine.

@JinglingHellsBells Ok, thanks. The doc said 'take a pill a night' so I didn't think that was more than one. The front says 'take as precribed' so it is a bit confusing. All very well to say read the leaflet, but I go with what the doc says usually! Thanks.

The 200mg progesterone is to protect the lining of your womb from the effects of oestrogen. If you don't take sufficient the lining can build up and turn into cancer, which is what has happened to me. It's worth double checking I'd say. 100mg is usually the dose if you're post-menopausal.

thank you @SierraSapphire and sorry to hear you're going through this :(