Starting on utrogestan

[Furryfeet]

I’ve been on Evorel patch for 4 weeks on Weds (100 for 3 weeks now and 50 for 1 week before this), so due to start 12 days of Utrogestan soon. I naughtily ‘sampled’ 2 utrogestan tablets a few weeks ago when curiosity got the better of me, with mixed results. Just looking for some advice from seasoned utrogestan users. If it doesn’t agree with me would you suggest toughing it out for 12 days in the hope things improve, switching it to admin as a pessary, or something else? I’m not due to see the consultant for a few weeks (although they mentioned pessary as an option) and GP’S unlikely to shed much light. I think I’m feeling a bit nervous because this week I’ve had rare moments of genuine calm and happiness and occasionally even feel like my old self, so I’d rather not be introducing any new meds (though I realise needs must)

I am on utrogestan but on the advise of the menopause specialist I saw I take it vaginally. Maybe try taking it this way and give it a the whole 12 days. It seems to cause a lot less side effects than it does if you take it orally.

Thanks, do you take 2 tablets a day this way or just 1? I’d heard it was more readily absorbed as a pessary, necessitating a lower dose. And do you notice any sedative effects at all? I suppose I can only try and find out for myself…

You have to use 2 capsules whichever way.

It's been Dr Louise Newson suggesting halving the dose. BUT in Jan this year there was an updated directive from the British Menopause Society saying it had to be taken as the stated dose. They have seen a rise in hyperplasia in women halving the dose. I don't know if Dr N has updated her website accordingly, yet.

This has been discussed here a few times, both by me (I left a link in January to the paper) and also by another poster.

I didn’t do well on the evorel sequi progesterone phase, but switched to full time oestrogen patch and full time Utrogestan tablets nightly (100g/mg)-no break.

I think taking it nightly, and maybe I a lesser dose, negates some of the symptoms that may present.

i am doing fine on it, when I previously felt like I fell off a cliff during the two weeks of Combi patches (which may have been more to do with not taking oestrogen at this time)

I take one tablet per day continuously and I take it just before bed as it can make you tired, although I'm not sure if this is the case for me. it's not licensed to take vaginally so I haven't told my doctor that's how I take it but he's never asked. Whatever dose you would take orally, take the same vaginally. I started off taking it once every other night but the guidelines have changed on that now.

Thanks everyone! All really helpful 😊

@siblingrevelryagain that's really interesting as that sounds similar to me. Except I'm a bit confused about you saying you didn't take the oestrogen patches with the progesterone - surely the oestrogen part is continual and it's only the progestin (or progesterone) that changes for a sequi regime? If so it wouldn't be the dip in oestrogen as that should be constant all the way through? Is this not right?

If so, it sounds similar to the sequi regime I did but mine was an oestrogen patch twice a week for the whole month and then utrogestan added in two weeks out of every four. I had some good overall effects, but struggled an awful lot with the utrogestan part of the regime and had a lot of side effects. Switching to vaginal didn't work for me - i didn't give it very long though as i immediately got cramping and felt like the symptoms of a UTI so thought life's too short. I'm now switched to the continual regime - so that's oestrogen patches twice weekly all month and then the utrogestan at a lower dose than before but continual rather than two weeks on and two weeks off. It's made a huge difference and I'm feeling very good on this and this has got rid of the side effects for me. I think the lower dose suits me - or maybe not all the chopping and changing of the two weeks on and off. Sounds like maybe you and I had a similar experience @siblingrevelryagain and it's good to hear I'm not completely alone there.

@furryfeet maybe don't anticipate problems and see how you get on. If you do have problems there seem to be lots of different things to try or tweak with supervision.

I had evorel sequi where it was 2 weeks of oestrogen and then 2 weeks of progesterone; Hence feeling fab during the oestrogen stage and crappy on just the progesterone.

I find I get sleepy with the Utrogestan tablets if I taken them too early, because it is a sedative, but at least it means I never struggle going to sleep!

Hi @siblingrevelryagain I'm not trying to undermine what you're saying or anything but I think this is important info for people to know. I looked up Evorel Sequi and a pharmacy site says this:

"Evorel Sequi is a sequential hormone replacement therapy (sometimes referred to as cyclical HRT) made up of two different types of patches. One type of patch releases estradiol only (a form of oestrogen), and the other patch releases both estradiol and norethisterone (a synthetic form of progesterone). You will use the oestrogen-only patches for the first two weeks of a treatment cycle and then switch to the combined patches for the second half of a cycle."

This means that the oestrogen only is for the first two weeks and then its oestrogen and a synthetic progesterone in the patches for the next two weeks. Which is the same idea as the sequential I was on - the oestrogen is running through all the time and its the progesterone part that is 2 weeks on and 2 weeks off. I can see why it looks like it's oestrogen and then progesterone but the oestrogen is in all the patches. It's the progesterone part that changes. I think it's important just to clarify for anyone reading this.

I also was knocked out by the progesterone part (in my case utrogestan) when taking it in a sequential regime. But it's fine for me now I'm taking it in a continual regime. I'm hoping all of this isn't confusing for the OP. I find it takes a while to get heads around the whole sequential and continual thing and it is massively confusing.

@siblingrevelryagain As a pp has said

On all sequential regimes using one product ( ie patch or tablets)

You have estrogen every single day (it's in the patch or tablet)
and for 2 weeks the patch or tablet contains estrogen+progestin.

You need to give HRT time to settle and then tweak under doctor supervision so just trying it randomly doesn't really suggest anything. I love my two weeks of progesterone (taken orally). I sleep so well, am so calm and settled. It suits lots of people but you may have to experiment with how and when you take it in the evening if you get side effects. Good luck!

I didn’t know it was progesterone with oestrogen; still felt shit on it though!

i was previously on Evorel 50, but had a consultation with a menopause specialist at a private clinic and now I take Evorel 75 continuously and Utrogestan nightly, and a lot of the symptoms that had started to come back have gone away again.

i started when I was 42, and I’m now 46 so it makes sense that I might be needing an increased dose.

Just thought I’d give an update. So far I’m on day 5 of 200mg of utrogestan. On the second evening I felt pretty bad (a short moment of calm and the hint of sedation was followed by palpitations and general jitteriness, skin crawling, sinking feelings). I decided if I’m going to feel this rubbish I’d rather it was earlier in the day not lying in bed (sleep is bad already!) so have taken subsequent doses in the afternoon. All in all I’ve been feeling a bit depressed and discussed AD’s with GP but tbh was feeling that way before and I wouldn’t say it’s been intolerable. I’m definitely not going to pursue AD’s till I’ve completed the 12 days. There are so many progesterone horror stories out there - so I’m feeling chuffed that I’ve muddled through so far 😊

@Furryfeet are you taking it very last thing at night? Ideally when your head hits the pillow. You ought not to have all the side effects if you manage to get to sleep quite quickly as it takes about an hour for it to start to be absorbed. Do be careful taking it during the afternoon. It is a sedative. It can also make you dizzy, so it could be quite unsafe to drive or similar if you take it in the daytime. This is why the directions say take at bedtime. I had a very dizzy episode once when I took it about an hour before bed.

You don't have to persevere after giving it a couple of weeks/ or cycles. There are many other types of HRT out there and if you are seeing a consultant ( as you said) they can offer others. You could go onto tablets- Femoston- or patches. or have a Mirena coil, or use norethisterone each month instead of Utrogestan.

all options for you! and yes, you can also use it vaginally to see if that is better. same capsules, just insert as high as you can at bedtime ideally, although day time is okay as they don't affect the brain if used vaginally.

I didn’t know it was a sedative - that explains a lot! I am already taking amitriptyline at night ( 25mg) but my doctor didn’t tell me that Utrogestan could also make me sleepy. Some days I can barely function! I use Utrogestan with Oestrogen gel since it became difficult to obtain Evorel Conti patches.

@JinglingHellsBells I took it at night for first 2 nights but at your suggestion I’ll try the ‘head hits the pillow’ thing tomorrow. I just don’t get a sedative feeling - almost the opposite. I took it at 3pm today, chatted to my Dad on the phone for an hour and made a chicken pie. I certainly wouldn’t drive or operate machinery (great excuse not to mow the lawn!) I’ve heard the sedative effect can build up over days (which would be great if it were true - feeling tired at night is my ultimate dream right now) so would welcome another bash at an evening dose