New to HRT, can you help me with utrogestan days and bleeds?

[HairyKitty]

Hi all
I’ve got my first prescription for gel plus utrogestan. I still have regular periods almost monthly, usually about 3 or 4 days flow and another 3 or 4 days spotting.

GP has prescribed utrogestan 1 x 100 daily from day 1 to 25 instead of 200mg daily from day 12-25. She said I can choose but she recommends the 100 for 25 days to reduce side effects of the progesterone.
What do you think? What’s the difference to me of these two regimes? By the way this is for a 28 day cycle.

Also, if I’m only stopping the progesterone for 3 days wha5 kind of bleed can I expect? I really prefer it to stay roughly how it was, not reduce to just a couple of days spotting. Does the length of progesterone gap affect the length of bleed?

Thanks all, I have joined you all just to ask this question.

My understanding is that you should not move to the continuous regime (days 1-25) until you have had 1 year on HRT or have had 1-2 years of no periods, depending on age. The reasoning behind that is that if you are still having periods the 200mg sequential regime allows your body to have regular bleeds and regulate with the HRT.
Moving over too soon can lead to more breakthrough bleeding and spotting if your uterus is not ready to comply!
Don't know how that translates into real life though

Hmm does 25 days out of 28 count as continuous? GP explicitly said I needed cyclical, started to prescribe the 12 days x 200 then changed her mind to the 25 days to reduce side effects

I have been prescribed the same and end up with bleeds about day 15 (of the 25 days of taking the progesterone) - I keep meaning to ask the GP why she told me to take it days 1-25 then with 5 days off as the more I read the less this seems right (given that I still have periods)

Yes it does. Sequential is 2 weeks out of 4 or days 15-26 or thereabouts. Continuous is days 1-25 (the 3 days off is supposed to reduce spotting) or all the time
Not sure that gives you any answers though, sorry!

There is a bit of a muddle going on here :)

The usual starting regime for anyone with periods is using it for 12 days per month. Ideally you start it mid-cycle if your periods are regular, so it ties in with your progesterone each month. This will create a withdrawal bleed 3 days after stopping it.

It's also better to start with 2 weeks of estrogen only to see how you feel on that dose and whether you might need more. Using utrogestan at the same time can mask this. Some consultants suggest women have a complete month on estrogen-only for this reason.

By side effects, your GP means you might avoid the possible PMS type effect of a cyclical regime.

However, that's very personal! I am still on a cyclical regime after many years as a) it's supposed to be safer re. some risks and b) continuous made me feel rubbish!

Also....sorry if this is too much info....most drs now prescribe continuous as taking it every day (not 25 days.) The 25 days is a bit outdated now and is only there to give a light bleed as a kind of precaution if the lining has built up (which it shouldn't on a conti regime.)

All other conti regimes (pills and patches) have both hormones daily.

Your GP may be a bit confused or just not explaining it very well.

I’m thinking maybe gp was confused?? She definitely wanted me on cyclical and she considered both the 12 days and 25 days to be cyclical.
What kind of pmt symptoms might you get on the 200? I think I only get breast tenderness usually.
What kind of bleed do women get on the 25 days one?

I’m thinking of trying the way she has prescribed for a few months to see what happens then deciding if I want to try the 200 for 12 days at my 12 weeks review?

Using it for 25 days out of 30 when you are still having regular periods, makes it more likely you will get spotting and odd bleeding. 100mgs is a low dose and it may not be enough to control the effects of your own estrogen + HRT on the lining.

Experiment if you want to!

No one can really predict how you feel. I had a daily headache when using it every day- stuck it out for 3 weeks then gave up. I also had daily spotting and was late 50s then and post menopause.

The amount of bleeding is individual. It depends how your own estrogen levels are and if you are still ovulating. More estrogen=more bleeding.