utrogestan dosage - so confused

[tipping]

I've seen a doctor at Newson health. I have long term problems with depression & anxiety. She suggested I take Utorgstan 100mg vaginally on alternate days, all through the month (I don't get bleeds anymore). Plus 3 pumps of oestrogel.

Reading the 'Progestogens and endometrial protection' doc from the BMS, I wonder whether I should be taking 100mg vaginally every day as that would be the more normal dose?

I worried that i was taking too little so self prescribed (I know, stupid) and began taking 100mg vaginally one day and then 100mg orally the next day and so on. My mood seems to have got a lot worse.

I would ring the clinic for clarification. Some do take it only on alternate days which the Newson clinic advocates but apparently this is based on limited evidence. However if your mood is worse on daily doses they may well say
stick with alternate dates.

As you're private you could book a surveillance scan after 6m to check the endometrium. This can be done on the nhs too but it's a bit of a postcode lottery as usual regarding the availability.

That is a very low dose of Utrogestan.
You are right in that the BMS says do not reduce the dose for vaginal use. (Or go less than 100mgs daily.)

The BMS does say though that the same amount is absorbed orally / vaginally.
Your moods have probably dropped as you are using it orally (as well.)

There was some very limited research in Europe a few years ago about using it on alternate days. BUT as @Janiie says, when private drs prescribe off-label, they usually monitor you and say that you will have occasional scans to check your lining. (like once a year .) Unlikely to find a cooperative NHS GP to do this is you don't have symptoms and the HRT is being given privately, and off-licence.

Thanks @JinglingXmasbells and @Janiie it seems I should consider taking 100mg utrogestan vaginally daily or go on mirena. I wonder if there’s any sense that mirena can be gentler ion moods than utrogestan (taken vaginally)?.