Absolutely hate Utrogestan - is there an alternative?

[AreWeThereYet69]

I feel fantastic during the estrogen part of my hrt cycle (I take divigel) but when I add in the utrogestan I feel awful, headaches, exhausted, emotional...I would say worse than perimenopause symptoms. I think I might be progesterone insensitive (I could never handle the contraceptive pill).
Has anyone found changing types of progesterone helped with this? I've tried vaginally and that didn't help either.
I've actually been skipping the utrogestan but have been told that is dangerous as can cause endometrial cancer.
I'd be gutted to have to stop hrt altogether 😥

My dr just started me on utrogestan alongside oestrogel. She told me if I don't get on with it I could try a coil is that maybe an option for you?

I really get on well with my Mirena. It doesn’t make me as spaced out as utrogestan. I was 56 when I had it insruand I should have done it a decade earlier for perimenopause.

@2anddone I'd be very reluctant to try the coil given my past experience with the pill. Plus I've heard a lot of women getting side effects from it

@AreWeThereYet69 that's why I have currently refused the coil and tried the utrogestan I have heard and read too many people having problems with the coil

I take utrogestan as a vaginal suppository after experiencing bad side effects from taking it orally. That was recommended by my doctor at the Newson clinic. It has made a massive difference? Are you under a private clinic? Maybe ask?

How are you taking it? The 2 week cycle or continuous?

I hated taking it orally - same symptoms as you plus insomnia. Using it as a pessary it’s been a mixed bag with lots of stomach cramps and a day or so of feeling miserable and when I took it seemed to have no bearing on when I got my period - so I ended up taking it 2 days after my period stopped which seemed really counter intuitive.

This is my 4th month and I decided not to take it on the ‘right date’ which was 4 days after my period stopped but 14 days after and (I’m hoping it’s not coincidence) I’m feeling lots better - fewer stomach aches and less depression etc. I feel like maybe it was causing symptoms because it was fighting against my natural cycle.

I don’t know if this is any help for you but basically as long as you’re occasionally having a period then surely it’s good enough?

There are a lot of women who are really happy with the Mirena @AreWeThereYet69 but they won't come onto forums to say so-it tends to be women who don't like it who ask for help or talk about it.
What do you have to lose? You could try it for 3 months.

I guess you aren't in the UK as Divigel is not a recognised brand in the UK.

There are plenty of other options but it depends on how old you are, any risk factors (ie you might be fine on tablet form but depends on your clot risk/family history), patches, gel + Norethsiterone, etc.

@AreWeThereYet69

I was exactly the same on Utrogestan - I took it for 3 months & had 2 weeks of feeling perimenopausal, low mood, awful anxiety - the other fortnight was amazing on the oestrogen patches.

It surprised me as Utrogestan is bioidentical.

My GP switched me to Duphaston which has been great - no side effects at all. I'm in Ireland however, and I think I read on previous threads it's not available in the UK?

Duphaston is, I think, the name of the progestogen dydrogesterone. It's in Femoston (tablet) but not available as a single drug on its own in the UK.

I'm sensitive. On oestrogel and then cyclicAl. Have always taken vaginally as already knew I was progesterone sensitive. Under a clinic.

I have been awful on it. Numb limbs, anger, you name it. Am currently on third cycle trying an alternative lutigest. I didn't have a bleed the first two times - this could be coincidence, I'm 53 so maybe behind the hrt im just having less and less oestrogen in my system. Will see what happens this month, but I bled after the utrogeston each time!

I'm also - and shoot me - only telling the 14 days every 2-3 months. This is done regularly in some other countries and as I'm probably menopausal or at least very late peri behind the scenes might mimic where I'd be anyway. I've been told here we offer monthly or Continuously but long cyclical can be ok. I've been on a year so mindful a scan at some point might be good soon, but no way would I have a coil. I've had issues before with non- hormonal ones, and if one is sensitive to the mirena contents, am not sure I want it inside my body in a more permanent way (yes I know it can come out). I know the dosage is super low but I'd rather take it more dynamically. If the lutigest doesn't work out then I think there's another option they mentioned. Apart from the No bleed, I think, and I'm not totally sure that their were less side effects. Less rage and tears, we shall see! Happy to chat if you want to PM me.

I'm also thinking about trying continuously - would be ok for me now. I've had friends that have got on better with it that way than on a cycle!

@paranoidmumdroid1 Unfortunatley I didn't feel much better when taking it vaginally. @JinglingSpringbells Divigel is a bioidentical estogen gel. And yes fair point, it is when people have an issue with the coil that they are more likely to be vocal about it. I suppose it's based on the fact I found the contraceptive pill very hard to take (very low mood, no sex drive etc. only took it for a month 2 different times) that I fear I'd be the same on the coil.
@EarringsandLipstick I'm also in Ireland. That's fantastic to hear the switch to Duphaston worked for you. I'm going to see my GP and give that a go. Do you have any idea why some women can tolerate that more easily?
@nevermindtherind I've even tried reducing the dosage to 100mg but still felt crap and the longest I managed to take it was 10 days in a row! I just couldn't bare it any longer.
I have had a bleed, probably 3 times in the last 15 monts and has been very light. Prior to starting HRT (Iwas 49) my period had become quite sporadic and very light too

@AreWeThereYet69 Ive never had a Mirena, but I know the type of progestogen in it is listed (levo... something or other!) and it might be worth researching if you used that in any Pill. There are really loads of synthetic progestogens and it's impossible to say if one will make you feel the same as a previous one.

The poster mentioning Duphaston.

This is dydrogesterone and is in Femoston. Femoston is a tablet form. That's why I mentioned knowing your age and risk factors was something for you to consider as tablets have a slightly higher risk of clots but are usually very safe for younger women (under 60.)

In the UK, Duphaston can't be bought as a separate drug.

Yes, I take 100 vaginally. Always been prescribed this by the clinic. And, as well as taking it less frequently I take it gradually..50 for 4 days, 75 for 4 days and then 100 for 9 days. This way I'm taking the same amount as taking 100 for 14 days (1400mg) but spread out longer. If I took 100mg straight off I'd been really Ill.

Today I'm on day 5 and have peripheral neuropathy really badly, tingling arms and lips etc. it's awful. Apparently not particularly worrisome but a side effect of the fluctuation in hormones. I know some women get it in meno without hrt, I never did, it's the progesterone for me.

I had the same when I was younger on the mini pill. Couldn't feel my limbs and came straight off it. That's why the clinic started me vaginally because I was known to be sensitive. Feel awful today. Actually thinking I may have to come if hrt. Devastating.

I hear you @AreWeThereYet69 Funnily enough, I stopped taking my Utrogestan just yesterday after only 8 days of miserable side affects. This was my first attempt too.

I have an autoimmune disease & quality of life is very poor anyway, but the oestrogen has really lifted my mood & positivity & I really want to continue on it.

I won't be having a coil (previous coil issues) & like you I've always been progesterone sensitive, so not sure what I'll do.

One of my HRT doctors says to take it cyclically every 3 months for just two weeks, which sounds more manageable. One of my other HRT doctors (different clinic) says every 3 months is definitely an option, but only if you have regular pelvic scans. I already spend a lot of time managing my health & don't intend to add more medical screening to my life

I do feel anxious at the thought of higher cancer risks, taking it only every 3 months though.

I see Louise Newson mentions the 3 month here, but no mention of scan.

www.newsonhealth.co.uk/wp-content/uploads/2021/07/FAQs-about-taking-HRT-March-22-update.pdf

I should have added my current dose is 200mg, taken vaginally, for 14 days, every 3 months.

Does anyone do every two months? Is that an option too, like splitting the difference?

I'm hoping it'll settle down over time? Fingers crossed!

I'm sort of doing ten weeks

I've never been told 200 though even though they know I'm not taking every month. Told vaginally 100. Through a clinic. Didn't bleed after the last two times though and am a little worried about that. I know they say 85% have a bleed but up until this point I've bled quite soon after taking the progesterone. Last two gos have been on lutigest rather than utrogeston. Throwing by everything at trying to stay on hrt but fear i may need to stop if I continue to feel like this on progesterone.

I'm on a 2 month cycle so I only take progesterone (200mg cyclogest vaginally) for 12 days every 2 months. I haven't had a scan though but am bleeding at the end of the 12 days. My GP agreed to this as I'm progesterone intolerant but he suggested starting on 2 months rather than 3.

@JinglingSpringbells Duphaston is available separately in Ireland. It's a shame it isn't available in the UK as, despite being synthetic, it is well tolerated and has very low risk, possibly even lower than Utrogestan

@nevermindtherind Every 10 weeks sounds better than every 2 weeks doesn't it. Obviously depends on the severity of your symptoms though & whether you can still manage any sort of life during that time.

Very interesting that you've only been given 100mg. I got the impression that that dose was only for continual cycle, completely menopausal women.

I can understand your concern re: not bleeding. I would feel the same.

Thanks for sharing. I hope it settle down for you & you able to continue & get the benefits.

Interesting @PetShopGals that your GP suggested this. Was this NHS? In England?

I understood that a longer cyclical approach was only recommended & supervised by a private HRT Doctor.

I think I'd be a bit more reassured if more women were on the longer cycle, without scans. It does make a tad nervous. I have enough health stuff to deal with!

Do you have any idea why some women can tolerate that more easily?

That's great you're in Ireland so that Duphaston may help!

I've no idea 🤷🏻‍♀️ my GP was a bit surprised but I wasn't alone, and she did say women seem to tolerate Duphaston well.

I was delighted with the change!

oh @LutealLucy being told to only take it every 3 months sounds much more doable! I think I could just about manage that.
So far I've only been to my GP regarding HRT and she's far from knowledgable! It was more a case of me saying I wanted to try Divigel and Utrogestan... and she just prescribed!
There are long waiting lists here in Ireland to see a specilised menopause doctor. But think I will put my name down so I can eventually see someone and run that by them.
I feel so good on the divigel that I'd hate to come off it. I sleep better, don't get menstraul migraine anymore, no hot flashes....