reducing dose/changing cycle

[Pepsipie]

Hi, I'm looking for some advice on dosing please.
I started HRT gel Estradiol and Utrogestan three months ago, initially on a continuous cycle of two pumps and 100mg, the first month was glorious, life changing, then i realised that maybe i shouldn't be on a continuous cycle as i still have periods, so did an e consult and Doc recommended cyclical Utrogestan 200mg for 15 days from the first of the month then the rest of the month off.

Second month started to have morning sickness feeling/Nausea with a small bleed as soon as stopping the tablets.

Third month same Nausea/sickness with considerable mood changes between on and off the tablets, tired when on the tablets and irritable when not and a substantial bleed for seven days.
Also my boobs have grown substantially.
I have now stopped taking it to see if i can manage without it and my pre HRT symptoms have again returned.

To put into context i am almost 50, physically active and started taking HRT because i was having awful fatigue and severe muscle/joint body aches which was starting to leave me feeling very drained emotionally and an increasingly low mood and no motivation and wanting to sleep all day. I have not suffered with any hot flashes or sweats at all. I have had blood tests to check thyroid etc.

Any advice on whether i should re start and do the continuous cycle or maybe half the dose to reduce the symptoms, or conclude that it just doesn't work for me and try to manage myself.
Thank you

Hi You are using too much Utrogestan.
The dose per month is 12 days x2 capsules (can be 14 days for women with heavy bleeds.) You don't need 15 days.

You can't reduce the dose more than 200mgs per day (for 12 days ) but you could try it on a longer cycle. This is in the NICE guidance, for women in peri.
Not many GPs are offering this option (I was offered it right at the start over 12 years ago by consultant.)

You could try lengthening the cycle to 5 or 6 weeks and see how that feels.
It's a bit harder to count- so it would be (example) 1st Jan, then leave 6 weeks and 14 Feb. etc. In theory, you can use Utrogestan once every 3rd month.

I'd run it by your GP but it is in the NICE guidance under Regimes.

You could also try using the capsules vaginally. Pop them in right up last thing at night (they ooze a bit.) This should avoid the nausea the next day and the mood changes.

Worth a try?