Taking utrogestan vaginally if you’re progesterone intolerant

[frances2000]

I’ve just come off HRT after 2 months - I got horrible panic attacks and anxiety for the 12 days on Utrogestan (200mg a day orally). I really want to try again though (for the oestrogen part) and my doc has suggested taking 100mg of utrogestan vaginally a day for 12 days. Does anyone who had
anxiety taking utrogestan orally have experience of it being side effect free when you take it vaginally? And is the halved dose enough to get a proper bleed / not increase cancer risk! Thank you for any advice!!

The dose vaginally is the same- 200mgs.

The half dose was suggested by Dr Louise Newson who wrote a training manual for GPs but that dose was based on very limited research.

The British Menopause Society produced a report on the use and dose of Progesterone, a year ago, and it states that the vaginal dose has to be the same.

thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

• Based on current evidence if progesterone were considered for vaginal administration (out of license use) in women who experience side effects with oral intake, this should be given in similar doses and durations to those applied to oral progesterone intake with HRT.

Your GP has missed the update so if you do see them again maybe print this and share it?

I have found my general symptoms reduced. I'm sorry for the TMI but a new problem was it meant we couldn't have unprotected sex for 12 days as having sex and inserting the tablets on the same night didn't seem a good mix. I couldn't find a solution to that.

My gp swapped me to taking this vaginally as I got palpitations and and anxiety when wearing the patch that has progesterone as well as oestrogen. I use 2 of the capsules (200mg) for 14 days every month. I’ve not had any of the issues I had with the combined patch. It’s a bit of a faff, I’m thinking about asking for a mirena coil, but I thought I’d give this a few months first to see if it becomes an easy routine.

I struggled a lot with the progesterone side of HRT, as Utrogestan didn’t agree with me at all. Like you I had terrible panic attacks and heightened anxiety. I tried using it as a pessary too, but it negatively affected my sex life and I didn’t notice a huge improvement in my anxiety (tho it did improve). As a last resort I had a Mirena coil fitted. It was an utter faff for the first 4 months as I bled or had brown discharge almost constantly. But it has settled, and although I’ve noticed some bloating it has been the least difficult so I stick with it. HRT hasn’t been the magic I’d hoped for tho, the Louise Newsom clinic promised miracles!

Thank you, that’s really encouraging! I might give it a go!

That’s interesting - I’ve always avoided the coil cause of it being hard to remove if I did have side effects (I knew I was progesterone sensitive thanks to having bad PMT). Might look into it if things are still not good using utrogestan vaginally

THANK YOU! Will show the GP when I see her tomorrow! Last thing I want to do is reduce anxiety by taking utrogestan a different way only to give myself something else to worry about

Hadn’t thought about that aspect of it. Deffo worth it for me though to get the HRT!