Best way to take Utrogestan for headaches and nausea?

[BetterCare]

I really hope the wisdom of MN can help.

I am perimenopausal and have been taking 2pumps Oestorgel and Utorgesatan orally; I take these daily with a three-day break between packs. I have been doing this for about nine months now. Both of which I don't seem to have any side effects from.

I have periods about every three to four weeks, but they are not in line with the break, and I don't know whether they should be or not.

The problem I am having, which is the same problem that finally made me choose to use HRT is headaches and nausea.

I manage to get some relief from them by taking Soya Isoflavones but there is a period of about a week to two weeks where I get daily headaches and feel nauseous. I have one to two days where it is really bad and any kind of pain relief doesn't even touch the sides, but the rest of the time just have this low-level headache & feeling like I a been driving a car for too long. (I don't think they are migraines). I can still function it just makes me feel a bit miserable and I don't want to rely on Ibuprofen and Paracetamol and I don't like the idea of taking them long-term.

My understanding is that these symptoms occur when your Progesterone levels are low (I maybe wrong about that). So I have been thinking if it would be better for me to do 200mg for a number of days. Is it 12 or 14? If so when would I start that?

My GP isn't very knowledgeable, however, was very good and immediately gave me what I asked for when I went onto HRT. I have spoken to the Menopausal nurse who was lovely and who was the one that gave me a couple of options including doubling up on dosage for a number of days with a longer break or maybe going onto patches because the combination may work better.

It would really help to have real-life experiences. So I was wondering if any of you have experienced these symptoms and managed to do something about them and if so how?

For everything other symptom, either the HRT has helped or I have been able to find a successful solution through supplementation, it is just these two symptoms that are driving me insane.

I would be so grateful for your help, it is starting to get embarrassing when the chemist already knows to give me Ibuprofen when I walk through the door.

If you are still having periods and are under 54, the regime is 12 days x 200mgs of progesterone a month.

You are using 25 days / out of 28 which is for women post menopause (or with very irregular periods- like one every few months.) That's called a continuous regime and most women doing that use progesterone every day, not 25 days.

Basically I'd say the amount of progesterone you are using is just too much for you and not suiting you.

I wouldn't over-think whether it's because your own levels are too high or low. It's impossible to know in peri as they vary a lot.

If you change to sequential ( 12 days x 200mgs a month) your periods should follow the HRT and you will get a withdrawal bleed roughly 4 days after the last tablet.

FWIW I have been on this regime for years, and I did try changing from sequential to continuous, which resulted in a migraine, daily. I've carried on with sequential with my dr's approval (he's a meno specialist.)

@JinglingSpringbells Thank you so much for this, you have explained it perfectly.

Just one quick question, when would be the best time to start? I am now four days into a new packet. Do I wait until I have a period and then start?

It's up to you really. You could carry on now for another 10 days x 200mgs which would be okay, or wait till your next period and start either on the day it starts or 2 weeks later.

@JinglingSpringbells You have been so helpful thank you so much. I think I am going to start straight away.

Once again thank you.