Ultrogestan

[Workinghardeveryday]

My first month of taking.

I am doing 14 days off, 14 days on.

On day 3 of taking.

Omg. Extremely tired, I mean seriously tired like wishing the day away to go to sleep.

Took tonight about an hour ago, don’t feel myself at all, feel drugged up. Tired but wired, giddy. Not right.

Normal or not? Will it settle? Help!

My NHS consultant gynaecologist has switched me to continuous. I'm still very much in peri. I'm on 200mg every day, to try to thin my womb lining. He said it's safe to do, it's just not usually prescribed that way because it can lead to irregular bleeding. It's been brilliant for me so far - lighter periods, more level moods, better sleep.

@SmartHome @ItBeFivePotatoesHigh @PelicanWings

The guidance on using Utrogestan (continuous or sequential) has not changed.

This explains it well
www.menopausematters.co.uk/postmeno.php

What a Dr suggests at a private clinic is not necessarily suitable for everyone. Private clinics and private consultants can suggest variations, but they are also able to sort out private scans if anything needs investigating, like odd bleeding. These cost around £200-300. If someone not post-meno is using continuous, they ought to be told to expect odd bleeding.

Sadly, there have been many threads here from women who've been mis-prescribed by their GP - given continuous too early.

They have bleeding (which is what often happens) and the GP doesn't know why, so end up being sent for scans or biopsies, which can be stressful.

There is sometimes a bit more flexibility with women who are late peri- who have a period maybe every 4 months or so - and some drs are saying 'okay try continuous' but there is still a risk of break-through bleeding.

The other option (now in the NICE guidance) is to use long cycles in late peri or with women intolerant to progesterone. These are 3-month cycles, with progesterone for 14 days every 12 weeks.

I was on a tablet hrt for three years. My doc has just switched me to continuous. She said it's fine if still getting periods and I had been on hrt already for a year. Two pumps and one 100g tablet. So much better as I'm pretty consistent in moods and emotions all month and I sleep better x

@mrsnjw How would you know if you were having natural periods if you've been having a monthly withdrawal bleed? Did your dr discuss this? what she says doesn't make sense as you have used hrt for 3 years, not one. (and length of time on hrt isn't a criteria for swapping to continuous.)

Hope you carry on feeling ok and it suits you!

Once you have been on hrt for a year you can switch to continuous. I've also just turned fifty and doc said gel is less risky in terms of clots. No headaches, no period pains and no fluctuations in moods so am happy to carry on. I do get a bit of breakthrough bleeding when I wipe but it's usually at the beginning of a bottle of gel when lots squirt out.

Doc also said that I shouldn't get any periods on this dose.

But by that argument any woman starting sequi HRT in peri, will never be able to move up to continuous as they will be having withdrawal bleeds. How will anyone know they have gone through the menopause?

In my case, I'm 54 this year and fairly sure I'm still having periods as I still have ovulation symptoms, plus the bleed doesn't come at the right time for a withdrawal bleed.

No, the opposite. I had panic attacks for the first few days after progestogen cycle ended, plus felt really, really anxious.
The progestogen made me drowsy and I slept like a log. Tbh I felt that 200mg was just too big of a daily dose. I would be happy to try it again if I could try a daily 100mg.

Sorry forgot to add, Evening Primrose Oil sorted my sore breasts out. You need to take it for a while though to see the benefits.

My Newson Health doctor prescribed 100m daily a year ago, and a different doc (but also Newson Health) has just seen me and adjusted the estrogen but continued to prescribe 100 Utrogestan daily. Still having monthly periods

In the past I was on evorel sequi, and whilst it was a huge improvement I felt I fell off a cliff during the two weeks of progesterone only patches (which could have been a combination of being without estrogen and the addition of progesterone)

im 48 and still perimenopausal (have been on HRT since age 42, but had to fight 4 docs to get it, now I pay for it because I feel it’s something my own docs don’t understand and the shortages made me massively anxious, so I just suck it up and go through Newson Health).

I now take permanent evorel 100 patch (has steadily increased over the years, was finding recently some symptoms returning with 75 patch), and 100m progesterone daily. Just started on testosterone too, for low mood and poor concentration, so I won’t necessarily know whether it’s the increased estrogen or the addition of testosterone that helped.

I had a blood test at age 42, where my doc said I wasn’t showing as menopausal (which isn’t hugely scientific anyway, as it was just a random blood test, god knows where in my cycle, and was only one), she said she hadn’t needed HRT so I’d probably be ok but she’d review it once I was older, 2 more (male) docs sent me for thyroid test, vit D deficiency test, one tried to prescribe anti-depressants when I choked up telling him my Dad had just been diagnosed with cancer; he thought that because I was a working single Mom with unwell parents I was clearly depressed, but I knew that I could cope with the shit of modern life, but what I was feeling was something different.

In the end I went to a 4th doc armed with the NICE guidelines and the arguments for and he agreed to me trying it for 3 months. After a very short while I knew they’d have to prize it from my cold, dead hands, such was the difference it made to my life. Joint pain, brain fog, rage all went away almost straight away. Now I’m ageing further it’s not a magic bullet, as my hormones fluctuate and wane/surge, but with tweaking and knowing my body (and the benefit of half an hour to talk with an expert) HRT keeps me topped up and functioning well.

We should all have the facility to work it through with an expert as one size definitely doesn’t fit all, but it’s such a lottery. I’m politically to the left of Lenin, so it goes against everything I believe in that I am able to access better health because I am paying for it (I am still a working single mom so I can’t really afford it, but I have to prioritise it over new clothes/nights out etc and make it work). It makes me mad that many women will be deciding between getting their prescription paid or feeding their children.

I've tried evening primrose even before I started HRT as I've always had sore breasts in the 10 days leading up to my period and its given me awful diahrea every time.

So not an option I don't think unfortunately.

Its really interesting reading about how we are all affected by this so differently.

If you read the link, it says 1 years without a period or aged over 54.

That's because by 54, over 80% of women are post-meno.

In my case, I'm 54 this year and fairly sure I'm still having periods as I still have ovulation symptoms, plus the bleed doesn't come at the right time for a withdrawal bleed

So are you saying you are having a bleed (period) in addition to the withdrawal bleed?

Newson Health has become a bit of a 'law unto themselves' since they expanded so much. (I was amazed to see the number of GPs now working for them. It used to be a small handful.)

It appears they have been indirectly criticised in a report (not named) for their 'variations' on the use of too little progesterone and also the huge doses of estrogen they prescribe.

I just have my period (or what I'm assuming is a period). I don't have a withdrawal bleed, when the progestogen cycle ends. The nurse seemed to think this was fine.

I hadn't even registered the info re. over 54s, I mentioned I was nearly 54 just because I am 😆 But that's useful info, thank you. I'm due a review and might see if I can try continuous.

Feel so poorly since being on it and fed up of it tbh.

So so tired all day long. I am still in bed because I feel so sick and groggy. It’s like having a huge hangover without the headache.

I did have a drink last night but everything I have read has said this is fine. Does anyone have any experience of mixing with alcohol?

I have the drunk / dizzy effect using 200mg Utrogestan too and as I have a toddler I’m still getting up in the night for I felt uneasy about feeling too out of it and hard to rouse. what I do with my dr’s consent is to split my dose 1x 100mg dose late afternoon and 1x100mg at bedtime. Works a treat.

@Goosebarnacle I don't intend to ever stop hrt so I guess I'm not worried about knowing if and when my periods have stopped x

That's why I used it vaginally, the drunk feeling

I guess I'd like to know from an end of an era/psychological point of view. I actually thought my periods had finished, I went 6mths without, with only mild menopausal symptoms, but felt really well, no hormonal ups and downs. Then I had the AZ covid vaccine and hormonal hell ensued (I'm not an anti-vaxer btw and have been fine with Pfizer).

A number of local area guidelines suggest a GP can move a woman to continuous HRT if they have been on HRT for more than a year, at any age.

It also says this on the Newsome website.

I guess women need to be aware they might get breakthrough bleeding or odd bleeding. I think this can always be the case in the first 6 months of continuous anyway.

However, I guess women who were naturally having very irregular and far spaced out periods before starting HRT are often in that late peri phase anyway, so more suited to it. Perhaps it is them typically who are given continuous before being 54.

Plus, what is the problem with getting some breakthrough bleeding beyond the inconvenience? Is there a medical reason why this should be avoided or some people think it should be avoided? If some women find being on cyclical difficult….perhaps problems coming onto or coming off progesterone phase or that the withdrawal bleeds are very painful, can continuous without a regular breakthrough bleed and perhaps some unpredictable but less painful occasional breakthrough bleeds be better?

People always seem to mention the problem of being on continuous too early, as being getting some breakthrough bleeding. But given cyclical includes a bleed anyway, what’s the difference and why is it actually advised against?

Incidentally, I’m 50. I was 49 when I started HRT and had only had 2 periods in the previous year. I went straight onto continuous after speaking to NHS GP about my migraines with aura. More recently I’ve seen an NHS gynaecologist consultant regarding testosterone (GP had also prescribed this - off licence - but after a blood test revealed higher levels of testosterone I was referred to specialist). I asked the gynaecologist about taking continuous HRT. I told her the length of time I’d been on HRT and also about my pattern of periods pre HRT. She was perfectly happy with me being on continuous.

In my first few mo this I did have a little bit of bleeding….very little. Now I don’t have any. Occasionally I’ve done a 25 day cycle of progesterone with 3 or 5 days off, to give a chance for a bleed if one is needed….but no bleeding. It could be my periods would have finished by now and so continuous would be seen by everyone as right for me anyway…but like many women on cyclical HRT, I do t know if my natural periods have finished and won’t know when they do finish if they haven’t already.

@WombatChocolate summed up well. I am happy to put up with a bit if spotting and breakthrough bleeding if it gets rid of the migraines and painful flooding periods.

I was also advised by my gynaecologist that it’s okay to move to daily utrogestan after a year on hrt. I’m 51. It’s been great for me - no bleeding at all.

Plus, what is the problem with getting some breakthrough bleeding beyond the inconvenience? Is there a medical reason why this should be avoided or some people think it should be avoided?

It can be a symptom of more serious things, which may prompt medical investigation.

@WombatChocolate interesting that you mention migraines with aura. I have very occasional optical migraines, which I have kept quiet about as I thought it was a barrier to HRT. Funnily enough, I've had no symptoms since starting HRT and normally I would have one or two a year.

Did you start HRT whilst still having periods?