Correct dose of urtogestan if only one pump of oestrogel?

[Hellomeno]

I started taking one pump of oestrogel a few months ago, as prescribed. On the second month I went up to two (my doctor told me to do this) - but felt crazy lightheaded and dizzy. I googled it and google said I was probably taking too much. Gone back to one pump and all is good with my mood and I feel fine.

I don’t love the urtogestan part of the HRT process. If I’m only taking one pump of oestrogel, do I really need x2 capsules for 14 days of urtogestan? Or can I take less?

I have my doctor’s appointment at the end of this cycle, but just wondered if anyone knows on here? I am about to start the urtogestan cycle and don’t want to take the max dose if I don’t have to, as I didn’t get on super well with it! It also made my periods really early and really light.

Surely it will mean you cut the utrogestan down too to 1/2 that dose.

That’s what I’m hoping to be honest! Would be more tolerable maybe…

@Hellomeno sorry- you have to stick with the dose of 2 capsules.

@zzzexhaustedzzz No, the dose is not halved. It doesn't work like that.

1 pump is not unusual and you can't tell how much it's stimulating the lining- all women are different.

I used 1 pump or 1.5 pumps for a long time and on 200mgs of Utrogestan had a heavy withdrawal bleed. (I'm now using 2 pumps.)

There is no guidance about reducing the dose only about increasing it for women on more than 4 pumps of gel.

If you were using patches or tablets, equivalent to just under 1mg estrogen, the progestin dose is the same, whether it's a low dose patch or tablet or not.

If you were on HRT under a menopause consultant they might tweak the dose a little but that would be on the basis of a scan every year to check your lining was ok.

If you don't get on with Utrogestan, there are many other HRT options - patches, the Mirena coil, or tablets.

I'm not sure if this will be of any use as I'm postmenopausal and on continuous combined HRT so the regime might be different.

I was prescribed 1 pump of oestrogel plus 100mg Utrogestan, ie just one tablet. All was absolutely fine, felt great and no bleeding apart from after the first month.

After a few months I felt I needed a bit more oestrogen, so with GP's approval upped my dose to two pumps, but still 100mg of Utrogestan. Unfortunately it made me bleed, continuously.

I've gone back down to one pump, but will see my GP to see if I need to increase the Utrogestan to 200mg if I want to take two pumps of oestrogel.

@Hellomeno

You do need x2 for half the cycle but you could try taking exactly the same dose vaginally.

Worth reading to the end as also discusses taking more if needed @DramaAlpaca

Mirena is the other option

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