200mg Utrogestan daily?

[Badtasteflump]

Have finally seen consultant after 2 year wait. Had been taking 100mg daily utrogestan for a few weeks on advice from GP, having previously been following two weeks on, two weeks off pattern for a year. Now consultant has advised I should double the daily dose to 200mg because of the dose of EvoreI I take (100mg). She said it will ensure I get a high enough level of protection for my womb and should stop monthly bleed (after a few months).

So I'm following her advice, but my boobs are feeling really, really sore & I'm concerned that will continue with the upped dose. I googled and now can't find any reference, anywhere, to taking such a high utrogestan dose, anywhere! Is anyone else doing this, or have heard of it? She also recommended against testosterone as she said I need to give my higher dose patch time to see if it does the trick without it (I only upped to a 100 patch a few weeks ago). Any insights appreciated please!

This is a screen shot of the recommendation from this recent British menopause society recommendations

https://journals.sagepub.com/doi/pdf/10.1177/20533691211058030

Could you ask your consultant if you can use it vaginally rather than orally to reduce side effects maybe?

@RestrictiveCovenant thank you, that's really helpful. I've not heard of taking them vaginally before so will look into that. Presumably you use the same tablets or are there specific pessary type ones?

I use the same tablets. They do make a Pessary box of them that apparently comes with an applicator, but my Dr said they are identical tablets, just cost a fair bit more, so she just changed the prescription to be the same tablets, but to say orally or vaginally.

I take two different types of progesterone- utrogestan 100mg every single night and the mini pill - which provides another element of progesterone and also stops any bleeding I have. I’m on 2 pumps of oestrogel. The one thing I will say is the breast tenderness is probably more related to the oestrogen rather than the progesterone part - mine were very sore and swollen on 3 pumps so I had to go back down to 2 pumps. The progesterone makes no difference to me in that regard. But maybe we’re all different!

Thank you both. Interesting point about the estrogen possibly causing sore boobs - I've only been on a higher dose for a few weeks so maybe it's that.

I take 100mg estrogen patch and daily 100mg of utrogestan and still bleed every month. Wondering now if I should up my utrogestan?

@codeblue12 could be worth checking. Fwiw, my GP never brought it up, it was only when I saw a consultant that it was recommended.

Ok thanks @Badtasteflump

My gynae consultant has recommended the same thing, for heavy bleeding related to adenomyosis. I'm on 3 pumps of gel and 200 daily utrogestan. Still bleeding roughly every five or six weeks, but much less heavy.

So rebooting my thread from a few weeks ago as I've been taking 200 utrogestan daily and feel ok apart from random bleeding which is a pita. I have none for a few days then one big bleed which only lasts a few hours or a day or two at worst, but is really heavy. Is this normal after upping dose or should I go back to GP?

Sorry I missed this at the time. This was my experience:

A friend who is a Gp has recently done BMS training and mentioned this to me. I double checked and she said "the higher doses" so 100 and maybe even 75 if there's bleeding.

Went back to My Gp who was happy to go to x2 utro daily. I was on 100 estradot. She said she'd normally do so if going into 125 patches which she is happy to do based on blood tests. I've since gone to 125 patches.

I have had random light bleeding/ spotting practically every fortnight for 2-3 months before it's settled down. I'm actually on the 25/28 regime at my request incase there's some build up. I get a very light bleed indeed but I'm fine with that as can't cope with the ups and downs going on and off utro.

They are increasing utro for upper doses to give extra protection. I now find I really like it but used one vaginally and one orally at first.

I didn't have heavy bleeds however.

Always worth checking with Gp.

Changes to regimes can take 3-4 months to settle and I think in the Utrogestan box it says 6 months

Thank you that's really helpful :)

It's actually mentioned here from the BMS

The dose of the progestogen should be proportionate to the dose of estrogen. While no data is currently available on the endometrial effects of high doses of estrogen and the optimal dose of oral or vaginal progestogen in this context, women who require high dose estrogen intake should consider having their progestogen dose increased to ensure adequate endometrial protection (e.g. micronised progesterone 300 mg for 12 days a month instead of 200 mg in cyclical HRT regimens or 200 mg daily on a continuous basis instead of 100 mg in continuous combined HRT regimens).

Page 3

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

My friend said that they actually class "high dose" as 75 and 100 - but from my experience most gps seem to think it's more than 100.

I often have found it's into the 4th month that symptoms settle. the random bleeds or drawn out spotting was tedious but it does appear to have settled.

I'm actually not going to bother breaking for 3 days now unless i do seem to be bleeding. It didn't make any difference to the timing or break through. And I felt worse from stopping for 3 days. Gp wasn't bothered but I'm going to double check with her at an appt soon.

I just underwent a few tests as was getting bleeding when I shouldn't. Luckily tests were all good, however apparent I am estrogen dominant. So, my doctor recommended I take 200mg of utrogestan instead if 100mg per day, as he didn't want me to decrease estrogen as it helps me with all my peri menopause symptoms. So, as if today I am starting the double dose and sticking to my 3 pumps if estrogen gel. Am hoping no nasty side effects.

Perimenopause regime: I am 48 and in perimenopause have been on HRT for 3 years currently 3 pumps estrogel and 200mg utrogestran 14 days of the month. My periods have become a lot heavier/longer/painful over last few months and I have had a couple out of sync with dates. I have been having more breast pain bloating and lower moods. I had some bloods done last week and my estradiol was at 187 which I believe is low. Just had my menopause appointment and have been told to lower my estrogen to 2 pumps and take utrogestran 200mg every day now. I’m so confused by it all my estrogen low so why reduce and why do I need such a massive increase in utrogestran. It’s really getting me down now as I just don’t know what to do for the best 😢

If taking utrogestan daily when still having periods your own periods can breakthrough and cause irregular bleeding. It should be taken cyclical if still peri