Chronic IBS (D) and Progesterone - Help!

[Chocolateporridge]

I've had chronic IBS (D) for at least 15 years, it was horrendous through each of my pregnancies and always got worse before each period. Now I'm peri-meni and I realise why! I'm on high dose Oestrogel and my GP recently advised me to double my Utrogestan to two tablets at night based on new guidance. I was dreading it because I remembered how starting Utrogestan upset my IBS and I had to end up taking one a day for 25 out of 28 days instead of two a day for a fortnight. So I started the double dose and, as expected, my IBS has gone crazy. I'm taking 8 immodium a day and it's not making a different, I feel constantly nauseous and the stomach cramps are horrendous.

Will this pass if I stick it out? I'm getting so much benefit from HRT but this is really horrendous.

Look into using the utrogestan vaginally rather than orally. I can’t tolerate it orally (same effect on my digestive system a you) but vaginally it’s fine. But I’m going to have mirena coil fitted for the progestogen element instead, hopefully I’ll be fine on that too as it’s an even smaller dose. That’s another option possibly?

Thank you very much, I'll ask the GP about that!

@Chocolateporridge A high dose of estrogen is more than 100mcgs patch a day- so anything up to that dose is fine.

Unless you are using more than 4 pumps of gel, or more than a 100mcg patch, then you don't need double the dose of Utrogestan.

It's unusual that it's causing diarrhea as it's usually a cause of constipation.

Have you had a colonoscopy to look at your bowel?

I really think you ought to, as if 8 Imodium is not controlling things, it needs looking into. Or a blood test for coeliac disease?

Also, the trend now is for women to use Utrogestan, but it's only ONE sort of progesterone. There are many others. Unless you are at risk from blood clots, there are tablets- eg Femoston- or patches (no risk of clots) with a different progestogen in them.

Why is your dr not suggesting these instead of ploughing on with Utrogestan?

@jinglingspringbells I'm using 4 pumps a day. My IBS had previously improved a lot on HRT but it just seems to be the progestogen that makes it flare up.
I've requested that I switch it to a pessary type and I'll try to get an appointment with my GP and raise the issues you mention, thank you so much.

@Chocolateporridge You just use 2 x 100 vaginally. You can have a 1 x 200 if you want but it's exactly the same just bigger! I've used both.