Little 'survey' on Utrogestan

[JinglingSpringbells]

With all the shortages of this I'm really curious.

Is everyone being offered Utrogestan now as the default progesterone?
Are you asking for it or being given it with no discussion?

If so, I think it's happened because of a training manual for GPs written by a meno dr, to help make prescribing easier and they don't have to think about it.

It's a bit odd because almost daily, this forum is full of women asking for support with it and not liking it.

I moved onto it after 6 years on Norethisterone because it's supposed to be safer for long term use. I was warned I'd love it or hate it!

But for women using HRT for 5 years or less, the other options are safe and it always used to be accepted that up to 5 years had negligible risks.

The other options are
Mirena coil

Dydrogesterone (only as part of Femoston except in Ireland where it can be prescribed on its own along with gel/ ptaches.)

Norethisterone (in all patches and most tablets) but can be prescribed alone to use with gel or estrogen patches.

MPA - in many patches and tablets

Provera (same as MPA but can be prescribed as a tablet rather than as part of a combined estrogen+progestogen pack of tablets.)

Mine too, which is why a lot of hay I read here baffles me a bit. I spoke to my GP at length about how to handle my timing of my cycle days. Because my cycles are still 28 - 31 days, I am using my natural cycle timing for now. Obviously if they start to get random I will need to do something else, but for now this is working for me. I don’t have any side effects and the benefits are massive.

There are a few different ways to take utrogestan, that's why people have different lengths. Some people only take it once every three months.
I'm the same, @HeidiUpTheMountain , I time it to my natural cycle at the moment or else I end up with a natural period and a lighter withdrawal bleed. Too much bleeding!

I wasn't offered any alternative just the gel and because I had a womb utrogestan. No supply problems yet I'm in Scotland but it might come

I was offered from the start but keen to stick to body identical due to issues with synthetic hormones in the past.

It's not been plain sailing simply as I think peri isn't and it's been a juggling act.

However went I went to 200 continuously (or rather 25/28) something clicked and o found it excellent for some symptoms not traditionally associated, including hot flushes. Some spotting for a while but tht seems to be settling.

Without realising though it may be making how my body processes thyroxine better, so I've gone a little hyper. So trying to get everything to balance out is a tad challenging!

Water retention became a problem for me as i increased patches and it really helped with that.

Came across this very complex professional webinar chaired by Dr Nick Panay recently which confirmed some of the things I've found In myself recently .

HOWEVER at first I couldn't tolerate it and used it vaginally, successfully, on lower doses of oestrogen. So I can appreciate it's really not for everyone at all. And I may ask for a coil in addition as I seem to have a slight cycle; still only 3 months into this regime so still judging. And hate the breaks from it!

It's easier for some. It's mainly about making it easy to remember. And why mirena is preferred.

This says 12 days out of 4 weeks, so 28. But some women find it easier to think weekly, so two weeks on two weeks off.

Some are told 14 out of a calendar month which is longer by a few days so a little more protection.

The key aim for progesterone is protection of the womb first and foremost. So that is a priority, and why other forms are a good choice too.

www.liverpoolwomens.nhs.uk/media/3548/taking-utrogestan-patient-information-leaflet.pdf

Oh it absolutely knocks me out at bedtime, which is glorious.

I took it before bed and tried to finish my online shopping downstairs- was practically drunk on it within 10 mins ! now I also wake up without the hangover I used to have with it thankfully.

It appears that many GPs are following the 'GP HRT prescribing guidance' doc written by Dr Louise Newson.

In that doc, she says the dose is for 12 days but it's 'easier' to tell women to do 14.

(You can see this doc online by putting in those search terms.)

Obviously if you have side effects then stick with 12 days.

Also, you are not supposed to follow your own cycle when starting it unless your cycles are bang-on regular.

HRT overrides your own cycles and creates an HRT cycle.

Women on tablets and patches are not 'counting days in their own cycles' before using the progestogen part, they just take the tablets or apply the patch in the order they come in the pack.

I know the line is that HRT over rides your cycle, but it really doesn't always.

Which makes complete sense because it's not all that strong really, or isn't necessarily.

The pill over rode my natural cycle. HRT just supports it.

The point about following your own cycle is if they aren't regular. You just end up with two periods in the end. A proper one that happens regardless of where you are in the hrt cycle and then a bit of a withdrawal bleed one as well. It's annoying. I used to believe people who posted that too, but I've tried it, for so many months that I just ended up back at the beginning and decided ... yeah, mumsnetters aren't always right!

Oh, I don't mean 'if they aren't regular '. I mean, they are regular but are not the 28 day cycle that's considered the norm. Mine are 32. 4 days out, across months and months, ends up being weeks out, then a whole month out. It's just irritating. Syncing up with 32 days makes much more sense. Plus it's easy on patches as you can wear them for 4 days anyway.

That's why I went to continuous. Cyclical did work well for a few months when I first started but covid infection upset the apple cart and I definitely went further into menopause a few months later and needed increasing doses of oestrogen.

However I do wonder if a "cycle" has now re-emerged sometimes but I need the utro so much now I can't cope with any dips. I think it's going on behind the scenes a little but boosted with the hrt.

I tried to go back to cyclical after a couple of months on continuous and couldn't cope with the mental crashes.

Yes, I need to go continuous at some point anyway, but my cycle is still there. I do feel like it's starting to change this year - actual menopause rather than peri. I think I have stopped ovulating, last few months, so probably could try continuous now. I always enjoyed the break from progesterone though. It's why I didn't want a mirena as well.

Here's a question worth chucking in...if you're taking HRT how do you know when you're actually in menopause? I'm 56 and have been taking HRT for at least 6 years. I was having irregular bleeds/2 periods for quite a while, even taking continuously. When I changed to Utrogestan that all stopped thank goodness.
But if you still have an HRT bleed, how do you know when you're menopausal?

Owww, I've got several splits/cuts - I use oestrogen cream twice a week but can the utrogestan vaginally cause extra dry skin? I tore using loo roll after a pee yesterday, that's worse than when I went on the HRT

I was put on Sandrena gel and Utrogestan at my first HRT consultation. Wasn't given any alternatives but didn't know enough about it at the time, so just started.
Felt awful pretty much straight away but it took a while before I worked out it was the Utrogestan. Tried it vaginally and it was marginally better at first but then felt terrible again. Like having the flu, I couldn't really function on it. In the end, it was so bad even my family was telling me to stop taking it.

Spoke to the practice nurse, who advised I stop taking it straight away and put me on Provera. It was marvellous! No side effects whatsoever and I was able to feel the benefit of HRT for the first time.
For the past couple of prescriptions, I have had trouble getting any stock. Lloyds direct can't get any and I have previously had luck with local pharmacies but this time, even they can't seem to get any. I have a weeks worth left, so I'm scouring further afield to track some down.
I don't know if its the shortage of Utrogestan that's causing it, as people are receiving it as an alternative but it seems with all HRT products at the moment, demand is outstripping supply 😕