If I have Evorel patches increased, should my progesterone also be increased?

[sheeplikessleep]

My GP has increased my Evorel from 50 to 75 and with that, increased my progesterone tablets from 200mg to 300mg (3 tablets for 14 out of 28 days).

I wish I’d asked at the time if it was necessary, but I am struggling to find anything online about it and wondered if others had had both increased or just the estrogen?

Thanks

I don’t know but I’m on 75mg patches and 200mg for 12 days a cycle (vaginally) so watching with interest

Yes so that’s a different progesterone prescription, which is odd.
Thanks for posting

You should be okay on 200 each month. 300 sounds like an overload to me?

Yes that’s what I’m concerned about and why I posted. I might rebook with my GP.
Thankyou

The British Menopause society has updated their guidance on this recently and do advise that progestogen should be increased for higher doses of oestrogen to privde greater protection from the risk of edometrial hyperplasia. You can read the guidnace here. Scroll down the second last paragraph where it talks about increasinf from 200mg to 300mg utrogestan. So I would suggest that your GP is correct and following the latest guidance.

sorry, that should say scroll down to second last paragraph on page 3

I am currently on 100 everol and 200 progesterone 12 days but!! I am still having hot flushes at night so GP wants to add lenzetto spray 2 a day. I am currently waiting to see if she will increase my progesterone. Not keen to take this much oestrogen tbh

Interested in this, as had upped my patches to 75s, but tablets have remained the same. Similarly to the PP above, my night sweats had started again, after being much improved, but I've swapped to a lighter duvet and that's helped! 🤷🏼‍♀️🤣

@sheeplikessleep The BMS guidance that a poser linked to says (if my memory is correct) that it's only higher, unlicensed doses of estrogen that warrant more progesterone.

@allsogreen

That's for doses above 100mgs patch, more than 4 pumps of gel, or 2mgs tablets + some additional estrogen.

I don't see why you need 300mgs with a 75mcg patch.

@sheeplikessleep A 75mcg patch is very similar to a 2mg tablet, or 3 pumps of gel. No increase in progesterone is required with those doses.

Thankyou everyone for taking the time to post.

I’ve got a GP appointment next Thursday as I’ve been struggling with low mood / possible depression, so also been prescribed sertraline but I haven’t yet started. I’m reluctant because it all feels hormonal and some days fine, some days not. It’s a struggle to know if it’s depression or hormonal. So I want to go in armed with knowledge about my progesterone dose as well for that.

Appreciate everyone taking the time to post up.

@sheeplikessleep is it possible your depression is related to the Utrogestan?

Lots of us on here reacted very badly to oral utrogestan and have swapped to vaginal (and in my case I've done two months vaginally and I'm going to give the coil another go with the understanding that if I get suicidal again they take it straight out!)

I cried for four months on oral utrogestan. Horrific. I thought about walking in front of a truck all day. And then once I wasn't taking it, I got my life and happiness back.

Possibly moredarkchocolateplease, but I was low before starting HRT (alongside the memory issues, anxiety, tiredness, sleep issues and struggling to focus). It's hard to work out what is hormonal and what is depression or whether it is a bit of both tbh.

My husband (who knows me best) thinks my mood hasn't necessarily improved or got worse since starting HRT 4 or 5 months ago. I started HRT hoping it was perimenopause causing it all (I'm 46).

Interestingly, it is oral utrogestan I am on. I wonder if worth trying to vaginal suppositories to see if that helps.

Also, my GP originally tried to encourage me on the Mirena for progesterone side of things ...

@sheeplikessleep you can use the bog standard utrogestan vaginally, just shove them up with your finger. Or get pessaries which are 200mg, I have those.

For me it was apparent about 10 days after having no utrogestan in my system AND increasing the oestrogen, that I was significantly better. I had been down for about 6 months at this point and the utro made it so much worse.

WHC guidance seems to suggest that 75 and 100 are classed as high dose (see table at top of page 3) which surprised me
https://www.womens-health-concern.org/wp-content/uploads/2022/11/27-WHC-FACTSHEET-HRT-Doses-NOV2022-A.pdf
It does, however, go on to say "In situations when a higher estrogen dose is needed and progesterone is taken separately, great care must be taken to ensure that the progesterone is adequate for protection of the womb lining. It should be noted that no data is available for the effect on the womb lining of varying doses of transdermal estrogen and Utrogestan." so they don't seem to now either