Completely confused about progesterone - can anyone enlighten me?

[Picklemeyellow]

Why is it not advisable for a woman to take only the progesterone part of HRT but ok for them to take the mini pill, have the Mirena coil or other forms of synthetic progesterone?

I ask this question because I have suffered for decades with gynae issues and during the last 10 years or so (I am now 50) I have had endless issues with very heavy bleeding caused by recurring uterine polyps which I’ve had removed endless times via hysteroscopy, each time I am being told they won’t grown back but they always do.

Following on from a failed uterine ablation last year I have discovered (just before Christmas) that I have endometriosis (most likely the cause of my decades of issues) and adenomyosis. My regular (and pretty useless imo/ime) gynaecologist is now referring me to the endo team for further investigations.

Before I discovered about the endo issues, I had suspected for years that my gynae problems have been caused by unopposed oestrogen but always told that it isn’t. In recent years, during the start of my perimenopause I asked if I could take Utrogestan on its own as I’ve always wanted as natural as my own hormones as possible but always told no as I would need oestrogen as well. However, I am now told that due to the discovery of the endometriosis & adenomyosis I should not be taking any extra oestrogen incase it triggers the endo off but for the time being, until I’ve seen the endo team my gynae will prescribe me the mini pill yet still won’t prescribe me utrogestan.

As far as I am aware they are both progesterone (obviously the mini pill being more of a synthetic version) so how come it’s ok for me to take the mini pill but not the utrogestan?

Can anyone help me with this? I am being discharged by my regular gynae and now sitting on a (God only knows how long) waiting list to see the endometriosis team so have no one to ask and I won’t even bother with my GP as last time I asked about HRT she told me Utrogestan causes blood clots and wouldn’t prescribe it to me (even though I have no history of blood clots and can not find any online evidence Utrogestan causes these).

I have no scientific data on this, nor am I in the UK.
But I can tell you that I - 48, in peri, with disturbed sleep and mood, but cycles still more or less regular - was prescribed just utrogestan 200mg on days 14-25 of the cycle. My gynecologist said we would decide on next steps when I see her next fall.

I'm not sure, because everything I've read on the subject agrees with you that unopposed estrogen is an issue that can be solved by bio identical progesterone (as you said, Utrogestan but not mini-pill or mirena). It doesn't make sense does it? Sorry no helpful advice.

How are you getting on with it Slavica? Are you finding it helpful?

EverySporkIsSacred it’s really makes no sense to me either. I’m really confused and no idea who to talk discuss this with. Just had a letter this morning, from the gynaecologist confirming he has referred me to the endo team and has discharged me from his services. Just asked on my local endometriosis fb group and apparently it’s months and months to see anyone on the endo team so currently floating in limbo land.

I am wondering this too. I have endo/adeno/cysts and I have just started HRT. I've only been on it a few weeks but in the few weeks that I've been on it, the days when I take the unopposed oestrogen I felt worse and the days I was taking it with Utrogestan, after 3-4 days, I felt great.

I am due to report back after 6-8 weeks and I'm going to ask about it all then but until then, I'm going to follow their instructions so I can give proper feedback!

ps I still have regular periods and am 50 (about to be 51)

You are so very similar to me, I’m also 51 in a few months. No let up in my regular cycle as yet.
I may have to see if I can go private to consult with a gynae who has an interest in menopause?
Good luck with the hrt, I hope it eventually settles for you.
What have they recommended for the adenomyosis? My gynae says I’ll probably need a hysterectomy 😢

Yes, it has helped! It's not a panacea, but somewhat reliable sleep is wonderful. I've also been lucky in that I've had no side effects (I take it vaginally); it's been a bit more than three months now for me, and so far, so good.

@Picklemeyellow I don't want a major operation so for the moment, even though that's an option, I'm not going for it. Yes we sound very similar! I don't think Utrogestan causes problems taken consecutively but it's not what you're meant to get when you are still having periods so i think you have to get a specialist to prescribe it for you if you want to take it that way. I'm going to ask when I've finished this 6-8 week period - I already can't wait for the 12th which is when I start taking progesterone again!

That sounds good, hope it continues to help you.

I don’t want an op either right now, my mental health isn’t great and an op will tip me over the edge.
I’ll see what the endo team can offer, hopefully it won’t be too long a wait.