Confused about Utrogestan

[offtofeedthesheep]

Hi,
I have been prescribed HRT for the first time this week, but I am confused about the dosage my GP has prescribed.

I am 47, til having mostly regular periods. My prescription says to take 100mg daily for 1-25 days, then 3 days off. From my research on here, this seems to be a regime for post meonpause? I am reluctant to start it as worried about this dose and wondering if I should phone GP to query it?

I also have estradiol gel that I should take daily.

Has anyone else been recommended to take progesterone like this when still experiencing periods?

Thanks for any advice.

My specialist gave me the option of either cyclical or constant, so I don’t think it’s definite that if you’re still having periods you can’t do continuous. I’m 44

I still have periods at 55 and I take it day 1 - 12

Following. I literally googled Utrogestan this evening. I've been on it since October and realised I didn't know that much about it. I take two on days 18-28.
Has definitely calmed the rage I experience around that time.

https://www.menopausematters.co.uk/postmeno.php

@offtofeedthesheep Your Dr is incorrect.

See the medical link above.

Continuous is for these ^ women.

Women in peri use it on a cycle of 12 days per month.

Yes, I know some women swear they are ok on the regimen for post-menopausal women BUT the risk is you'll possibly get lots of odd bleeding and that will mean investigations and a lot of questions, or going onto sequential which is the right regimen.

It is definite, according to the link from consultant gynae above (Dr Heather Currie.)

There is a risk of natural periods breaking through with 100mgs a day.

Thank you everyone. I will phone my drs tomorrow and query the dosage. If I move to 12 days, does it matter where I am in my cycle when I start to take it?

I am 48 with regular periods still, I take Utrogestan 100 daily with no break, have done for 2 years

It was prescribed by a specialist menopause doctor

I was told day 15-26

Do you get a bleed at all if you have no break ?

@siblingrevelryagain thats interesting that you were advised similar by a specialist.

I have been very impressed with my GP and the ease of getting HRT, so wondered about just going with it and seeing what happened! Just worried about side effects.

46 with periods but I was told to take for 25 days then break for 5 to have a period
Are you saying we can just keep taking??? Maybe 1 period per quarter?

@KeeeeeepDancing that is an unusual regime it’s usually 12-14days with a bleed or everyday for no bleed.
as @JinglingSpringbells said if go on continuous HRT whilst still having periods your natural periods can breakthrough and and cause irregular bleeding.

@offtofeedthesheep when I first got prescribed utrog my GP made the same mistake as yours it and found out on here and got it changed. You can take it 2 weeks on and 2 weeks off too. Or as previously mentioned pick a date and take it for 12 or 14days and start on the same date each month.

I take it continuously and still have totally normal periods. Am perimenopausal. Seems to make no difference if I take it for just 25 of the 28 days, or just back to back. I still have a period either way

@FoamyBanana that’s the thing if taking it continuously you aren’t meant to bleed. Your own cycles are breaking through.

I just take it from 1st of month for 12 days easier to remember that way.

As PP says-
That's your own periods.

Daily progesterone is the bleed-free type. And it's for women who are post menopause or maybe have very few periods a year- like 2.

The 25 days regimen has been changed, in practice, to every day. Hardly any women using it for 25 days would bleed anyway, because the 25 day regimen is for women with no natural periods.

Women of your age with regular periods take it on a cycle to mimic their own natural cycles.

I left a link to this some weeks ago to the 3-monthly option and the link is to the NICE prescribing guidance.

It states that for women who are intolerant to progesterone there is the option of a 3-monthly cycle, rather than a monthly cycle.

You can probably find the link on the thread I started - it's under 3-monthly option for Utrogestan.

There is also a tablet form of HRT called TRIDESTRA which is a 3-monthly cycle (as tablets) so that's the same thing.

@KeeeeeepDancing Maybe if you need to see a GP about HRT, choose another one?

The dose you've been advised to use is wrong in 2 ways.

There are 2 options, as listed in the leaflet in the pack.

1 The information on the Patient Leaflet (in the pack) is 25 days and a 3-day break (but this is only for women who've not had a period for at least 12 months.) This is based on a 28 day cycle.

This has now been superseded in practice and women who use this combined continuous regimen use progestogen every day (as they would in a patch or tablet.)
The 3-day break is now usually not advised, despite what is says on the leaflet.

2 Sequential dose for women with natural periods- 12 days every 28 days for women who still have natural periods. Again, many drs have simplified this and some women use it for 12 days per calendar month, starting on the same day each month.

Although the 14 days on and 14 days off is in GP guidance, this is not entirely necessary and was only created for 'ease of use'. 12 days is enough (medically) and that's on the Patient Leaflet. Many women find that's better if they have side effects.

Sorry if this sounds so complicated but a lot of women are being given the incorrect doses for their age/ period status.

Menopause Matters website is a consultant led website and there is a LOT of info on this there, under HRT.

I've just summarised it for you!

Blimey. Thanks, I will study this carefully and go and see a different GP at my practice.

Ok so reading that I'm actually having too much prog by taking it for 25 days. I just need days 1 to 12 of my cycle? Or any 12 days of my cycle?
It has to be consecutive?
Thanks

Try to imagine how it works for women using tablets or patches and it might help.

They use a tablet or a patch for half the month which contains estrogen. For the 2nd half of the month the tablet or patch contains estrogen and progestogen.

You're doing exactly the same but you have two items to use, not one pre-packaged.

So, for women in peri, you create a cycle.
This is half a month on just estrogen, then you add progesterone for 12 days.

Don't try to follow your own cycle. You are now going to have HRT cycles.

Just choose a starting day for the Utrogestan. IF your periods are bang on regular, you could wait till Day 15 of the next cycle. If (for example) that's 15 February, you'd take 12 capsules from that day.

Then in March, you'd take another 12 tablets from 15 March.

And so on.

If your own periods are AWOL then you can start this pattern on any day from now you choose. Stick to the same date each month for Utrogestan.

Blimey. I honestly had no idea. Thanks.
May I enquire as to your source of your knowledge? I'm not sure my GP will appreciate me saying 'someone in Mumsnet says'
But there's a heck of a lot of well qualified folks on here!

So this is the wrong dose?

Me too! Prescribed by specialist at my GP practice.