Is Utrogestan causing this - bladder frequency and cramping?

[newnamenellie]

Hi,

I've been on cyclical HRT for five months now. I take 2 pumps Oestrogel and 12 days of Utrogestan (vaginally). I'm 49.

I've made some minor tweaks since starting but on the whole have had no issues with it.

Last month, I had a breakthrough bleed mid cycle (around the time I would normally start the 12 days of Utro. It was like a normal period and it was suggested that this was most likely to be my own cycle breaking through). For this reason, I 'reset' my HRT cycle using the first day of the 'breakthrough' bleed as day 1. This meant that I didn't use Utro for four weeks instead of the usual two. I started back on the Utro three days ago and yesterday I began feeling that I needed to wee constantly. I have a dull period like cramp in my pelvis too.

In the past I've suffered with bladders issues (frequency mainly) but not had a problem with this for a good long time.

I'm wondering two things. Firstly, are the cramps and the frequency symptoms linked? Secondly, is this likely to be linked to Utro?

I'm working on the basis that this isn't a UTI as I had lots of experience of this in the past (frequency but no burning which could go on for weeks at a time and no sign of infection on tests).

I've read elsewhere that Utro can cause these issues, but I'm puzzled as I have been taking it for five months now without any real issue. Could it be because I had a longer break from it? Or because I take it vaginally (which I have always done?)

Thank

Sorry I can't answer on the Utro but no sign of infection on UTI tests doesn't mean much since the tests haven't changed since (IIRC) 1958 and they aren't fit for purpose. Indeed the NICE guidelines are now that antibiotics can be prescribed based on symptoms alone rather than a positive dipstick or MC&S.

I have had several episodes of bladder frequency and they mostly (but not completely) calmed down once I started taking topical oestrogen (Vagifem) alongside the HRT I was already on. I have to take it nightly though otherwise my bladder starts playing up, GP is fine with this. So it could be worth trying that. I also do some pelvic floor opener exercises when I remember as I find them helpful.

How much Utrogestan are you taking?

@over50andfab I’m taking two tablets vaginally for 12 days out of 28

Good - just checking as some women only use 1 on a sequential regime.

Taking it this way shouldn’t affect the bladder but low estrogen can. As mentioned above topical estrogen can help with this. Also, ensure you’re drinking plenty of water as concentrated urine can irritate the thinner lining of the urethral tract, and you could look at reducing any potential bladder irritants in your diet.

if you continue to get bleeds at other times than the withdrawal bleed due to pausing the progestogen part of your HRT, you could look at other options like trying Utrogestan orally, a Mirena coil or a combined patch

It can affect the bladder @newnamenellie

When I take it orally (usually for a couple of nights out of the 12, so I can continue to use Ovestin) I always have to get up at night to wee and it feels very urgent.

There was a post here a few days ago by someone saying that she got on okay with Utrogestan apart from having to get up and wee a lot at night.

When I use it vaginally it happens much less.

I found that surprising and put off using it vaginally for ages because I've had very severe bladder issues for years (now improved using HRT ).

My guess is that you may have genito urinary syndrome of the menopause (GUM) (what a mouthful!) formerly knows as vaginal atrophy. The bladder lining thins and can be easily irritated. It can happen gradually and one day you're fine then the next there are issues- and the lack of infection usually means it's GUM.

Also, if you're not aware, the bladder responds to estrogen (favourably) and when you use vaginal estrogen it's absorbed by the bladder through the vaginal walls.

I also get some period type cramps with Utrogestan but very mild and more towards the end of the 12 days, and I think it's the action of Utrogestan on the lining- it changes it.

Do you want to try it orally and see if that's any better?

And ask your GP for either Vagifem or Ovestin and use it regularly.

Thanks everyone.

Lots of helpful advice.

I used to take Vagifem until around a year ago (before I started the other HRT) but stopped because I felt I didn’t need it. I’ve had no UTI/bladder issues for a few years now - the reason I started in Vagifem was due to soreness in that area.

I have Vagifem in my cupboard so could try tonight. As you say @JinglingSpringbells I’ll need to take the Utro orally which I have so far avoided doing. Not sure I want to after reading people’s bad experiences…

The cramping has subsided after taking Feminax (but not paracetamol) which makes me think it must be my uterus rather than my bladder causing the pain.

I’m tempted to just get some ABs in case it is a UTI, though I’m convinced it’s HRT related (same as all of my recent issues in that department!).

Thanks again 😊

Sorry, just to clarify I haven’t tested for infection on this occasion, just basing my thoughts on previous experiences of UTIs and bladder symptoms that weren’t UTIs (which this is similar to).