Utrogestan has been upped from 100mg to 200mg...

[LifeInAHamsterWheel]

I had my annual review today (private clinic) for the last couple of years I've been on 75mg estradot patches with 100mg utrogestan & azalia (mini pill) taken every night. I feel brilliant, have had no issues or side effects and felt the benefits almost as soon as I started it. Today the doc said that guidance has changed and that my estrogen dose is medium-high so I'd need more progesterone. So she'd upped my Utrogestan to 200mg every night. I'm just a bit worried that this is going to upset the really good balance I've had! Is anyone else taking 75mg of estrogen and 200mg of Utrogestan (every night) and do you find it ok? Thanks

I tried 200mg utrogestan daily for 3 months but I turned into a zombie. I had a chat with doctor and trying one oral one vaginal daily ( at my own risk, as she said limited info ) and I've reduced HRT slightly.

https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

This is on Page 3 (of 9) BRITISH MENOPAUSE SOCIETY GUIDANCE

It's GUIDANCE.
This is not a 'must do'. It's down to the individual and their responses to estrogen/ Utrogestan. Note the word 'consider'.

One consideration is an increase in side effects.

The first sign of hyperplasia is usually spotting or other bleeding.
Ideally your GP should scan your womb lining before increasing the dose. Or do a scan if you have unexplained spotting etc. It's rare for this precautionary scanning to be offered by the NHS but you could ask. Or you could change to private HRT prescribing and pay for scans etc and a more individualised approach from a more experienced doctor, if it's within your means!

The dose of the progestogen should be proportionate to the dose of estrogen. While no data is currently available on the endometrial effects of high doses of estrogen and the optimal dose of oral or vaginal progestogen in this context, women who require high dose estrogen intake should consider having their progestogen dose increased to ensure adequate endometrial protection (e.g. micronised progesterone 300 mg for 12 days a month instead of 200 mg in cyclical HRT regimens or 200 mg daily on a continuous basis instead of 100 mg in continuous combined HRT regimens).

Thank you (both)

As I said, I've had no problems at all, no bleeding or headaches etc so I sort of feel 'if it's not broken why fix it' but then again I'm not a doctor! I might give it a go and see how I get on, if I sense any negative side effects I'll reduce it back to 100mg. I'm hoping my prescription will still be the 100mg pills and I just take 2 of them.

I'm in the same place. Have been using a 50mcg combined patch with a 25mcg estrogen top up patch for 3 years without issue. Have had surgery recently for uterine polyps, lining was fine. GP has insisted on giving me 200mg of utrogestan. I have taken it before and it is awful, I only lasted 3wks last time. GP said I need to give it longer and the side effects will lessen.
Can't work up the courage to take it, so atm I've reduced my estrogen patch, but now I'm getting menopausal symptoms again.
I'm really not convinced and the utrogestan doses are massive, as it is mg not mcg like Norethisterone, which was my previous progesterone.
So pissed off.
Just edited to add, the utrogestan will be 100mg capsules. You can use them vaginally, but they do contain titanium dioxide which isn't ideal.

That's awful @LaughingHistorically do you mind me asking what symptoms did you have?

My friend is a nurse and she says to try it but if I find it really bad to go back to the lower dose, it's only 'guidance' ?

Just edited to add, the utrogestan will be 100mg capsules. You can use them vaginally, but they do contain titanium dioxide which isn't ideal

The 200mgs ones are exactly the same.
They are used for fertility (usually 200mg x 3 capsules a day.)

You can get the 200mgs for HRT (and some women do).

You can't compare Norethisterone and micronised progesterone ( one is synthetic and very strong.)

GPs seem a bit OTT with this.
Hyperplasia isn't cancer. You can have hyperplasia (thick lining) and usually you'll get spotting. This is treatable with more progestogen or a Mirena coil.
Hyperplasia that is 'atypical' (meaning irregular cells) can turn to cancer but most women would not get to that stage as they'd see their dr about spotting and it would be treated.

Most hyperplasia and endo cancer is in women not using HRT because either they ignore spotting or they aren't being monitored as part of being on HRT.

The exhaustion was the worst, I didn't actually feel safe driving it was so bad, I felt sedated. Also I couldn't think straight, which was ironic as brain fog was one of the reasons I needed HRT. My breasts were really sore too and I was bloated, which the GP insisted could only have been caused by too high a dose of estrogen (the same dose that I'd been taking for years without issue 🤦). I was also tearful and bad tempered.
I don't think I'm progestogen intolerant as I've never had issues before with various types for birth control and used it as a teen to delay periods. I didn't have bad PMT pre menopause either (which apparently is another risk factor for intolerance). I just felt that the utrogestan was too strong.

The 200mgs ones are exactly the same.
They are used for fertility (usually 200mg x 3 capsules a day.)

Jeez. The thought of 600mg a day 😭. I didn't get on with using them vaginally either.

I tried taking one 100mg am and one 100mg pm
not sure if I should or how long utrogestan is in your blood
but have muscle pain particularly after my 3rd oestrogel pump at night. Am on 3 pumps a day
the menopause the gift that keeps on giving😩