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Menopause

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Gepretix - confused!

8 replies

Didisquat · 15/03/2024 17:38

Hi,

ive been prescriped hrt and have just picked it up and i have 100mg gepretix and oestrogel. My gp said to take one gepretix in the evening every day.
the box says the same on my printed label.
i still have periods and they are still vaguely regular and im confused cos the leaflet says 200mg for 12 days or 100mg day 1 to day 25?!?
I’ve googled and it says you shouldn’t take it continuously unless your periods have stopped?!
also when is day 1?! When is day 25?! My cycle is usually around 27 28 days??
I don’t know when or what to take 🫣
can’t call GP until Monday now and I wanted to crack on with it today
can anyone help please

OP posts:
Lazery · 15/03/2024 18:45

I take 100 mg of this for 25 days too. Day 1 is the first day of my period - that's when I take the progesterone. I stop taking it on day 25 and start it again on day 28. That then becomes your day 1. You have 3 days of not taking it.

Between days 25 - 28. you will have a period or a withdrawal bleed as it's called.

Didisquat · 15/03/2024 19:07

Thank you so much! Couldn’t get my head around it at all after GP said take it every day. So do I need to wait until day 1 of my period to start which would be about 10 days from now? Can I use the gel now or shall I wait and start both at same time?

OP posts:
Lazery · 15/03/2024 19:15

I've been on HRT for a year now so can't remember exactly. Although I think I recall waiting until day 1 of my period to start. I felt it was easier this way as I could start the progesterone count.

I would start the gel & progesterone together. I wouldn't take oestrogen without the progesterone as the progesterone is there to keep the womb lining thin.

Didisquat · 15/03/2024 19:28

Thank you! I will do that. Wait until day 1 and start them both then…. wish it wasn’t all so confusing!

OP posts:
JinglingSpringbells · 15/03/2024 19:42

Lazery · 15/03/2024 18:45

I take 100 mg of this for 25 days too. Day 1 is the first day of my period - that's when I take the progesterone. I stop taking it on day 25 and start it again on day 28. That then becomes your day 1. You have 3 days of not taking it.

Between days 25 - 28. you will have a period or a withdrawal bleed as it's called.

@Lazery This has been changed in practice to daily not 25 days.

See this link.https://www.menopausematters.co.uk/postmeno.php
POST MENOPAUSAL -

Continuous combined therapies.
"Period free" or continuous combined therapy can be used by women who are 54 + yrs, or more than one year since last period at any age.

The criteria should be fulfilled in order to offer such treatment to women who no longer have a continuing ovarian cycle, so that steady levels of both estrogen and progestogen can be achieved.

When there are steady levels of estrogen and progestogen from daily administration of both, the womb lining stays thin.

Although some bleeding in the first 6 months of therapy is common, there should not be bleeding after that and the lining does not go through the stages of stimulation and then shedding as it does during a normal cycle and with sequential therapy.

UTROGESTAN Micronised progesterone 100mg at bedtime from day 1 to 25 of each 28 day cycle (licensed regimen), though taken every day is usually recommended

^^The regimen is for women post menopause.
The likelihood of a withdrawal bleed on 25 days is quite unlikely. It's there as a type of 'insurance' if there is any lining to come away but in post meno women there isn't.

@Didisquat If you more or less regular periods you should be using the sequential/cyclical regimen of 12 days per month.
The best way to start this is to choose the same day every month (ie 1st) and stick to it. In time, your own natural cycle will fall into the pattern set by HRT.

Sadly, there are posts here almost daily where GPs just dont know how to prescribe.

Postmenopause : Menopause Matters

Menopause and treatment options. An independent, clinician-led site aiming to provide accurate information about the menopause.

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

JinglingSpringbells · 15/03/2024 19:45

Oh and by the way Gepritex is a cheaper brand of Utrogestan. It's just been launched onto the market.

@Lazery The way you are using it is not a withdrawal bleed regimen.
The withdrawal bleed comes on the 12 days a month type.

(This is all on the patient leaflet.)

Didisquat · 15/03/2024 19:50

Oh I’m even more confused 😫 is this for 200mg then? Would I take 2 for 12 days then?! Thank you

OP posts:
Gepretix · 31/12/2024 15:17

Hi. Iv been taking combined hrt for around 6 months due to severe moods and anxiety. I wasn't having periods but do have a mirina coil which was placed as I have cervical endometriosis. This has been in for 5 years and i need surgery due as there are complications, to have it removed (I am in no hurry). So I need to take progesterone for my cervical endo.
My point is this, I am on continuous combined hrt, I am 44, and yes I no longer have periods but probably as I have a coil in place? I did know when I would be on as I can just tell, may have had very slight marks on liner.
Is it safe for me to be on continuously combined hrt?! My moods and anxiety have completely subsided but the cervical endo could be encouraged to grow back? I want to take progesterone on its own?! I am unsure if this is safe, not sure I trust gp advice as not sure I should have been suscribed this in tbe first place, although I feel much better. Thanks

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