Are soft capsules some kind of a joke

[Userxyd]

Just opened a new pack of progesterone tablets - soft capsules again. Why??
They're almost impossible to swallow as they're soft and rubbery so they grip onto your oesophagus as you're trying swallow - absolutely revolting as no matter how much water I swallow they stay stuck there for ages. Especially as you're meant to take them at bedtime so you lie down straight afterwards.
Theyre not suppositories, they're meant to be swallowed- can anyone tell me the logic behind these evil creations? What's wrong with standard hard shiny tablets that just fly down your throat with no effort?

I am in complete agreement. Why do they make them impossible to swallow? The number of times I’ve gagged on the stuck capsule.
I now have a good drink first then the tablet straightaway whilst my mouth is still wet, chin down, and this reduces the instances for me of it getting stuck.

I agree, being totally round they are a stupid shape for swallowing. When I used to take them I squished them between my fingers to flatten them a bit which made it easier.

Because they are mostly used vaginally.

(Spain, France, Italy etc)

Thank you - I thought I was missing something but glad it's not just me.
Thanks also @BlackStrayCat - not sure knowing this will stop me gagging but it does explain it!!
Wonder why we don't take it that way here? I suppose it's more European that way lol

My capsules in Spain say "for oral or vaginal use"

I think menopase doctors do prescribe it this way as it is better absorbed and bypasses the liver.

Just push the capsual up your hoo haa like you would a tampon!

I mean menopause doctors/specialists in the UK.

Many on here take it like that.

I've never had any problem swallowing them. Just take them with plenty of water.

I didn't know about the liver risk taking them orally. I'll think about that, thanks!

I just love the solid nights sleep you get with them - fantastic 😍

I always do it just seems the water sloshes past while the little buggers cling to my throat! Maybe I'll try milk instead as it's thicker

@Userxyd it's not a liver risk, everything you absorb from your gut goes through the liver to be sorted before going anywhere else. It's called first pass metabolism.

It is more effective as it is not processed by the liver, it is absorbed directly where it is needed.

Utrogestan is approved as an oral treatment however, can be used vaginally off-licence by those who do not tolerate it orally.

I’ve attached some information on this from the British Menopause Society. See page 4 which also mentions absorption levels being unknown when taken vaginally for treatments intended for oral use. That said, when used at the same dose as orally many women find it effective used this way. Personally I tried both when I took HRT and found I preferred the oral route.

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

If you don't fancy vaginal use just pop it in a spoonful of yoghurt, that'll help it go down!

@Userxyd There isn't any risk to the liver when swallowing them.

'Bypassing' the liver means that more of the active drug gets absorbed directly into the system, because the drug isn't being digested in the gut in order to be metabolised.

That doesn't mean that drugs which are processed via digestive system will harm the liver.

With Utrogestan, more of the progesterone gets straight to the uterus through the cervix and vaginal walls (it still goes into the blood stream) rather than some being lost as it's processed by the stomach, then the liver etc etc.

Sorry @toomuchfaster I missed your explanation before posting!

@over50andfab The BMS are relying on limited data and being extremely cautious. It's common practice to use the 100mgs capsules either way.
The 100mgs oral capsules used vaginally are exactly the same as the 200mgs ones that are marketed as vaginal capsules (and used in the UK mainly for fertility.)

I've had both but prefer the 100mgs as I can use those orally as well if I need to (vaginal use causes some irritation after a while.)

@Userxyd Have you tried keeping them somewhere colder?
I've just noticed an issue with swallowing them, for the first time ever, and can only think it's because they have been somewhere slightly warner than in the usual cupboard where I store them!

Thank you all so much for this info and for the yogurt/cold capsules swallowing tips! Annoyingly I literally just finished a yogurt then had the same thought I could've had the capsules with it. Will try tomorrow though. My bedside table is usually quite cold and the house has been freezing lately but I'll ponder it anyway.

And v reassuring to know it's no risk to the liver taking them orally. I'll stick to that then as it suits me that way.
Thanks for all your helpful advice - MN wisdom is unparalleled 🥹