Utrogestan please advise

[LongtimeLurker2]

I've recently started HRT after suffering terrible peri symptoms for months and feel I've messed up at the first step.
In my haste to get on with treatment I started HRT the night I got my prescription 17/4/24.
I've been prescribed Everol 50 and Utrogestan 100mg to be taken once daily day 1-25 of 28 day cycle.
It's dawned on me this week after feeling rotten and like I need to have my period after a few days spotting the day 1 is day one of my cycle!
So what should I do now, continue to say 25 which would be 12/05/24 or break off early to relieve bloating and have a period.
My period prior to starting HRT started 11/04/24.
In the main my period cycle is no longer 28 days and varies between 22-26!
I've contacted the Pharmacist who refers me back to the doctors. I cannot get an appointment in the next few days so I'm hoping somebody here in the know can please help/advise! I'm worried I've messed it up, the past few days I've felt terrible with anxiety and confided my hormones are now messed up ( self inflicted). Any help or advise would be appreciated

Despite my username I'm not a Dr, but personally I'd just keep going now. Sounds like you're just getting some side effects from starting the utrogestan but they'll probably just subside naturally in a few days. If you break now and start again you'll just go through this all next time.

I was advised to do it on dates seeing as my cycle is all over! So I'm doing from 1st if every month.

Thank you for replying, I wondered if these were side effects from the HRT. I've been worried about this messing up of dates for a few weeks so not sure what's what anymore. Hard to know what to do for the best sometimes. I've managed to get an appointment with a HRT specialist through my Dr's however again that's in 3 weeks. Not ideal.

If it helps I felt really bloated for a few days when first taking utrogestan, tearful and massively sore boobs. Lasted about a week I think.

Im 3 weeks in so maybe I'm expecting thins to feel more settled too quickly.

The 25 days a month has now been changed in practice and women use it every day as a combined continuous regimen. 100mgs ( 1 tablet)

If you are post menopausal then your GP should appreciate the dose is now every day (contrary to the leaflet.)

But if you are having periods still you should use HRT on a cycle,
which is 12 days per month, (200mgs daily for 12 days. )

Normally it's best IF YOU CAN to start the cycle of 12 days midcycle (your own cycle) but if periods are not regular you can start anytime.

HRT will eventually create a new HRT cycle.

Are you sure your GP knows what they are doing?

I didn't feel like my GP knew what he was doing during consultation, I've also read that about taking it for 14 days on then off hence why I thought I'd better get into see the HRT specialist.
I'm very bloated, I feel like I need to have a period as spotting.
What would you suggest be the correct thing to do going forward. I can't even get a telephone consultation with my GP urgently.
My HRT specialist appointment is 22/5/24.

Sorry to add prior to HRT I was having periods, they were lighter and more frequent than 28 days.

I took utrogestan for big and had all those symptoms you are describing. Not fun

IVF. Not big

Can I ask did they ease at all, I just feel hopeless with it all. I thought I'd start to feel better but if anything one set of issues has ended and another set has begun.
I feel huge at the minute, my belly is so bloated but didn't know if that's because I need to have a period.
I just don't know what to do with it all.

I'd start taking it for the second two weeks of your cycle from your next period, it is meant to be taken in that part not the first two weeks.

Would you continue on for the next 5 days to complete this 21 day cycle the doctor has put me on then count from my period start date?

TBH there is a LOT of confusion over this even between doctors.

The regimen is 12 days per month and most specialists don't go by the 14 days on/off but suggest 12 days each calendar month.

(The 14 days on and off was suggested in GP 'training' to help women remember how to take it .)

I'm not clear where you are in your cycle.
Put it this way, nothing terrible is going to happen whatever you do over the next few days or weeks, regardless of how you take it.

And to be honest this shouldn't need a menopause clinic to sort out- it's very very basic HRT prescribing and your GP could easily update themselves with all the online guidance that's there.

You've said your dr has put you on 21 days but upthread you said 25 days. Typo?

Taking 100gms a day doesn't stop the bleeding or reset your periods. The dose is too low. It's supposed to be for women who don't bleed at all (or very very rarely.)

You could stop now and then start again on 1 June taking it for 12 days.
Then the 12 July etc.
But you have to take 200mgs not 100mgs.

Your period will come as and when, and as you're in peri may be delayed but ignore that.

@Orangesandlemons77 But the problem with that is that some women don't have a regular cycle and they could be waiting forever for the '2nd half'.

That's why it's better to start on a set date every month and HRT resets a HRT cycle.

There's none of this confusion with tablets or patches.
They are estrogen only for 14 days then estrogen + progestogen for 14 days.

That's helpful and reassuring thank you.

Sorry that was a typo, I'm on 1 100mg taken daily for day 1-25 of 28 day cycle.

Started Utrogestan on 17/04/24.

My period prior to that started 11/04/24.

I feel I've got myself in a mess with it and currently have backache and pains as if I'm due on however still have 5 more nights of taking a tablet. I'm tempted to just stop tonight. I feel dreadful.

I'm on almost exactly the same regime as you - (not peri menopause, post menopause) on Evorel 75 and 100mg Utrogestan for 25 days out of a 28 day cycle, and they ALWAYS come in a box with 30 in them. Ive mucked up my dates more than once via my iphone calendar and even when I've gone to the trouble of writing dates on the blister packs, confused myself with the leftover tablets. I have now also been recalled for a hysteroscopy due to spotting going on. I find the whole Progesterone side difficult. Never gone wrong with the Evorel patches though.

I was on the same as you - 25 days on 3 days off. I also started as soon as I got the pack rather than on day 1
I just carried on for the full 25, then 3 days off. Absolutely fine
It takes a while for your body to adjust

@abracadabra1980 This is why women who are post meno are advised by drs to take them daily- so that's the whole 30 in the pack = a month.

If you are post meno you don't need the 3-day break.
This is now considered outdated. It was only there in case there was any lining to come away. But after 6 months on a continuous regimen the lining should stay thin.

Spotting is normal and expected within 6 months.

If you are missing pills each month that could be why you're spotting.

Has your dr not been updated on the daily dose rather than 25 days a month? Most of the guidance for GPs says women should use it every day and ignore the 25 day in the leaflet.

(Women using pills or patches don't miss 3 days a month.)

I really appreciate everyone's responses and contributions .
I've been doing some watching of Dr Louise Newsons YouTube videos and had a look at her balance app.
The advice on there is if still having periods to take 2 pills day 15-26 of cycle or 2 weeks on two weeks off.
It's such a shame that GP's are still not giving out consistent and up to date information on how to use HRT. It's been reassuring to hear others experience and symptoms. I don't know anyone else my age who's started HRT so feeling quite alone with it all.

@JinglingSpringbells conscious I don't want to derail OP's post but nearly started an identical one tonight. I know you have excellent advice from other threads (are you medical?). I've been lazy seeing my GP, just because of DDad being at the 'end' of his life for a very long 3 years. Caring duties have been immense - no headspace for me at times. So I can just carry on taking them for 30 days as of now? If yes, that will be a godsend.

I am 58 and post menopause for 5 years , started on Evorel Conti in January felt good a few side effects mood swings, sore boobs etc. However after 10 weeks I started to have a light bleed, then after three weeks became a full on bleed......having been period free for 5 plus years wasn't too impressed. Back to GP who put me on Evorel 75 patch change twice a week and Utrogestan 100mg daily, felt great on this and my sleep was brilliant finally getting full nights sleep , not had that in years so happy days, then one month in felt off moody etc , boobs tender and here we are again light bleed started . I will monitor this and see if it gets heavier or hopefully goes away, I understand its a juggle to get the balance right and I'm happy to give this new medication a full 6 months but after that I think I may have to stop or try alternative.