Utrogestan every 13 weeks question

[pharmachameleon]

Just want to make sure I'm interpreting the NICE guidelines dosing information correctly before I see my GP soon. I was on Oestrogel 4 pumps daily and Utrogestan 100mcg each night for years without any problems. The pump pack of Oestrogel changed shape and when I switched to this I felt like crap. I was waking up at night with palpitations and had weird numb patches over my legs. Saw my GP who changed me to Evorel 100mcg patches and said my Utrogestan dose should have been higher so increased this to 200mcg each night.
I feel horrendous on two caps at night. It's like a strong sleeping tablet so I feel really groggy during the day and I'm flat and depressed.
I'm going to ask my GP if I can switch to the long cycle HRT as I think I'd manage ok on Utrogestan every 13 weeks. Can I ask when I start counting the 13 weeks? Is it from day 1 of Utrogestan or from the last day of 14 of Utrogestan? No idea!

It's every 12 weeks, not 13.

Or 84 days.

So you'd be using Utrogestan from Day 70 to 84.

If this was the start of using HRT, you'd use only estrogen for 70 days then add in Utrogestan.

I am not 'medical' so this is only based on my own experience of long cycle (with a consultant) but I wouldn't think it wise to go to a 12 week cycle when you are 100mcg patch. Your lining may become very thick.

There are variations on the long cycle (individualised by a doctor) and in your case where you're using a high dose (twice what I use), you might want to think about a 6 or 8 week cycle.

So, for example, if you took estrogen only from 1 June, you'd have 4 weeks of it, then 2 weeks with Utrogestan from mid-July.

OR 6 weeks of estrogen only then 2 weeks of Utrogestan.

Aw crap @JinglingSpringbells. I was quite excited about the prospect of not taking Utrogestan for 12 weeks. Thanks for replying anyway.

Well, you need an expert to advise.

It's not impossible but my own opinion (and it's just that) is that if you did this off-label on 100mcgs patch, the 'deal' would be you had a scan once a year to check all was ok. (and unlikely the NHS would provide that.)

And bear in mind too that the withdrawal bleed would be 3 months of lining and could be heavy.

I used to do a 3 month cycle and the bleeds were yuck to be honest.

I hadn't really thought of that. I naively thought as I've always had pretty light periods that a bleed every 3 months would be fine. But of course it's not a true period.
Back to the drawing board. I'll maybe need to go private. The two Utrogestan each night are really killing me though. I feel like an angry, bitter zombie on them!