Utrogestan out of sync with period?

[redfacebigdisgrace]

I used to have a 28 day cycle but the last few months it’s been more erratic. I’ve just started HRT - Evorel 50 and 100mg Utrogestan.

I did patch only for the first 14 days then took the Utrogestan for 14 days too. But on day 35 I’ve still not got my period (I’m now 6 days post finishing my 14 day Utrogestan) -is this OK?

At this rate, it looks like I’ll be on my next Utrogestan 14 days cycle whilst I’ve got my period from the prior month. I’m confused!

Any help would be great, thanks.

I used to have a 28 day cycle but the last few months it’s been more erratic. I’ve just started HRT - Evorel 50 and 100mg Utrogestan.

Is this from your GP?

The dose is incorrect unless it's a typo? :).

If you are on a sequential regimen, you take 200mgs Utrogestan for 12 or 14 days per month. This is also on the leaflet in the box if your GP isn't sure.

It's actually a choice of 12 or 14 days (as per the leaflet.) 12 days is enough but 14 is for women who need more if their withdrawal bleed is heavy.

A withdrawal bleed doesn't always happen, especially in the first month and it can take 3 months at least to get into a regular HRT pattern. Don't worry just make sure your dose is right.

@JinglingSpringbells hi thanks for your reply. Yes, you are right. It is 200 mg. I just got confused because the tablets themselves are 100 mg, but my dosage is two tablets per night.

I am on the same prescription.

My cycle is haywire and unpredictable. GP told me to just take it at the same time each month, so I take it 1st to the 14th.

Very interested to hear if this is normal / anyone else having to do it this way?

And I have the 100g tablets but only take 1 per day. Have I messed up there too??

@Luckingfovely what is your oestrogen prescription?

As others have said - this doesn't seem right. Do you wear your patch all the time ?your post sounds like you only use it for 2 weeks then switch to utrogestan. And 100mg is definitely not enough - I think 200 is the minimum for a sequential regime.

@Localher0 no I’ve just replied underneath. It’s 200mg. I forgot I took two pills at 100mg each. And yes the patches are on the whole month.

You really don't need to worry.

1 HRT resets the cycle so your own periods should follow it eventually.

2 You can take 3 months or more for a regular withdrawal bleed to occur.

3 Not all women have a withdrawal bleed every single month (you can read more about this if you google - put the question into a search.)

Mine experience was the same - random bleeds not synced up with utrogestan. The bleeds got rarer to about 2-3 a year, and now I am considered post menopausal and take continuous rather than cyclic hrt.

@redfacebigdisgrace
ah ha! That makes sense now. When I started on this regime I was on 300 mg for the first few months and that reset my cycle well. Then I dropped down to 200 and have been on that ever since with a cycle that was around 23-26 days but recently has steadied at 28 on the dot! I'm 54 and still have a period every month. My Evorel patch is now 100 but I'm thinking of asking to drop it as I have sore boobs all month 😡

@Localher0 It's not a period each month- it's a withdrawal bleed. If you carried on with a HRT cyclical regime for life, you'd have a withdrawal bleed forever- even at 90!

I think you should query the amount of Utrogestan. For women on a high estrogen dose (patches of 75 or 100mcgs) the advice now is for 300mgs Utrogestan for 12/14 days a month.

The reason is it seems you're bleeding early. If your bleed starts on day 28, then presumably you've just taken Day 14 of Utrogestan? If you were bleeding on day 23 that was well before the end of the Utrogestan.

A bleed usually starts 3 or 4 days after the last dose, when progesterone levels fall.

@JinglingSpringbells Thanks - that's very helpful! I think I'm counting my days differently- yes I bleed after the progesterone. Usually 1-2 days after the last one. I count the first day of bleeding as day 1. I asked my Dr when I would know if I'd gone through menopause and she said that my periods would get lighter and shorter and less regular and then we'd switch to continuous. I've got a review next month so I'll ask about it then.

The day the bleeding starts is Day 1 of your cycle, so that's right.

If you're taking Utrogestan from (example) Day 14, for 14 days, that's 28 days in total and the bleed would be Day 30 from what you say.

I asked my Dr when I would know if I'd gone through menopause and she said that my periods would get lighter and shorter and less regular and then we'd switch to continuous.

Errrr....no! That's only for women not using HRT.

You will continue with a withdrawal bleed forever regardless of if your periods have stopped. (I've chosen to stay on cyclical for 16 years and still have a withdrawal bleed. My own periods stopped 16 years ago.)

I am so confused!

My prescription is Evoral 50 patches x 2 per week all of the time.

Plus Utrogestan 100mg capsules - One To Be Taken Daily On Days 1 To 14 of cycle

I currently take the Utrogestan on days 1 to 14 on each month as cycle is unreliable. Gp advised to do this.

From comments above this doesn't seem right?

And also - can I 'manage' the medication to stop a bleed coming? For a dream holiday abroad!

P.s. I'm so sorry OP to jump on, there seems to be awesome advice here, so lmk if a prob and I'll start another thread!

I don't have withdrawal bleeds for some reason. No one seems to know why but apparently it's fine. I do still have periods though. My cycles vary from 20 to 40 days so I'm bleeding at random points now. As long as I'm bleeding eventually my dr isn't worried

If what you are doing is 'prescribed' it's shocking that a GP is wrong.
The dose is on the leaflet in the box, for a start (if they don't know.)

It's very clear what the dose is (unless prescribed otherwise by a specialist.)
It's not your fault, but I'd always recommend everyone reads the leaflets in the pack of any drug in case the dr or even the pharmacist has made an error.

The dose for sequential is 200mgs a day- that's 2 x 100 capsules.

You're supposed to a) take them at bedtime and b) keep to the same date each month. So for example, on 1st May you'd do 2 capsules for 12 or 14 days
Then again from the 1st June.

Again, on the leaflet it mentions 12 days with 14 as an option for women who find they bleed heavily.

Yes, you can adjust the dose if you want to avoid a bleed but the first thing to do is get your dose correct. Too little Utrogestan often causes heavy bleeds.

If you want a 'holiday gap' you need to start the Utrogestan earlier or later so the withdrawal bleed is outside the holiday.

@JinglingSpringbells thanks so much for your thoughts.

I copied and posted that prescription dosage from the NHS, that is definitely correct. Oh, and I take it in the morning!

I will go back and challenge this with them. Really appreciate your input.

@Luckingfovely no worries at all. It’s all useful info! Hope you get it sorted!

@JinglingSpringbells Hi, I’m the OP - I was just planning on doing 14 days patch only, 14 days Utrogestan and patch, 14 day patch only, 14 days Utrogestan and patch and so on….Just keep it to a Tuesday and switch up that way. Or do you think I should do it in the same date each month? Or does it not matter? Thanks for your help - much appreciated!