Desoestrogel (mini pill) and utrogestan?

[AlertCat]

Unusual one perhaps. I have been in perimenopause for a few years now, and two years ago was going to have a mirena coil fitted as part of starting HRT. However, she couldn’t get it in past my cervix and while I was waiting for an appointment at the sexual health specialist clinic, I went onto the POP as a contraceptive. I also took the Health & Her supplement and found that this combination really helped my symptoms, so I didn’t pursue the HRT.

Now, I am getting more symptoms again and want to go back to the doctor for HRT. But I don’t really want a coil (I didn’t really want it before) and I REALLY don’t want to become pregnant. I haven’t had a period since starting the POP but they had become very irregular when I was last tracking them; I have no reason to think I’m not ovulating any more.

A client of mine has given me (unasked but very kindly) a box of utrogestan and a box of Lenzetto. I’m quite keen to give them a try but I know the utrogestan isn’t a contraceptive (and desoestrogel doesn’t have the protective effect for the uterus that Mirena or utrogestan would).

My questions are- can I take both forms of progesterone together- one as a contraception and one to protect me from “unopposed oestrogen”?
two- could I try just the oestrogen for a month and see if it helps with my symptoms?
three- would I be wiser to wait and see the doctor? The client isn’t someone I know well but she’s very keen on sharing the HRT love. She also sent me links to information and also a well women’s clinic in case I wanted to go there. Both products are sealed and new.

(In the longer term partner would be willing to get the snip so I’m really wondering for the short term.)

Well I don't think you should do anything without discussing with your GP, but I've been on HRT for over 2 years and I didn't want a mirena coil so I take the mini pill which I had already been on for 8 years and take Utrogestan every night (and estrogen patches twice weekly) Never had any problems with it.

Lenzetto a very low dose and I didn't absorb at all.

I think gel/patches are preferable along side nightly utrogesten.

I take both. The mini pill sorted out my very painful periods but I also take utrogestan as part of my HRT. Menopause doctor keeps trying to get me to have a Mirena but I really don’t want to.

I was told by my consultant that the mini pill can be used as part of HRT but in a larger dose- like 3 tablets a day. I chose Utrogestan instead.

I wouldn't advise you to take any prescribed drugs given to someone else without seeing a doctor.

How would you get an ongoing supply if you got them from a friend? You'd need to see a dr and hide the fact that you'd already tried them.

@Fedupwithneighbours same, I don’t fancy the coil at all.

@JinglingSpringbells yes, I know, I feel a bit odd about it and haven’t used them partly because of that, partly because of not knowing how much to use. I will make another appointment with the dr. My menopause GP told me that the POP doesn’t have the protective effect on the uterus, so she said they wouldn’t prescribe it as part of HRT. It annoys me that different people are being told different things, I bet if men went through this the medical treatment path would be much clearer and better studied!

i also need contraception so had hoped desoestrogel would do both!

Your GP is not a menopause consultant. I'd not expect them to know. However, apart from being told about this myself from an excellent consultant, I'm sure the info is provided for drs on guidance by the British Menopause Society on progestogens in HRT.

If I have time I will look for it for you.

In my experience as I am still having periods and 51 I need some form of contraception so I am taking the mini pill. In addition I am having loads of perimenopause symptoms so I am on HRT. I use gel daily and because I still have periods I take progesterone every two weeks roughly.

I can not exactly remember the guidelines for continuing to have some form of contraception but I think that if you are still having periods you can stop after 55, if you have had no periods you can stop after 2 years if you are under 50 and 1 year if you are over 50.

I seem to think that the need for contraception and HRT are separate things.

@lorisparkle yes I’m sure they are. I’m not 50 yet and conceived first cycle with my dc so I am really cautious about contraception (I don’t trust condoms!) so need to know that that’s covered. OH is considering a vasectomy but it wouldn’t be his first choice.

Maybe I just need to go back to the GP and ask for all of it, and suck up the prescription costs. (I have a vague memory of the Mirena being offered because it could be free as a contraceptive, whereas the other progesterones would not be. But I am concerned about the insertion process, the risk of it falling out, and the potential for painful periods with it; I used to have horrific pain with my periods and really don’t want that again.)

In the uk you can buy a HRT prepayment certificate so the cost of HRT is cheaper than the usual prescriptions. I ended up getting a prepayment certificate for all prescriptions as I was needing prescriptions for many of the other things I was suffering with which I am sure are linked to menopause but HRT is not helping with.

@AlertCat This is from the BMS guide for GPs on progestogen in HRT.

This would be a combined continuous regime as you'd need the POP daily for contracpetion.

Progestogen:

Micronised Progesterone: Utrogestan 100mg orally at night daily on continuous basis
Or Provera a minimum of 2.5mg orally daily on continuous basis
Or Norethisterone 5mg orally daily on continuous basis (1mg would be sufficient for use in a continuous combined regimen but not available in stand-alone preparations)

Off license use of norethisterone in progestogen only contraceptive pills (e.g. Noriday 3 x tablets of 350 micrograms a day, will provide 1.05mg of norethisterone) may be considered as an equivalent alternative.

Or 52mg Levonorgestrel IUD

Or Drospirenone 4 mg (Slynd) 1 active hormonal tablet 4 mg can be taken daily on a continuous basis (omitting the 4 hormone free pills in the pack)

Off licence use of this progestogen-only contraceptive pill can be considered as an equivalent alternative for women experiencing progestogenic side effects with other preparations