Utrogestan depression

[JJkate]

Hi, I've been on hrt for two years; estrogen gel and utrogestan tablets. I find I'm badly affected by the utrogestan (very low mood, irritable etc) so have been able to convince the Dr to let me take 3 pumps of gel with two utrogestan tablets. This has taken the edge off the utrogestan low mood but only a bit.

I tried taking utrogestan vaginally but the side effects were bad. I dare not try the coil as the thought of having something that has to be removed feels like such a loss of control if it doesn't work out. My question is, do I just put up with this? Low mood for 12 days a month forever?

If I stop all hrt I can't sleep and have very inconsistent mood changes with peri symptoms so opted for this as the least worst option as at least I sleep however I'm feeling so ground down by this depression and irritabity each month and also worry that I'm taking too high estrogen dose. If anyone has found a way out of this please could you share your stories. Thanks.

I’m the same. I dread taking it. Mine also makes me feel dizzy. Had awful vertigo last month on day 4 of my progesterone. GP dismissed it as relating to progesterone though but I know it is. I’ve knocked gel back to one squirt but more regularly (would sometimes forget) and eating better which helps. Dread the progesterone though. Feeling your pain x

I got the Mirena in the end. I swore I wouldn’t for the same reasons you don’t want it, but I had had some slight thickening of the uterine lining and was referred for a hysteroscopy. I had it under GA so if seemed like a good time to give the coil a go.

Haven’t looked back. I’ve had none of the shitty Utrogestan side effects, still sleep well, has been fine.

The gynaecologist I was seeing was very sympathetic and suggested I ask the GP what could be arranged if I didn’t get on with the Mirena, how long would they want me to try it before they’d agree to remove it. Would it reassure you if there was a plan in place if you wanted it out?

I can't tolerate utrogestan, but I can tolerate the combined Evorel patch which contains norethisterone. Unfortunately it's not available in the same strength as 3 pumps of gel, the patch is equivalent to 2.
There's also another combined patch which contains the same progesterone as the Mirena -I think it is the Estradot, that might be worth a try to see if you get on with that progesterone before trying a Mirena.

I was the same. I was invincible for 2w t
hen spent 2w knowing the world would be a better place if I wasn't in it.

I also had periods when I took utrogestan so couldn't take it vaginally.

Initially I switched to evorel sequi patches - where my mood swings were not as bad but weirdly mood was really low on the weeks without progesterone. I wasn't suicidal, just miserable and overwhelmed and I put it down to work stress. The GP asked why work was consistently stressful for 2/4 weeks... And I realised it wasn't that! We almost got to prosac for 2w on, 2w off to try to stabilise my moods.

I take evorel conti now. I still have periods so it's off license but signed off but 2 GPs. I'm much more functional with consistent hormones. I function as a human being. It's due for review later this month but I'm really hoping there are no side effects that I'm not aware of because it's working really well.

I used to be the same.

I went for the coil and my GP PROMISED to take it out immediately if I ever asked her to.

It takes 5 seconds to remove a coil.

@JJkate my coil did have to get taken out last year because it moved and my GP did it immediately. The next fitting was months away though and my gynae said he'd write a prescription for utro. I told him that I'd find someone privately to do the coil fitting (he couldn't for various reasons) as if I had to take utro again, I'd jump off a bridge. I felt so horrific and suicidal on it.

I found a private GP to fit the coil the same week. £££ but worth every penny.

Hade you tried taking 1 Utrogestan every day rather than 2 for 12/14 days? I now take it this way and it’s really helped.

@PampampamI haven't tried that as feel so awful on two for twelve days the thought of taking it everyday fills me dread but maybe I should consider it.

@Ilovelowrythat sounds like it's doable. I will ask my GP if they could do this.

Can I ask if people who are struggling with progesterone had issues with the combined pill? I’m about to start hrt and I felt suicidal on the pill, so am very nervous, I’ve said no to the coil as I want to be able to stop everything if I start feeling depressed.

Currently exhausted and anxious..

@trainedopossumhow did you know it had thickened? I sometimes read things like this and wonder as my GP doesn't seem remotely interested in monitoring me in the two years I've been on it.

What @Pampampammentions is the usual way the gel and the Utrogestan is prescribed once periods have stopped for long enough for you to be considered post menopausal. To be honest some GPs seem very unwilling to discuss HRT or any adjustment to it. I think many simply don’t know. I’m very fortunate with my GP but it seems quite rare even in 2025. I found the Menopause Matters forum really helpful @JJkateso it might be worth having a search there to see if your problem has been discussed there in the past. There are some gynaecologists and gynae nurses on those boards so it can have some helpful pointers when you are planning to speak face to face to your GP.

Why don't you try other sorts of HRT?
Gel and Utrogestan is just one type.

There are loads more.

There are tablets, patches, the Mirena, estrogen only patches or gel that you can use with Norethisterone (it's a tablet) or even the mini pill Noriday (as 3 tablets per day.)

Have any of these been offered?

@JJkate For me it’s really helped as I just couldn’t cope with taking 2 Utrogestan for 12/14 days (even vaginally was awful). The lower dose taken consistently works much better for me and I don’t have the awful low moods. I’m perimenopausal so it’s not how it was prescribed to me but research suggests that taking Utrogestan every day offers slightly greater protection against thickening of the uterine lining.

Bite the bullet and get a Mirena. If it has side effects you can get it removed.
However, whilst I don’t have side effects from the Mirena (I have had one for 20 years) I found that my first menopause symptom was splitting headaches, and my progesterone blood tests results came back very low, despite having a Mirena. The mirena contains a different type of progesterone - fine for stopping womb lining build up but for me not enough.. so I take the utgestron as well but not consistently. I don’t have any side effects from taking it.

Same here. I was on Evorel 75 patches and 3x Noriday daily as I really couldn’t tolerate Utrogestan and felt okay on that regime. But when I went to pick up my last prescription the Noriday was out of stock and I was prescribed Gepretix instead. Within just a few days I was miserable and bloated. Despite being post menopausal the GP said I could use it 12 days every two months instead of daily to see if that helped. It doesn’t really but at least I know I’ll only feel shit for a couple of weeks rather than every day.

Absolutely no way would I have a coil either.

I told the GP I had some spotting (I was already in menopause) and was referred for an ultrasound, pretty standard I think.
My GP isn’t great either. After literally years of asking for help with this I finally spoke to a locum who agreed to refer me.
I have phone appointments with a menopause-trained GP who works out of gynaecology in the local hospital, she advises my GP. They request the ‘active’ stuff to be done by my GP (not sure how to word that, my GP does prescriptions and blood tests).

I can’t tolerate progesterone at all, orally or vaginally. The mirena was my last resort - I have a family history of uterine cancer and gynae said I would have to come off oestrogen if I didn’t have the progesterone. Anyway the mirena has been brilliant, my mood is fine and my previously hideous flooding periods have disappeared.

I find taking it daily much better too. I did have a couple of bleeds a month at first but that has settled down now. I feel much less tired taking one tablet daily.

It's frustrating to hear that Utrogestan has become the default progesterone (for obvious reasons as it's possibly safer long term and for at least 5 years.)
But GPs clearly lack training in all of the other types.

The BMS is quite clear that for many women, tablets are still fine (they are more an issue for the over 60s) and many women get on fine with tablets or patches containing Norethisterone. The other option is Femoston tablets which are similar to Utrogestan but not identical.

When I started HRT years ago, no one I knew was being given Utrogestan. I started on Norethisterone along with gel and changed after a few years to Utrogestan.

At the time, I was advised I'd love or hate it- that's how divided women are on it!

If it's not suiting you, talk to your GP about other options and don't accept that there are none.

Women who are very intolerant can take it less often (longer cycles or 10 days a month ) but you do need to be willing to have scans to check it's working ok and your GP should be able to arrange that.

With the Mirena, IF you can manage the cost, you can have it fitted privately, (the actual coil is around £90 but there's the drs' fee too) and you can easily have it removed after a few months if it's not suiting you. There shouldn't be any delay in removing it if it's a private appt.

I was talked into having a mirena a year ago. It’s been fantastic. I’m so glad I took the plunge.

I started taking gel and Utrogestan tablets a few months ago and am concerned I might be experiencing depressive side effects from the Utrogestan, but am also going through a hard time so it's hard to disaggregate. Could someone please explain what is different about the coil? My plan is to monitor things and return to my GP if I think a different option would help, but I have learned it is better to go armed with information and a specific request.

I’m progesterone intolerant but I had to suck up the utrogestan because I couldn’t cope without the oestrogen. I found that I can actually tolerate progesterone but I cannot tolerate the fluctuations. Once I went onto one a day with no breaks, I was absolutely fine.

Thank you everyone that's been really helpful. I'm going to go to GP and ask if I can try utrogestan once a day every day or the mirena or patches and see how it goes. I will update 😊

Let us know how you get on OP as I'm having the same dilemma!