'Three month cyclical regimen' (12 weekly Uteogestan)

[101trees]

Hello

I was just reading the NICE guidelines about regimens here: https://cks.nice.org.uk/topics/menopause/prescribing-information/hormone-replacement-therapy-hrt/#regimen

It says that on a 3 monthly cycle, a bleed only occurs every 3 months in peri-menopause. Does that mean it effectively stops your own cycle until you use the utrogestan at the end of the 10 weeks, or just it does mean you only get a withdrawal bleed every 3 months, but your own cycle occurs as normal (whatever normal is for you at this poin)?

I'm thinking it must just mean it stops 2/3 withdrawal bleeds, but you can still have your own cycle occurring throughout.

Is utrogestan still the same dose of 200mg if used 12-weekly?

Is that really sufficient to give endometrial protection ?

Bonus question: if you are struggling with utrogestan, do you get used to it and the side effects lessen? Or does that never happen because you're only using it for 12 days out of the month?

Sorry... many questions... just trying to wrap my head around it all !

I'm also very sorry for all the typos. That was atrocious!

I can help you with this because it's how I used HRT when I first started it years ago.

If you read the guide (link) it's best for women in late peri -
A 3-monthly regimen may be more suitable for women with infrequent periods or who are intolerant to progestogens

I started a 3-monthly cycle at 53, when my periods had pretty much stopped.

If yours are more frequent, you may still have periods before you reach Week 10 when you'd start Utrogestan. So no, it doesn't stop your own cycle and yes, the withdrawal bleed is once every 3 months.

Yes, the dose is still 200mgs but for 14 days (not 12).

It's not something to do without medical advice and surveillance. There is also 'caution' (in the more recent guidance from the British Menopause Society) that women on longer cycles should have regular scans to check the womb lining.

It's more suitable for women who are very intolerant to progesterone.

The side effects don't lessen - it'll be the same each time you use it.

I dropped from a 3 monthly cycle to a shorter one (but still longer than 4 weeks) because the withdrawal bleed after 3 months was too heavy. My consultant ensures I have a scan once a year (which I pay for.)

Your GP may be happy to do this with you but they may not be keen as there are small risks and they'd have to scan you now and then (costs etc.)You might need to do this privately if it's something you really want to do and can afford.