Can I take progesterone tablets vaginally without telling gp?

[Zenlifeforme]

Hi all, I want to try progesterone vaginally. I haven’t taken it at all, only have the mirena coil and esteogen patch. But I’m worried about future bone health etc as I’m so young to be starting with this (early 40s). So I want to add progesterone and then up my patch to 75mg. I also don’t sleep well at all when I don’t take a sedative every night (antipsychotic medication), so I think this masks my low progesterone.
I’m going to ask my gp for body identical progesterone and say I’ll take it orally, but not do this and take it vaginally.

Private specialists say it’s safe and many mumsnetters have said they do it too from private specialists support.

is there any brands I should avoid doing this with? Or anything I need to be aware of? It’s just ensuring I get body identical progesterone isn’t it. Could people share the names of brands they safely do this with, and what the active ingredient is on the packet?

thanks

I do it with mine. There's no actual safety issues doing it this way it's just not licensed to be prescribed to be used vaginally. My NHS GP suggested I do it!

I use utrogestan, meant to add!

If you have the Mirena coil you don't need Utrogestan as well.

Hi all, I want to try progesterone vaginally. I haven’t taken it at all, only have the mirena coil and esteogen patch.

It's not good to over-do progesterone. Why do you want to use it?

The GP is not the boss of you, please don’t ever think they are.

What are the advantages to taking it vaginally?

It avoids sedation and digestive issues and can mean more gets to the uterus more easily.

Apparently the amount you get from the coil isn’t much. Or at least it doesn’t help with any of the brain function symptoms.

I want to up my eatrogen patch to 75mg and I tried it (without extra progesterone) and I got such rage. Research online suggested esteogen dominance, and so perhaps I’d be better with 100mg progesterone pill (vaginally) and then I can up my patch too.

I still get so much heart burn and my skin is aging I’m noticing eg sagging eyelids (so that’s esteogen) and also brain fog and sleep disturbed (progesterone). I’m less bothered about aging skin than I am about this blumming heartburn.

Also what makes me wonder is, the research I did said ihaving the menopause young (which looks like I am, 42 and no period for 6 months and counting) then higher doses of both hormone are better.

I mainly want the heartburn to do one, as it’s so hard to keep my weight stable (as in up) as it is, so I struggle to eat more food with constant heartburn. I tried intermittent fasting and my weight started plummeting. Tho is really sorted the heartburn!

And @KatParr thank you for you reply, and do you use 1000mg progesterone this way or do you take more? Do you also have a coil? Do you just use the oral pill but insert it that way or do you have a special pessery? If that’s tmi no worries and thanks

100mg not 1000mg

No problem! I'm on 3 pumps of Oestrogel and take 200mg of Utrogestan, so 2 of the oral tablets from day 15 to 26 of my cycle. I don't have a pessary applicator, I just push them up as far as I can haha! I don't have a coil either.

Thanks that’s helpful 👍🏼

If you have the merina fitted, you're quite likely to not have a monthly bleed, as it prevents the build up of the uterine lining. Therefore you can't assume you are menopausal whilst you've got it fitted.

This isn’t relevant to my situation.

It’s entirely relevant, you can’t use your bleeding pattern when you have intrauterine contraception such as a Mirena for diagnosing menopause. You can of course use your menopausal symptoms to guide your oestrogen dosing.

Adding in micronised progesterone when you have a Mirena can be done, but usually only with higher doses of oestrogen or to help control unexpected bleeding. You may find your GP isn’t willing to prescribe it seeing as you have an IUS as it isn’t without risk (though the risks are likely to be low).

You are very unlikely to need extra progesterone if you have a mirena. The only reason you need progesterone really in HRT is to protect your womb. It’s oestrogen that gives you most of the benefits including better sleep (albeit progesterone can have soporific effects in some people) and improving brain fog. Oestrogen is also what protects your bones. You likely just need more oestrogen. Low oestrogen causes insomnia along with many other symptoms including (horrendous) brain fog. So it’s not correct that this is necessarily a low progesterone symptoms. There’s also no such thing as “oestrogen dominance”. It’s pseudoscientific nonsense so wouldn’t believe anything from a site that references it. Your oestrogen can obviously be too high from adding it artificially, but this is less likely with hrt during peri as the doses are significantly lower than your body would produce itself pre peri. The aim of HRT is to use the minimum you need to alleviate symptoms, but it’s unlikely to lead to overdosing on oestrogen as such.

As a pp said if there’s evidence of low progesterone such as bleeding in between cycles (which isn’t an indicator for you because of your mirena) or womb lining thickening (gp can arrange to check this via internal ultrasound) then more progesterone can be added but my understanding is this extremely unusual with the mirena.

I strongly suspect you need more oestrogen from your symptoms so I would focus on that. If you find the patch is not suiting you, it may be you need to try other types. The gel is good because you can adjust the levels yourself to maximise symptom control and you can also increasen very gradually if needed. How long did the rage last? Sometimes you do also need to let “side effects” from adding in oestrogen settle. For example I had bleeding gums when I first went on oestrogel and then later when I increased it but these settled after a short time (and with splitting my oestrogel application into twice a day rather than once a day which I believe helped smooth out fluctuations).

Those that take it vaginally - do you get more discharge. I’ve heard the casing doesn’t dissolve properly.

Hmm this information conflicts with what I’ve read. I’m not sure to believe it…. If you have sources @MyLov I’d be interested to read them.

the mirena coil point doesn’t apply to me as I have periods on it for 2.5 years before my periods stopped.

Also my mums had menopause at 40, I’m likely following suit and I do think this is the end.

I don’t think it will harm me to try 100mg progesterone and see what happens, especially is gp ok’s it, and my question to you for support was around taking it vaginally not whether anyone thinks my dose is right or not.

Focusing on ‘what everyone else is advised to do’ isn’t a helpful post to make, even if intentions were well meant. It just muddies waters.

I am really feeling my way with what I need, and I’m on the right track with it.

Heartburn has other causes too, don’t assume these drugs will fix it.

@Zenlifeforme

I agree 100% with everything @MyLov posted.

There is no such thing as estrogen dominance (do your own research on that term.)It was something invented mainly in the US by naturopaths and other unqualified 'doctors' and it's not accepted in the UK.

Private specialists say it’s safe and many mumsnetters have said they do it too from private specialists support.

Yes, micronised progesterone is safer than synthetic types of progestin regarding breast cancer so it seems, BUT that doesn't mean you use it AS WELL AS the Mirena.

And it's prescribed widely by the NHS - not just 'private specialists'.

Your GP won't (and shouldn't) prescribe it as well as the Mirena because there is no need. It's not good to use 2 different types anyway.

You only need progesterone with estrogen to protect the womb lining.
No other reason. Many women would give their right arm not to use it as it's the cause of most side effects (with HRT.) Women with no womb don't need to use it.

The Mirena doesn't always stop periods in ALL women. Many yes, but you were an outlier. So you can't use your experience of that to judge if you're post menopause now.

Also, you said that the dose of progestin in the Mirena was low.
The progestin (not progesterone) in the Mirena is totally different to micronised progesterone. It's an older, synthetic sort - so no comparison.
It is a low dose but it's roughly the same dose as in a 25mcgs combined patch.

If you feel your HRT isn't reducing your symptoms, the next step is to increase it. At your age you're likely to need more than 50mcg patch.

You could of course have your Mirena removed and use micronised progesterone as part of HRT.

200mgs a day sequentially at first to see how you get on .

I’m really interested that youre planning to take extra progesterone when you’ve got the Mirena already. When I started HRT my doctor only gave me oestrogen as she said the progesterone part was covered by the coil I was already on - why do you want extra, and are you sure your doctor will give it to you?