Provera 5mg shortage, Utrogestan doesn't agree with me, any suggestions?

[NippyNinjaCrab]

Hi, i was switched to continuous 5mg Provera a few months ago as the Utrogestan didn't agree with me at all. I tried both orally and vaginally.
My prescription couldn't be fulfilled 2 weeks ago and the GP gave me Utrogestan again as a temporary measure but Provera is still OOS here. I'm struggling with the tiredness, low mood and bloating. I was issued 200mg initially but I could hardly function the next day on that dose. I couldn't get an appointment so dropped to 100mg and still shattered so I am now taking it vaginally until my appointment in the morning. I've called round a few pharmacies and no Provera, can any experienced ladies help with any suggestions? I am 53 and have endometriosis if that makes a difference. X

Confused. If you're using continuous the dose is 100mgs a day (Utrogestan.)
Why were you told 200mgs?

There is another option such as Cyclogest.
Or you can take Norethisterone (tablets) alongside a separate estrogen.

The 200mg was too much as it doesnt agree with me, i couldn't get an appointment to ask about reducing until this morning so was taking 100mg. I literally couldn't function on 200mg. The GP has reduced my gel from 3 pumps to 2 pumps temporarily until Provera is back in stock. Thank you for your reply 🙏

There is no absolute rule about using 200mgs daily with 3 pumps of gel.
You can use 100mgs daily with 3 pumps UNLESS you've had odd bleeding and you've been told to use 200mgs a day.

Have you had a conversation with your GP about why they wanted you to use 200mgs?

The guidance is that women on 4 pumps of gel will probably need 200mgs a day BUT women on 3 pumps of gel only need to increase if they have bleeding (on combined continuous.)

3 pumps is 'higher' and 4 pumps is 'high'.

BMS guidance thebms.org.uk/wp-content/uploads/2023/04/14-BMS-TfC-Progestogens-and-endometrial-protection-APR2023-A.pdf

The dose of the progestogen should be proportionate to the dose of estrogen. While no data is currently available on the endometrial effects of high doses of estrogen and the optimal dose of oral or vaginal progestogen in this context, women who require high dose estrogen intake should consider having their progestogen dose increased to ensure adequate endometrial protection (e.g. micronised progesterone 300 mg for 12 days a month instead of 200 mg in cyclical HRT regimens or 200 mg daily on a continuous basis instead of 100 mg in continuous combined HRT regimens).

There was no discussion to why the initial dose was 200 of Utrogestan to replace the 5mg of Provera. It wasn't my usual GP. Same GP called me today to say that because I can't tolerate the 200mg Utrogestan and dropping to 100mg to prevent an increase risk of endometrial cancer, I should temporarily drop to 2 pumps as per the guidelines. She checked my weight and did say being slim the risk is low but it was to be on the safe side. I'm due a face to face with my usual GP when I can get an appointment so I will ask then if the Provera is still unavailable x