Dydrogesterone available on NHS

[Clockface222]

I see the dydrogesterone is being added to the hrt pre payment certificate list on 1st Sept.

Does anyone know if this means that GPs can now prescribe it? I am due to get a mirana fitted next month due to side effects with utrogestan but would rather hold off if dydrogesterone will be available soon.

https://cpe.org.uk/our-news/dydrogesterone-10mg-tablets-nalvee-added-to-the-hrt-ppc-medicines

I haven’t heard of this but just wanted to say another alternative to the coil is the standard mini pill. You can either take 3 a day to give you the progesterone you need or you can take one and use evorel conti patches alongside it (this is what I do; so you get some progesterone from the pill and some from that). I would never have a coil.

Thanks pepperedpickles. Will the gp give you the mini pill aged over 45? I am actually taking evorel sequi atm as an interim measure and am wondering about using it longer term but a bit worried about the higher risk of breast cancer etc from synthetic progesterone. I think the dydrogesterone is meant to be much lower risk as it is more like a natural progesterone.

Can I ask why would you not use the mirana? I am worried about all the horror stories online about it but the stats do seem to say that most women find it helpful.

If it's available as part of the HRT pre payment cert, then it will be available on the NHS, so no reason for GP not to prescribe it.

I thought it may have to be added to the local formulary list first? There seems to be some sort of local approval process.

Depends on if it’s included in your local area drug formulary and available from your GP - not all medications included in the HRT PPC are so you’d have to ask.

I’m not sure if you tried using Utrogestan vaginally if you experienced side-effects when taking it orally? Would also discuss current/future pros and cons for oral progestins vs transdermal with your doctor.

I'm also trying to get a GP appointment to ask for this for progesterone sensitivity. So do let us know if anyone is able to access via GP. Am also slightly confused about the nationwide availability and local formulary.

I heard back from my GP. She said she was unable to prescribe it until it gets added to the formulary and thought it could take several months. She wasn't sure whether it was even being stocked anywhere yet. I tried looking online but it doesn't even appear on private pharmacy lists. I have contacted a private menopause consultant to ask and also emailed the local formulary about their timescales. Will update if I hear anything. Really desperate for this medication as I am so fed up with progesterone side effects. If anyone has better luck please do post news.

@Clockface222 I could've written this myself. I am same also sick of progestin side effects. I have seen a couple of private doctors posts on Instagram that I think poss may prescribe. So will probably get the same answer as you from my doctor and may have to try private.

https://thebms.org.uk/wp-content/uploads/2024/02/15-BMS-TfC-HRT-preparations-and-equivalent-alternatives-JAN2024-B.pdf

There are other available types of progestogen. See pages 2 and 3.

There is Norethisterone (in tablets and patches but can be used singly with transdermal estrogen)

Or the mini pill (Noriday x 3 a day.)

Thanks Jingling but have already tried utrogestan both vaginally and orally, norethisterone patches, mini pill (although some years ago) and can't have mirana. I think I will give up on hrt completely if this new progesterone is not available soon.

I am due to get a mirana fitted next month due to side effects with utrogestan but would rather hold off if dydrogesterone will be available soon.Mirena -

your first post says you're due to have the Mirena fitted next month but you've now said you can't have it.

Why not try Femoston? At least that way you can try out the progesterone.
Your other options with your GP's consent are longer cycles ( 2 or 3 months) so you reduce the progesterone part, keeping to a monthly cycle but with 10 days (not 12-14) of progesterone.

Yes you are correct, it is debatable whether I can have it or not due to various issues. I will not know until they try to fit it plus I would rather not risk the various mood and other issues that are reported with it.

I considered Femoston but one issue is that I get reflux from the progesterone relaxing the LES and I understand that oral oestrogen is similar in raising that risk.

Are NHS GPs ameniable to trialing longer cycles? I thought that would have to be done privately becuase of the need for extra scans?

You could try Femoston for a short time and see how that goes.
Just because there is some evidence that oral estrogen causes more reflux of the sphincter doesn't mean it will happen to you.

I don't know if GPs will sanction cycle or dose variations. I know of someone (a friend) whose GP is happy with longer cycles ( 5-6 weeks) and the BMS says it's an option in their guidance which will include GPs.

They do however say that scans should be carried out to check the lining, although in practical terms they are usually only done if there is unusual bleeding between cycles.
You'd need to ask your GP.

It all depends on how bad your side effects are from other progestogens.
Is it all-consuming so you can't function or just not feeling 'great'?

I am keen to try the dydrogesterone (can't tolerate utrogesten and was fine on Femoston) but it is not listed in my local formulary (Sussex). Just wondering if it is common for there be a delay in drugs being added once approved by the NHS?

If anyone really wants to try it and you can afford it, it's worth thinking about seeing someone privately and asking if they can prescribe for you.
The actual drugs themselves are often very cheap.

@JinglingSpringbells I'm looking into private options. As been struggling for a good year now with evorel sequi and do think will be money well spent. To feel better ☺️

Thanks to this post I asked my GP about dydrogesterone and at first she said, ooh no, I don’t think so, I wouldn’t know what dose to give, blah blah. 10 mins later she called back and said, actually I’ve looked into it, let’s go ahead and try it. So, I have yet to take it, but it is available and it’s worth asking. I’m in London, in case it’s area dependent.

Hi all. Update.
So I've just had an appointment with doctors and they weren't able to prescribe Nalvee as its not even on there system as yet. But have already pre emted that answer and looked into private and found a few specialists that are able to prescribe. So private route it is. Hopefully it is much more widely available very soon.

Has anyone had any luck getting Nalvee? Or any updates on when it is expected to be available more widely? Thanks

@Intrigued20 much to much surprise I have been able to get it through my GP. I am in Sussex and I couldn't find it listed in the Formulary, but I discussed at my hrt review (the GP was aware of it!) and she went off and investigated and phoned back with the good news. My local pharmacy was also able to get it with no problems

@Pollyanna8234 Great, thanks for getting back to me. That’s positive.
I’m in Newcastle and same - it’s not listed in the formulary. Checked to see if it was stocked locally at Boots - not in stock. But from your update I may be able to get it through my GP. Thanks again.

Good luck @Intrigued20!

It's listed online on community pharmacists' websites as being available now, from 1st Sept, for pre-paid HRT so it should be available everywhere - and it's dirt cheap- £6.49 for 20 tabs.

Thanks @JinglingSpringbells and good to know about the price.

I ended up going private as it wasn't available at my GP. The difference i feel from switching from evorel sequi to nalvee within 1 month is so much better.

Hopefully it will be much more widely available very soon. Xx