Utrogestan tablets - I'm so confused about when to take

[Livingthebestlife]

Can anyone advise me please as I really don't want to ring the GP . I've read some posts on here but the wording is different like 1 - 15 and 15 - 28 🤔

The instructions on the tablets say 1x 100mg 3 + 4 of cycle.

I don't really have a proper cycle , some months I get a period some I don't, GP knows this, he said to just start it .

I'm just unsure when I take it, do I start the same date each month, or week 3 + 4, or just do 2 weeks on 2 weeks off. The instructions are in a different language then when I googled it said the minimum starting dose is 200mg, the box does have 30 tablets but the instructions from the chemist says 1 tablet.

I hadn't realised how complicated this was going to be, anyone who can help I'd really appreciate it .

I have just started HRT. I’m 50 and still have regular periods. I’m using 2 pumps of Oestrogel every day. On days 15-28 of a 28 day cycle I have to take 2 x 100mg tablets of Utrogestan.

The instructions on the tablets say 1x 100mg 3 + 4 of cycle.

Looks like the pharmacist OR more likely your GP has got it wrong.

I suspect 3+4 refers to weeks 3 and 4 of a month.

You take 200mgs (2 tablets) for 12 or 14 days a month. 14 days is for women who have a heavier withdrawal bleed (the leaflet says take 12 days.)

You don't wait for your own cycle, you start on the same DATE each month and carry on that way. So if you start today you will do the next 12 days from 16 October.

You can't wait for your own cycle as eventually it won't be there or you'll miss several cycles as you get to menopause.

Trust me- this is consultant-led advice and I've used it for around 12 years.

@JinglingSpringbells Is right. I started in 25th, it was around my period anyway, and that's my birth date, just start on the 1st or any date that has a meaning and carry on. In the three years I took HRT I only had a handful of withdrawal bleeds that matched the cycle. They continued to be completely random. My cycles were always 35-42, and they continued to be much longer than the HRT cycle.

I had to ask the same question - the instructions are not overly clear if you don't have a regular cycle.

As above I now start taking them on the same date each month regardless of where I am in my cycle. My dose is two tablets a night for 12 days - I have to set an alarm for 8pm as otherwise I would foget to take them at all.

I’m confused. If it’s a 28 day cycle, why do you start them on the same date each month? Apologies if that’s a stupid question 😂

This is really useful (how to calculate the 14 days) and something the GP did not explain to me. They didn't seem hugely clear on it themselves. I had very long cycles (72 days) when I was prescribed it originally and was given 3 boxes of progesterone for every pump bottle of oestrogen! Which really suggests that the GP had no clue re the administration.

I have a mirena now, which sorts the progesterone element of HRT, so I don't have to think about the tablets anymore. I'm glad to be rid of that aspect.

Thank you all so much for explaining it to me. I was just so confused with it all.

After some calls, the GP is easing me in with the 100mg, the chemist had given me too many tablets for this month so that solved that confusion and thanks to you all for explaining about the dates to take the tablet I understand it completely, you all were so clear in your explanations, the GP just didn't explain it at all to me and I hadn't a clue.

Thanks again and hopefully these work 🤞

No, it's not stupid.

A couple of points...you stop thinking of it as a 28 day cycle.

1 Most women do not have 28 day cycles naturally (it's an average number.)
Using it per calendar month means you will go 30/31 days as a cycle. That's fine. Those couple of extra days aren't important.

2 The 28 days are there to bring micronised progesterone into line with other forms of HRT- tablets and patches- where they are packaged as 28 day cycles ( 4 weeks) as a tablet strip or a certain number of patches.

However, it's just not worth counting 12 days out of 28 when using a separate progestogen and far easier to do same date each month.

You shouldn't be 'eased in' with less progesterone. There are 2 reasons for this:

1 It's not enough to control your own cycle or the build up of your womb lining so you may have spotting all the time.

2 It's not the prescribed dose. The 100 mgs is for women who are very much post menopausal and taking 100 daily.

@JinglingSpringbellsthank you for explaining that.

Oh that's interesting, I'll have to ring the GP again, thank you for that.

The usual way is to start low on estrogen if necessary (1 pump not 2) but stick to the licensed dose for progesterone. This is in the guidance on prescribing..
If you read the leaflet in the box it lists the 2 ways of taking it- either 1 tablet post menopause or 2 for peri / sequential .

Ignore the 28 days on the leaflet as this has been overridden by more recent advice.

Watching this with interest! I've been on continuous HRT for about 4 years. I'm 52 and I haven't been through menopause. Last year, I had a hysteroscopy due to constant bleeding (all clear) and the consultant suggested I go up from 100 to 200 progesterone daily to stop the bleeding. So I did that, I still get occasional bleeding but I've put on about 8kg without making any changes to my diet/exercise. Read up on it all, and now I'm wondering why I was put on continuous HRT in the first place. I've spoken to my GP and she said I could "play around" with the progesterone a bit - so I'm thinking of doing 200 for 14 days and then none for 14 days. I'm on 1mg of Oestrogel. It's so bloody complicated.

I'm wondering if it's because I've had 6+ continuous months of no period, this year and last year, some months I would get a period but more without

I got really confused with this too. When I spoke to my GP, and told her my cycle was erratic anyway, she said I could just take it continuously - 1 tablet per day. It’s so much easier.

It exasperates me that GPs prescribe but don't explain.

The guidance for post meno HRT is 12 months with no periods, or a trial of 12 months ON HRT, or age over 54 . One capsule a day is the post meno version.

https://www.menopausematters.co.uk/postmeno.php
Menopause Matters is a website written by an NHS consultant, Dr Heather Currie.

If your GP thought you were ready for combined continuous (both hormones daily) why didn't they say rather than 'easing you in gently'?

It's usually offered after 12 months of no periods or if you have a few cycles a year, with long gaps of months.

If it's used too soon in peri, it can cause odd bleeding because it's not enough to control the womb lining.

That does appear to be the situation the OP is in.

It doesn't though because she's been told to use it for half a cycle.

That's sequential HRT, not combined continuous.

Whoah hold on! My Utrogestan prescription says two capsules (so 200mg), two weeks on/two weeks off. I’m peri, not post menopausal, but periods are irregular now (at 48 ☹️). Reading this thread, I am taking it wrong? If I start on the same date every month, then it doesn’t quite work at two weeks on then off? It’s ends up being longer off? Or am I missing something?

@Stevie77 you’re not doing it ‘wrong’, that’s what I’ve been told to do by my GP - 2 weeks on/2 weeks off - and a 28 day cycle is what’s stated on every website I’ve read. But some are starting the 2 weeks of Utrogestan on the same date each month for 2 weeks to save the headache of having to remember when the 2 weeks starts. Hope that makes sense. Someone else will come along soon to explain.

@Stevie77 I left a long post on this yesterday. If you scroll back, it's all there.
Basically, the extra 2 days a month makes no difference so it's easier to stick to the same date every month.

Thank you @aeroplaneoverthesea @JinglingSpringbells , this makes sense.

The GP didn’t go into a lot of detail wrt taking the a Utrogestan, so I just started them😬. Not tried to coordinate it with periods or dates. Now I’m wondering if it’s all out of sync with my system, or if to carry on as I have done until now, since I have already been taking them for a few months.

You can't coordinate with your cycle in peri as it will be all over the place with long gaps.

Choose a date to start the next 12 days roughly 4 weeks after you took them last and stick to that date every month.

women on patches or tablets don't try to sync with cycles- they just use the tablets or patches as a monthly cycle.