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Menopause

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Switching from oral progesterone to patches because of Mounjaro - anyone else?

11 replies

namechange0998776554799000 · 22/09/2025 11:54

I've been on HRT for about a year - estradiol gel sachets and progesterone capsules (200mg on days 1-14). I'm 45 and menopause was kicked off by chemo, my only major symptom was hot flushes which were unbearable. My periods stopped for a long time but have now come back very irregularly - I'd say I have a full period every few months, and light withdrawal bleeds sometimes in between. I've had an ultrasound recently, everything fine.

I started on one sachet of the estradiol then after a while the hot flushes started to come back so I increased to one and a half, then again to 2. I've been quite happy on this regimen - I hate the flat feeling I get while on the progesterone, but on the other hand it makes me sleep really well. So if there was no reason to, I wouldn't be changing anything.

Last week I started on Mounjaro and since I've been warned it can affect absorption of oral progesterone I had a GP appointment today to discuss switching to patches.

She's told me that patches only go up to the equivalent of 1 sachet of estradiol, so I'll essentially be halving my dose of oestrogen. She said maybe I could just use two patches, but admitted this is off licence and didn't seem confident. I've asked to be referred to the menopause clinic, who were excellent when I was first prescribed, but the wait time will be a few months. My plan in the meantime is to switch to the patches and just see how I go.

Has anyone had a similar experience? Any advice?

I'm not going to consider the coil, after a lot of cancer treatment and many complications I am 100% not putting any more objects into my body unless absolutely necessary.

OP posts:
PlanetSaturn · 22/09/2025 12:04

Look on the BMS website at equivalent doses.
https://thebms.org.uk/wp-content/uploads/2024/02/15-BMS-TfC-HRT-preparations-and-equivalent-alternatives-JAN2024-B.pdf
A 1mg sachet is equivalent to a 50mg patch. You can get 100mg patches (they’re not off-licence).

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

namechange0998776554799000 · 22/09/2025 12:24

@PlanetSaturnthe only 100mg patches I see on there are listed for women who've had a hysterectomy/don't need progesterone, maybe that's why the GP didn't mention them? (Although she specifically said they don't exist so sounds more likely she was just unaware!).

OP posts:
HundredMilesAnHour · 22/09/2025 12:30

@namechange0998776554799000 Are you taking generic progesterone pills or Utrogestan? I switched to taking my Utrogestan vaginally instead of orally. This is off-label in the UK but quite common. Oral Utrogestan makes me feel a bit ropey anyway whereas no side effects at all when I take it vaginally, and that also means the Mounjaro doesn’t affect it either. (So I take Oestrogel and Utrogestan).

namechange0998776554799000 · 22/09/2025 12:33

I'm taking utrogestan and yes I'd seen it mentioned on here about taking it vaginally. I'm thinking that will be my back up plan if I don't get on with the patches

OP posts:
namechange0998776554799000 · 22/09/2025 12:35

Actually, having said that, while my original prescription was utrogestan I now see that my latest batch were generic ones

OP posts:
Notsurewheretostarthere · 22/09/2025 15:31

Hi OP. I am on 100mcg patches prescribed by my GP.

I started at 50, went to 75 after two months then 100 two months further on.

They definitely exist. I am peri meno and use Mirena for progesterone. I also have testosterone.

namechange0998776554799000 · 22/09/2025 15:46

Hmm ok. Maybe I'll start with the 50 patches and if symptoms come back I'll make an appointment with a different GP, or hope the menopause clinic referral has come through

OP posts:
MeridaBrave · 22/09/2025 15:48

Another idea is to take the capsules vaginally.

Christine0708 · 27/09/2025 23:19

Op is talking about combined patches which only come in 1 strength 50. Another option is to take 300mg for the 2 weeks a month instead of 200 whilst on mounjaro.

NoTouch · 28/09/2025 09:50

https://thebms.org.uk/wp-content/uploads/2025/05/23-BMS-TfC-Use-of-incretin-based-therapies-APRIL2025-E.pdf

https://www.pcwhs.co.uk/_userfiles/pages/files/resources/glp1_contraception_hrt_article.pdf

you might find these links helpful if you haven’t seen already . One BMS suggestion is to increase utrogestan dose for the 4 weeks of initiating Mounjaro and at each dose increase. If you don’t go up the Mounjaro doses quickly (many stay on 2.5mg for months) that is just one month of increased utrogestan to try out.

i have been on Mounjaro for over a year on the same dose, I started HRT after Mounjaro and been fine on standard dose of oral utrogestan. I did try vaginal utrogestan for a month but didn’t like it, found it messy, and had some bleeding

https://thebms.org.uk/wp-content/uploads/2025/05/23-BMS-TfC-Use-of-incretin-based-therapies-APRIL2025-E.pdf

namechange0998776554799000 · 28/09/2025 10:44

Thanks @NoTouch, I'm reluctant to increase the oral progesterone because it already gives me side effects. Im hoping the patch will be better so I'm going to try it out but if I don't get on with the lower dose of oestrogen I'll see what the menopause clinic say

OP posts:
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