Do I really need to take progesterone tablets with the topical Oestrogen cream? *[title edited for clarification]

[kerstina]

Dr has prescribed me the oestrogen cream but also progesterone tablets which I can’t swallow anyway. I did tell him that and queried why I needed the tablets but he said because of risks of cancer with the oestrogen but looking online it seems because it’s topical and low dose I don’t need the tablets. Can anyone confirm the right information please.

• [Note from MNHQ: We've edited the title at the OP's request, to make it clear that it's topical oestrogen cream, not HRT gel, that she's been prescribed]

I don’t take the tablets due to the progesterone in the mirena coil. It is definitely recommended to have both, unless you’ve had a hysterectomy.

If you have utrogestan (progesterone) you can use them vaginally rather than swallowing them.

Do you mean Oestrogel or the vaginal oestrogen cream? If you mean Oestrogel - the systemic HRT - and you have a womb you will need some form of progesterone to prevent the thickening of the lining of the womb which can potentially cause cancer. You don’t have to take utrogestan, you can have a mirena coil or even the mini pill (dose dependent) or you can have a combined patch instead of the oestrogel. If it’s the vaginal oestrogen cream it is low dose and absorbed locally and you don’t need progesterone alongside this.

Yes - You do need progesterone :

”Oestrogen gel is an increasingly popular form of HRT. You take it by smoothing it onto your skin once a day. Oestrogen is gradually absorbed into your body.
If you have not had a hysterectomy, you must use this gel with a progestogen.”

source:
https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/types-of-hormone-replacement-therapy-hrt/#:~:text=Oestrogen%20gel%20is%20an%20increasingly,this%20gel%20with%20a%20progestogen.

Thank you so much for replies. Just to confirm it’s 0.01% Estriol cream . The ustrogestan capsules are 100mg .

And no I have not had a hysterectomy but it’s been quite a long time since my periods stopped probably about ten years but I forgot.

Maybe not that long but I can’t remember.

Yes you must take the progesterone. The estrogen makes the uterine lining grow which can cause uterine cancer if not shed, it can also cause heavy bleeding.The progesterone stops the uterine lining building up. Speak to your doctor about changing from the tablets if you dont want to take them as as the other ladies have said there's different ways of taking it.

You don't need to use a progesterone with topical estrogen.

Think your GP needs a refresher course!

Well I did think the same as you that as he was an older man he wasn’t aware of the fact it was such a low dose but the replies apart from yours seem to back the dr up. I am more confused than ever 😔

Yes you do!

I read that the dose is equivalent to about two days a year of oestrogen compared to the patches etc but might be confusing that with the cream you can get without seeing a dr. Was there not a dr in the public eye saying recently that all post menopausal women would benefit from a vaginal oestrogen cream and he didn’t mention tablets .

If it’s vaginal cream than that’s different and I don’t think you need it (progesterone). Your OP was confusing because if it was the gel, that is absorbed into the skin and therefore affects the whole body so it’s different.

@kerstina
Is your cream for vaginal application?
If yes - then you do not need progesterone, as it is topical and low dose.

But if your prescription is for application of cream on your body - then it's systemic, and you'll need to protect your uterus from cancer, and you'll need progesterone.

Maybe you need to go back to your GP surgery and ask for clarification?

Depends if it is the vaginal cream or topical gel. The former doesn’t need proven the later does if you till have a womb.

Yes it is a vaginal cream .

Is it possible the dr has got this wrong then I think it must just be standard at what they give out at this surgery . I think I will ask for a second opinion as I say I can’t swallow capsules I chew them and these ones say not to because of time release.

Yes sorry about that . I was upstairs posting so went downstairs and got the products to check exact names / dosage .

Vaginal only cream, no you don't need the progesterone from a safety point of view as the cream is localised and will just treat issues in that area, prolapse etc so no buildup of womb lining to be wary of. If it was transdermal systemic oestrogen eg patch/gel/spray yes you would need progesterone.

I think I will make use of this cream I hope one lot won’t kill me either way and maybe take anti depressants for other symptoms I have like edginess . I feel a bit anxious to take systemic h r t at the moment with all what I have had going on lately.

If you are ONLY using vaginal cream or pessaries (Estradiol, Ovestin, Vagifem or Vagirux are the usual ones) you definitely DON'T need the progesterone.

If you are using HRT gel (Oestrogel) or HRT patches, you DO need either Utrogestan progesterone tablets or a Mirena coil. Utrogestan tablets can be used vaginally.

If you've had a hysterectomy, you DON'T need progesterone, as you've no uterus to protect.

Sorry to shout, but it's important to get this right.

This.

As well as reducing the cancer risk from the oestrogen gel, doesn’t progesterone bring other benefits? I thought that was what was helping me sleep and reducing anxiety.

This is terrible advice. You absolutely do need to take progesterone, to prevent the lining of the uterus thickening too much.

The tablets are tiny but if you can’t swallow them, the progesterone can be administered via a coil or a patch.

edited to add I have seen that the OP has vaginal cream and the progesterone element isn’t necessary.

Yes I agree with you and I would have accepted that if he had said it will help your anxiety but when I queried it he said it was to protect from the cancer risk.