What’s your Progesterone regime?

[CanaryLibra]

My progesterone tablet prescription states to take 1 tablet every night on days 1 to 25 of a 28 day cycle. So after they were prescribed I started taking them on the first day of my next period as advised by my GP. I will be taking 25 tablets, have 3 days off, then start again. I’m also applying oestrogen gel daily.

Will I get my period on my 3 days off?

I chat to lots of different women daily as part of my job and I’ve yet to talk to anyone who’s progesterone dose/frequency is the same as mine, even though their oestrogen is the same.

Some take it for 10 days a month, some for 14, some double dose for a set number of days, usually 7 days.

How do you take yours? And why is everyone prescribed differently?

The way you've been told to take it is quite outdated now, and the patient leaflet where it advises 25 days hasn't been updated.

In practise, it's every day for combined continuous. The 3 day break on the old regimen is a kind of insurance for a bleed if there is any womb lining to come away but it's so unlikely to happen.

All other combined continuous regimens (patches and tablets) are progesterone daily with no break.

Combined continuous hrt is for women with no natural periods for at least 12 months or over age 54. Sometimes it can be tried for women in late peri who have very few periods (like 2 or 3 a year.)

If this ^^ isn't you, it would be usual to be on sequential HRT which mimics a natural cycle. So that's estrogen every day and progesterone for 12 -14 days a month. That usually results in a withdrawal bleed at the end of the progesterone phase.

For women who find they have side effects with progesterone, 10 days can be used, but this is usually through a consultant's guidance as it's the absolute minimum dose.

Highly unusual to take only 7 days (even if it's 200mgs a day) and I wonder if they've got that right, or are doing it through a specialist. If so, it would be normal to have regular scans to check the lining is okay.

Sorry for the essay!

If you're at right right age/ post meno age then you can take Utrogestan every day, otherwise it's on a monthly cycle.

That’s really helpful thank you!

I’m 48 and still having regular periods, though they are getting closer and closer together - currently around 19 days between them.

So if I followed the 14 day progesterone regime - then I would be 14 days taking the tablets, then 14 days off?

It’s not a surprise to learn that my GP is following outdated guidance, this is the same GP that insisted my iron is fine, despite my serum ferratin being 17 and even the lab putting a note on my test results saying I need iron therapy.

I was advised by my gp to take 25 days per month even though I continue to have regular periods as it was the changing levels of progesterone that were causing me acute symptoms. I have actually been so much better in this regime - I am about to turn 53. The GP was like - go with what works. Now I wondering if this is a harmful approach - but as far as I understand it is most important to take progesterone and not taking it has risks. I am on 100 patches of estrogen.

@CanaryLibra The reason for not using continuous hrt too son is you can get breakthrough bleeding and to be on the safe side this often leads to scans etc which can be stressful.

You can do 14 days off/on but it's fine to do 12 days per calendar month starting the same date each month.
The 14 days /on and off was only suggested to keep it easy to follow.

@HumphreyCobblers It's not harmful to take the prescribed doses, which are either sequential or continuous.

You're taking almost less the same amount as the sequential dose, as that dose is 200mgs for 12 /14 days and you're on 100mgs for 25 days.

It's recent advice that women on a high dose of estrogen like you may need to double the amount of progesterone to 200mgs a day IF they experience any bleeding. Has your GP suggested this?

No but not reason I couldn’t just do this. Thanks for the info

Daily progesterone and a mirena - endo, peri and 42

I’m 54 and have been on 100mg continuous since I started last June when I was 53. I have 2 pumps of oestrogel. Based on what you’ve said about your dosage instructions, if it was me, I’d make another appointment and have a review.

I’m 45 and on 75 mg of estrogen and 20o mg of progesterone 14 on 14 off. I still have moths where I have periods every 14 days and some not for 45 days but after a year and a bit is slowly getting more regular. I love the progesterone for the sleep if nothing else!

I started HRT 2 years ago and was on sequential (200mg 14 days on 14 off). After a year my Dr called me in and recommended continuous which was as yours is (100mg 25 days on).
I was still having periods although very erratic and I ended up having to have an ultrasound due to breakthrough bleeding. I was fine, the consultant said it was wrong to put me on continuous until my periods have completely stopped, just as @JinglingSpringbells says.

I couldn't find a way to make utrogestan work for me (messed up my sleep by making me tired but wired) but was reluctant to get a mirena. Got one in the end and i love it.

I take 1 progesterone tablet days 1-13 of my cycle and 2 tablet days 14 to when my period arrives.

Why?

That's not a recognised dose.

Has your GP suggested this?

I have PCOS. I’m not in the Uk. I also have 1 pump of the gel per arm. Entire cycle. It’s working well for me. Suggested by gynecologist.
Why wouldn’t a Uk Gp allow this?

I have a 75 patch (changed twice a week) and 1 progesterone tablet daily.

The reason it's not prescribed like that is because it's not the licensed dose(s.)
The licensed dose is either 100mgs daily or 200mgs x 12/ 14 days per month.

Your doctor must have some reason for doubling the dose during the 2nd half of the month. Maybe to stop you having a bleed or something like that?

Obviously you're being treated for PCOS which is completely different to women using it for menopause without that condition.

Using 2 pumps of gel is 'normal' and the usual dose in the UK/ internationally.

I’m post menopausal but stick to a cycle with my progesterone as it has an awful effect on my mood. Currently I’m on 12 days every other month and upping my gel to three pumps on the progesterone days.

It’s really annoying having a withdrawal bleed but better than the alternative of switching between absolute rage and tears every day on a continuous regime.

I have been prescribed continuous 100mg only. No estrogen as my levels are fine. I have not had a period since November - should I be sequencing or continuous? Dr prescribed continuous. Also my testosterone was low so was prescribed this too (private clinic)

I was put on 100mg for 25 of 28 days. I still wasn't sleeping so the doctor has suggested trying 200mg for days 14-28. She says I should do this anyway if I'm still having regular periods.

I’m in a weird place as was completely regular up until November so I’m not sure if that’s it or if they are going to come back. So hard to know.

I’m 14 days on and 14 days off. Periods…have a mind of their own! Sometimes appear in my 14 day “break” sometimes don’t. Does literally nothing for my sleep though!

I’m taking 24/28 days but that was after some trial and error, because my symptoms are worse off progesterone than on.

My period tends to come day 27-2 but I have had some more erratic cycles too. GP says not to worry about that, and to expect erratic cycles as we go on, and they eventually disappear.

My periods are very heavy. Always have been since my mid to late 30s -huge blood clots - sometimes the size of my palm and I had a phase of being in terrible pain. I’ve been anemic almost every year and had an iron infusion yearly since 2018.
So it’s probably why. I still have a period but it’s usually manageable.
She is a great gynecologist and I trust her. I’ve been with her about a year and things have really improved.

That's interesting.
It's usually better to increase estrogen as progesterone isn't used 'for sleep' it's just a side effect which some women find debilitating and others love..

Have you tried increasing your estrogen dose?

Might you talk to your GP on that?

It's not usual to use just progesterone.

Why are you using it- what symptoms?

Testing estrogen is not accurate and NICE doesn't advise it for that reason.
It can vary daily so that's why it's a bit meaningless.

I'm supposed to have a break on mine but I suspect it makes me stroppy.

I did muse recently that I probably don't need the break.