HRT confusion

[oatmilkisntsobad]

So I've just started HRT after asking for over a year. One of the gp's in my practice has just done a course - at flipping last! My worst symptom is not sleeping so she suggested that instead of patches which I wanted I should have oestrogen gel to apply in the morning and progesterone tablets to have at night as they also help with sleep. She said to take one every night about 1-2 hours before going to bed. So that's what I've done. For the past week I've taken one after dinner at around 8.30-9. I noticed this morning that on the prescription label on the box it says take 2 at night for 14 days then none for 14 days! I read the leaflet inside and it says to take on an empty stomach! I went to speak to the pharmacist where I got them and she said oh that's confusing and she doesn't know about every drug so would have to look it up the same as me! She suggested I speak to my gp tomorrow but I know that I'd be lucky to speak with her within a few weeks! I'm still having periods so peri menopausal. Any experts on here who can advise me please?

I've used that combo for years.

First, if you still have periods, the Utrogestan dose is 2 capsules for 12 days per month. This is all on the leaflet in the box. It is NOT 14 days on then off, which is what some GPs are saying. The pharmacist is following the GPs prescription but read the leaflet in the box. GP has got it wrong.

You are supposed to take them at bedtime as they can cause dizziness. Taking it when you are still up for another 1-2 hrs is not a good idea (speaking from experience!)

The taking on an empty stomach...
this is not critical. My consultant says it's not relevant. The reason you might take it on an empty stomach is that with food, there is a greater absorption. This is good in some ways (helps keep the lining thin) but you may get more side effects.

@JinglingHellsBells

I've used that combo for years.

First, if you still have periods, the Utrogestan dose is 2 capsules for 12 days per month. This is all on the leaflet in the box. It is NOT 14 days on then off, which is what some GPs are saying. The pharmacist is following the GPs prescription but read the leaflet in the box. GP has got it wrong.

You are supposed to take them at bedtime as they can cause dizziness. Taking it when you are still up for another 1-2 hrs is not a good idea (speaking from experience!)

The taking on an empty stomach...
this is not critical. My consultant says it's not relevant. The reason you might take it on an empty stomach is that with food, there is a greater absorption. This is good in some ways (helps keep the lining thin) but you may get more side effects.

Thank you so much! So you take the progesterone for 12 consecutive days every month? And the oestrogen every day?

Yes.

(My consultant is one of the top meno specialists in the UK and I've seen him for almost 15 years.)

Gel every day.

Utorgestan for 12 days. You can start it at mid-cycle if your periods are regular so it ties in with your own natural progesterone.

So, suppose your mid cycle day was the 16th March, you'd do 12 days from then, and then start the next 12 days on 12th April.

If your periods go AWOL or change, keep to the same date each month with the Utrogestan. It should 'reset' a regular HRT cycle.

*sorry- meant 16th April

@JinglingHellsBells I really appreciate this x

Can I jump in? I’m finding it impossible to tally box leaflet, GP, pharmacist - same combo. I thought the gel and tablets had to be at the same time.
I do days 1-15 gel then day 15 for ten days 2 tablets then finish pretend cycle on day 28 and start again. It’s exhausting to track!

@ENoeuf

Can I jump in? I’m finding it impossible to tally box leaflet, GP, pharmacist - same combo. I thought the gel and tablets had to be at the same time. I do days 1-15 gel then day 15 for ten days 2 tablets then finish pretend cycle on day 28 and start again. It’s exhausting to track!

It's not complicated although I can see why :)

You don't need to use gel and take tablets at the same time. The estrogen is circulating all the time so no point worrying about taking both together.

You use gel every single day. You can also split the dose to morning and evening as this sometimes helps - 1 pump morning, 1 pump bedtime.

You take 12 days of utrogestan. (24 capsules in total.)

You start them on the same day of each calendar month to make it simple.

Many women choose the 1st of the month or the 15th.

IF you still have regular periods, it can help to start Utrogestan mid-cycle. If you don't have regular periods, start it any day of the month but stick to that day each month.

Forget the 28 days - it's better to work in calendar months.

So for example...

April - gel daily, Utrogestan day 1 or 15 for 12 days - expect the withdrawal bleed 3 days later.
May - gel daily, Utrogestan day 1 or 15 for 12 days, bleed, as above.

and repeat.

Ah this is what I wanted to do and was told not to - I’ve been weirdly counting days etc .