Progesterone use in HRT
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- Опубліковано 1 гру 2018
- Dr Renée describes who needs progesterone in HRT and why. She then describes the different ways in which it can be delivered and how to use the commonly confused Utrogestan. In a nutshell:
Bleeding regimens:
Oestrogen daily
Utrogestan 200mg days 15-26
Non Bleed regimen:
Oestrogen daily
Utrogestan 100mg every day (no break)
She talks through HRT tablets, patches, gel and micronised progesterone.
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Thanks so much. This made me cry with gratitude. I never have the sense that my GP has the time to explain things properly and that increases my anxiety massively. I so appreciate your work here. ❤
great little pod cast. I have been on continuous HRT pill form for 22 years and I am now 72 and doing great. My doctor kept telling me I should stop but I think now has finally done his research and stopped arguing with me.
Good!
Thanks so much I can't believe you are so persistent in your response. I went over a lot of your response had gotten a lot of info. Thank you again!
Wow! Very clear information in one video!!
You explained that very well. Thank you.
Sorry Dr Renée I listened to your video you already answered my question about taking the tablets continuously and not having a break like it says on the label on my tablets, makes sense as it's supposed to be continuous hrt x
This Video is extremely helpful !
HRT saves women‘s Life
Thanks for Sharing blessings 🌷🙏🏻
Just wanted to say thank you for doing this video it’s come just at the right time for me. You explain things very clearly in what is a bit of a mind field.
Ah its my pleasure and thank you for a lovely comment.
I am now on antidepressant tablets because I can't cope with the the menopausal symptoms that I am having. My ultrasound scan came back not sure what the result means. Waiting for a letter to see a specialist in this field. After I have seen the specialist, I will go private to see if I can go back on HRT.
Thank you for all your help.
Such an amazing video. Thank you so much. What is confusing to me is why some doctors suggest estrogen with progesterone during those 12 days or just progesterone alone. Could you possibly shed some light on that please?
Thank you so much for taking the time to give us ladies information about the menopause and HRT. I was put on antidepressants at the age of 46. I felt numb most of the time. I stopped taking the antidepressant medication at the age of 50. I struggled on with my symptoms until one day I felt that I was going mad in the head.
My doctor said I can try the antidepressant medication for my symptoms, I said no thank you, I do not want to feel numb. I started the HRT patches in November 2019. I have been told to stop talking my HRT because I am bleeding. I will have an emergency ultrasound to see what is going on. In the meantime I feel very nervous about not having anything to support my menopausal symptoms.
I have been told to go and see someone privately on the NHS. I am not sure how I do that.
Thank you for being here, I feel a little better now after getting that off my chest.
Oh dear, I'm afraid your doctors may be over reacting. Bleeding can be expected and accepted in the first 3-6 months of starting any new HRT - it is just a settling in period. Even if you have not had periods for many years. So, unless the bleeding is ultra heavy or unusual (compared to what your periods were like) I would carry on and wait with most patients. Also, you can't see someone privately on the NHS, its either NHS or private?
Thank you so much for the information. I feel at ease now. I have stopped bleeding. I had a word with my doctor this morning, I told him that I have stopped bleeding and can I go back on my HRT. He said no. I should have the scan and see what comes back. I told him that I am feeling anxious and nervous about the symptoms that may come back.
I think that I will go private.
@@DrRenee I'm hoping you can share your expertise as I suffered horrible side effects from prometrium. I am 51 and just stared hrt. Estrogel and prometrium. Would the synthetic progesterone gel work to protect my uterus with no crazy side effects...insomnia, depression, anger.
Thank you🙏
Thank you for this information. Dr, please can tell me what the side effects could be if taking 5mg of Provera? I have been on Utrogestan and a 75 patch. Due to spotting/bleeding my Dr put me up to 2x Utrogestan each night to try to stop the bleeding. Unfortunately it didn't stop it and she said that it's just not strong enough for my situation. I am not wanting a Mirena so my only option is Provera tablets. I'm worried these might not be the best option, and I'm also wondering about potential side effects. Thanks for your help.
Hi Dr Renee, so glad to have discovered you💗.
I haven't bled for 11 years. Went on HRT 8 months ago. Patches. Had slight improvement of symptoms. . Then 2 months ago GP increased dosage to Everol 75 patches and also introduced Utrogestan 100( I take orally). 4 days ago I had a bleed and cramping, not spot but enough to be a shock!. Do you think this is normal?. 💕🇬🇧
Hi did you get an answer to your question - please share with me am in same situation🙏🏼
I wish I could get my Elleste Duet. Sooo simple to take. One pill every day is the simplest way forward. Thank you for explaining the way to take this system correctly. Two pharmacists were unable to advise me. The practice Nurse told me to take Utrogestan for 25 days.... but no further instructions. Thank you for explaining things.
Hi it is possible to get similar alternatives to elleste duet if you want to stay on tablets. Obviously they are slightly less safe than transdermal types but many women do take them as their preferred choice.
Hello. I've only just spotted this one. When I came to see you in early summer I was using bioidentical hormone cream. After speaking to you I determined to swap onto Oestrogel and Utrogestan. First I had a blood test - hormone levels of Oestrogen were just 44! Wasn't getting much help from the cream then. I also had a scan and had no issues at all with the uterus, lining of 2mm and blood test to accompany it was also perfectly normal.
At first I got on well with Utrogestan vaginally every other night and 2 pumps of gel. But I felt I needed more gel. However, even on 2 pumps I started to bleed and it got very bad. I'd stand up and feel it running out. Horrible. I was told to increase to every night with the progesterone which I did. But once I did that I became very much more bloated, physical fatigue like never before, walking can be really hard now at times, sore breasts, itchy arms, swollen joints and all my motivation has gone again. My free T3 dropped yet my free T4 rose to 65% through the reference range. Plus I am now bleeding a lot. Everyday there will be something, then for a few days it will be like a period, then ease off. I'm using more sanitary ware than when I was a teenager.
I don't understand why this has happened. I was so much happier on the gel with less progesterone and felt like I was coming back to life slowly. I haven't had a natural period in years. In the past I have had a Mirena, apart from the first few months I didn't really have any issues with it. I used a progesterone only mini pill before that (there were a few years break between the 2 methods).
I know a lot of women have serious issues with progesterone, so I thought I'd put this here and hopefully you can share some thoughts so that other women who see it and suffer similar can have extra information.
Sue Wilkinson Hi Sue. Unfortunately you cannot have the progesterone every other day as it would leave you at risk of endometrial hyperplasia. If you really can’t tolerate the utrogestan you could go back to the mirena as this worked well for you. R
@@DrRenee That's what I'm thinking. But why am I bleeding with the daily Utrogestan? I don't understand the process that's happening with it.
I’m afraid no one can answer this definitively. The progesterone is not suppressing your endometrium stimulation enough hence the bleeding. Utrogestan is not always the best at stopping bleeding. Some women switch to Provera but if you are progesterone intolerant this is not an ideal solution. So mirena seems the answer.
I am on the progesterone implant for contraception. I have Oestrogel and Utrogestan. What way would you recommend taking the Utrogestan as I’ve been on the combined pill for years and have a really light withdrawal bleed.
Hi there, thanks for this information, it's very good.
The last period I had was about 3 months ago when I stopped taking femostan which I only took for 3 months, it caused me to bleed monthly which I wasn't happy about as my periods were slowing down to about 4 monthly. I'm 49 and been going through the perimenapause for about 5 years. I heard about taking hrt cyclicly and body identical hrt, so now I have Oestrogel and Utrogestan 100.
Today I took my first dose of Oestrogel, I want to take the progesterone 3 monthly but don't know whether to wait for the 13th week or to take it this week? It's like the beginning and the end of a cycle are the same? What do you think please?
Hi Dr Renee
I have a question that I need help with regarding Progesterone side effects..
Dose is 200mg orally on days 15-26.
If switching to vaginally should the dose be reduced to 100mg or continue with the 200mg?
Thanks
Hello from Across The Pond! Your videos helped me decide to start HRT as i was having Insomnia and anxiety with low energy (my GP sent me to psychiatrist). The first night i took the micronized progesterone soft gel pill, i slept straight through the night! I'm on day 4 and sleeping great now, but waking up with hangover headache. I will try inserting vaginally instead - appreciate that tip!
Hi. Thats good to hear. Before using vaginally I always advise women to take a bit earlier the night before sleep.
didi it work vaginally ?
Hello dr Renee.can I take prognova sublingual and how many doses is required.there is only premarin or prognova tablet form is available no patch no gel.so i want tablet don't go through my stomach
Hi Dr. Renne, I’ve stopped taking progesterone troches due to the fatigue and dizziness. I only took it for 5 days and 2 days after still feeling it. How long will it take to get out of my system? Or would it? 😓
Is there Utrogestan 200mg that is miconised? I did not get the 100mg but 200mg. In your video you emphasised the differences, and I m wondering if things have changed since 2018? Meaning that 200mg that I was prescribed is micronised and used for HRT rather then fertility treatment, which I don't need. Thank you very much in advance for answering my question.
Thank you for this video. I'm a 45 year old women and gave been on cyclical hrt using sandera and utrogestan. I was getting a bleed every month but for the lat two I've had no period. Is this a cause for concern?
Dr Renee, can I burst the utrogestan capsule and take it orally. I’m on sequential regime. I can’t invest the gelatine.
Great video and very informative. I have been prescribed Oestrogel pump and 100mg Utrogestan.
I am post menaporsal and have been for 4 years. I have been braving it out for the whole time. Today I decided this fake smile I have been carrying for so long needs to be a real one.
The doctor was fantastic and I feel life can change for the better.
My Question, how long before I notice a difference.
Many Thanks
I have recently been prescribed Evorel 50 and Utrogestan capsules, unfortunately, my pharmacist can only provide me with the Evoral patches until receiving a new batch of Utrogestan, can I take the Evorel without the Utrogestan and if so how long can I safely do this for .
Thankyou you are brilliant , you explained more than my doctor , I’m on continuous hrt and I keep bleeding but it’s because I haven’t gone through the menapause , and my xtra hormones floating around xxxxx thankyou x
Mabellucyanna ah it’s a pleasure. If it arms you with the info you need then I have done my job! X
Dr Renee can I ask you ? Because I keep bleeding would you suggest I have my hrt re adjusted or just keep on the same , the bleeding is annoying but I haven’t felt so good in years x I love hrt ❤️
Perhaps it would be better to use the sequential formulation of whatever HrT you are using? The oestrogen would stay stable and that’s what makes you feel better.
Dr Renee thankyou x 😘
Mabellucyanna this is what I was getting confused about two. I was having periods when I started hrt , so thought going to daily progesterone would stop this. But obviously not necessarily the case
I just started Estradot patches 50ug (Australia). I’ve also got body identical micronised progesterone (Prometrium) soft gel caps. I havent had a period for 3 months. My period is due today (but obviously haven’t been bleeding for three months so far). So should I take progesterone nightly 100mg. Or do I wait until day 14 of my so called cycle (even though it’s non existent at moment) and then take 200mg nightly for day 14-26??
Tha k you so much!!!
Thankyou x
I have been on daily progesterone for nearly two months now. The first month I had a normal period, which lasted around 7 days. I'm into month two now, and I've been having light to moderate bleeding for two weeks . Also I've increased the estrogel this past 3/4 weeks. I really feel lots better with taking the progesterone daily. Rather than every two weeks. But is it quite normal to have the prolonged bleed on daily. I imagine my body must still be adjusting after being on the cyclical for over 12 months
Hi. I've been on ustrogen for over a year and have recently been suffering with really bad acid reflux which has sent me spiral into a very dark place. I was give a anti acid tablet to take but on investigation found out that it can limit vitamin intake. I'm very thin already and don't want to loose anymore weight. I'm 57, no periods, suffering with anxiety all the time. Is the ustrogen the cause of the acid reflux and if so what can I do? Im also using 3 pump of ostegel. Any advice would be greatly appreciated. 🤗
Hi Dr. Renée,
I have started on HRT during peri menopause. Overall, I am feeling good but i think I have developed a progesterone intolerance. I have been recommended using the mirena coil but heard about the lawsuit in 2023 and the amount of money bayer had to handle because of the side effects.
Is there another option? I am taking at the moment 200 mg of micronized progesterone every two weeks for 12 days and sandrina gel.
Has progesterone something to do with histamine? Can you suffer allergy like symptoms when taking progesterone?
Hi doctor put me on estradiol gel and put me on noriday mini pill but he didn't tell me how to take them how do i use the 2 together
Hello dr,
When using the progesterone vaginally as you mentioned instead of orally is it ok to use vaginal estrogen at the same time?
Dr rennee I was on the combined patch years ago .I'm 60 and felt much better on thst than the separate oestrogen and tablets or coil. Is the combined patch safe ?
I had an operation 4 years ago to remove my overies & still have my womb. 3 1/2years ago I was put on Evrol Conti patch and have had a monthly bleed. Just had a scan done & all is good, lining of the womb lovely and thin. to stop breakthrough bleeding Doctor has prescribed me Evrol 75 & Utrogestan continuous HRT. So I have no bleeding. I’ve only just started day 4., and im bleeding , but understand this should settle with in 3 months ?
Hi Dr Renee, thanks for this topic. I have been taking HRT since March this year. I started on the Evorel Sequi which was great but I didn’t like the plasters. So my Doctor put me on Estrogel and Utrogestan. Unfortunately I started the Utrogestan whilst I was away and didn’t take the dosage properly (don’t ask!), I found it also really tricky with when to start taking it and when to stop. Therefore the following month I just decided to take 100 mg everyday (rather than 200mg) however I really want a bleed and want to go back to 200 mg. Can I do this and if so at what stage? I do feel I have not got into a good routine of taking these tablets which is scaring me a little. Thank you.
Firstly you should be doing all of this under the guidance of your doctor. I don't have your records or history so I can't advise you personally. If I had a patient like this I would increase the utrogestan to 200mg taking a note of the date on which we started the 200mg. (Lets say for arguments sake that it was today, 27th). I would then take for 12 days and stop. A bleed should follow. I would then advise them to start the 200mg utrogestan on the 27th every month for 12m days - no counting needed!
What happens if u don't bleed after taking 10 days of progestrone 200 mg. This month I just had some spotting , otherwise I would bleed for 3-4 days , I m on hrt for 8 months , is it normal not to bleed ??
Hi dr renee. Recently had the coil out as it was in for nearly 5 years . I didnt want another one as it was so painful going in . Been prescribed the tqblets but different brand , can these still be ised vaginally ? Also i found it easier using the combined patch but is this not as safe as the patch and tablet's? Im 60 and came off it after the coil came out but am burning up all the time so need to go back on HRT.
I've just started HRT,(2 weeks ago), I'm coming up 65, have put up with the constant hot Sandrena pack says take for 12 to 14 days, so I was very confused. So glad to have found your vlog and which explained so well. The flushes seem to be easing but I now have a continuous discharge which is worse than the flushes and other meno symptoms. Is this something I will have to put up with?
You may get irregular bleeding for 3-6 months when starting HRT new. After this and any bleeding must be investigated. If it is discharge rather than spotting, get a vaginal swab to check for infection/thrush.
Try berberine excellent for fungal infections and other imbalances in the body.
Hello, if I am prescribed hrt on day 18 of my cycle can I start the patch and insert the pills vaginally from day 18 as I noticed you did mention a few times it has to be days 15-26 but can it be days 18 -29?
Hi, your vedio is very informative.
I m 46, my last menstrual period was on 12 aug 2019,i missed 2 months, having terrible hot flashes, night sweats, insomnia nd other menopausal symptoms. Can I start with premarin 0.3 and take vaginal progestrone 200 mg for 1st 12 days nd then take tab premarin for rest of the cycle. I wud like to bleed. I m taking very low dose of premarin becoz tab yaz gave me melasma, so I want to go slow.
Dr Renee hi
I’m in full menapause
Please help I am on bi est compounded oestrogen
I want to get onto oestrodial patch only
Can I take my micronized progesterone 100 mg
With the patch
It’s Not utrogestan. But the same
Micronized from the compound pharmacy
My Gynae is not a meanapause specialist says I have to use mirana coil she says
I can’t use tablets
This is not true ??
Pls clarify
Hi dr Renée, I am progesterone intolerant, I had patches which were awful , I am currently on utrogestan tablet and Estrogel ..whilst better than patches still not great . Two hormone hrt doctors have suggested I try merino coil as it’s localised . My concern is it’s synthetic levonorgestrel ...which was also in patches . It’s a complete nightmare . Should I stick with my current hrt as it is better than patches or give mireno coil a go . What would you suggest for women experiencing progesterone intolerance in hrt ? Would be grateful to know what you think . 💕
Hiya. Firstly, have you tried the utrogestan vaginally? This way is usually well tolerated but off license. IF you are still suffering with that method I would try the mirena. It works beautifully for most women. I have one, don't even know its there. r
Question if you are on 3 pumps of Lenzetto is 100mg of utergestan enough??
Hello and thanks so much for your help. I'm about to switch from Evorel Conti patches to Evorel 50 patches and Ultrogestan tablets which I plan to use vaginally. The doctor says one every other day vaginally but one per day orally. Does that make sense to you?
Also, have you heard of any reports of the patch progestogen causing weight gain, water retention and muscle aches that the Ultrogestan might not? Many thanks!
No. There are some doctors who do this but there is no supporting evidence for safety and when I have raised it with the British Menopause society they have always said no, same dose vaginally and orally. As you should have less side effects vaginally there is no reason to not use 100mg daily.
@@drrenee1300 really grateful. Thanks!
I'm 47 years old in perimenopause. I'm on the 75 estradiol patch with the Mirena IUD. I was on Prometrium but the doctor told me to stop when I had the IUD inserted. I don’t think I'm getting enough progesterone. I'm still having many migraines, night sweats and hot flashes plus just an overall sense of unwell. I started taking the Prometrium tabs that I have... one a night 100mg. Is this okay to do with my Mirena because I feel so much better? I also like having birth control and not having a heavy period every 14 days and Mirena provides this.
Thank you for your advice . I am post menopausal 2 y now, and after some research I decided to try HTR, my GP prescribed Utrogestan 100 mg capsules at night. I took these orally for 6 days now and have side effects - I feel bloated and have pain in my ovaries . Can I use the same med viginally ? It does not say in leaflet that I can.
You can but it is an off license use. It is however often used that way and accepted as safe.
Thank you for this clarifying video. However, I have some doubts that I will take to the nurse appointment next week, and I hope she will be able to answer this. I would like to post it here anyway. I was not reallly asked about my last period, it was a year ago, nov 22, but I had a brown spotting in March that cannot count as a period, it didn't last long either. So I believe that I should have been given a continuous regimen but instead they gave me evorel 50 sequi and I am on it since last October. My 3 months were completed last week and I never had a bleed. I took two tests privately, on at the end of month 2 and another at the end of month 3, and found out that the progesteron levels were below 0.9, even lower than before starting HRT, estrogen instead went from 44 before taking HRT to 250, therefore I am concern that I am not absorbing the progesterone and therefore not protecting the uterus properly. Am I right in having this thought? Many thanks in advance.
Hi Ive recently been fitted with a mirena coil to help heavy bleeding and previous thickened lining of uterus. Because mirena is synthetic I would prefer transvaginal micronised progesterone. Would this be equally as effective as having the Mirena for uterine protectuon Thanks.
Hi. impossible to predict but as you have had previous endometrial thickening I would say that mirena a better choice to ensure no build up. Utrogestan can bring erratic bleeding for some women. The absorption from mirena is mainly local with very little systemic and this it is not as bad as other non body identical progestins.
Hi Cheryl how have you found the coil?
@@tallisinwonderland4724 Hi I had the coil removed as I had headaches . I am now taking Utrogestan 2 pills for 12 days They also give me a headache but as I am taking Estrogel I have to take progestetone. Thanks for asking.
Is progesterone cream harmful or beneficial if someone has varicose veins?
Thank you so much for your reply, I have responded in the below conversation. It seems like very hard work to try and get the answers I need which is why I have asked your opinion. One thing I am still unclear about regarding Utrogestan. I have taken my first dose this week on the 15th day and will continue until day 26. If I was to bleed early before finishing this month's Utrogestan, would I count my first day from that bleed, then wait 15 days before starting the progesterone again. Alternatively, am I supposed to be creating a cycle by having a diary of blocks of 28 days on which I start the Utrogestan on the 15th day of each 28-day block, and not worry about the point at which the bleed falls? Sorry if that sounds confusing, but I am not clear on how to work out the next 15th day for progesterone if the bleed is at variable times. Thank you😀
Hi. General advice, not individual. A woman can bleed at any point in the cycle, before the utrogestan has ended or after. Just carry on the utrogestan for the 12 days every month. Start on the same date each month. So for example if one takes it in the first month starting on the 20th, then always start on the 20th. As long as you have 200mg for 12 days each month, the uterus should be protected and a pattern should be established by 3-6 months. That pattern will be different woman to woman.
@@drrenee1300 Thank you for taking the time to reply, as I have no doubt you are incredibly busy. Your explanation will make it much easier to keep track of how to take it. I am surprised the leaflet didn't explain this a bit better. I really feel for anyone else who is struggling to get the information they need while trying to get settled down on the right type of HRT. I am sure some of the answers you have given me will also help others. Once again, thank you so much for your comments.x
Hi Dr Renee..Thank you for clarifying how HRT works.. I had my last period 11months ago and have been taking estrogel(2 pumps per day) and 100mg utrogestan vaginally for 4 weeks..I started bleeding yesterday..Should I continue with the utrogestan? Thank you in advance..
We tell
Women’s hat they can expect bleeding in the first 3-6 months. But if it’s unusual or heavy speak to your GP immediately.
I have been on everol sequi for nearly a year and now have a thickened womb lining so going for a hysteroscopy. Thought this would not happen but Doctor said as I’m peri could be my own hormones in the background so too much oestrogen! May switch after to mirena and gel. X
Hi Amanda, I’m in exactly the same boat as you, can I ask how you got on with the coil please
Hi there, Thank you for doing these videos, it's great to be able to find things out, GP's don't really know a great deal about the subject, though mine is quite happy for me to do the research and tell him what I would like to do.
I do have a question if you don't mind. I'm 51 years old, went on Femoston 1/10 last September, after having periods every 4 months for 18 months, I then changed to femoston 2/10 in January this year , I was always worried about the risk of clots etc so Ive just gone on to estrogel & utrogestan, really enjoying it and I wondered can I move over to continuous this september , when I will have been on some form of hrt for a year , or do I have to be on estrogel for a year.
Hi. It’s a pleasure. So the answer is that you can try continuous at any point, you don’t have to wait the year. If your body isn’t ready the bleeding will be erratic and you can go back for a while and then try again. It’s not dangerous to go continuous at any point, it’s just pesky if you get lots of unpredictable bleeding. Hope that helps.
Ooh thanks, that's great, we'll I'll just finish these 2 months worth that I've been given then ask to try conti, I really hope I'll be ready, the 200 is making me so tired I feel like it's too much, I'm trying it PV just now hoping that lessens the tiredness.
@@the_greenhouse_gardener The only difference between sequi and conti when it comes to utrogestan is that instead of taking 200mg for 12 days a month you take 100mg every day.
What if I’ve had an ablation? Do I need progesterone with my estriol?
Hi Dr Renée. I would like to move from cyclical to continuous progesterone. Could you advise how to go about this? Do I take my 200 for twelve days and then simply switch to 100 every day or do I need a break? My French GP is not up to speed I think as she prescribed 200 mg per day for continuous. However as I am new to HRT and my last period was last August I started on cyclical. Many thanks in anticipation.
I'm sorry Liz but I can't give individualised advice. I can confirm that the dose for continuous is 100mg every night. We usually wait a year on combined before switching or a year without periods naturally.
Dr Renee Hi, yes, I realise that and should have worded the question differently. You and I communicated last week as I had just started HRT and my GP had given me the option of either continuous or cyclical. I began on cyclical but am now wondering if that was the correct choice for me given our communication and so wondered how the regime, when the time is right, generally transitions. Are you able to share how you, in your practice, usually direct your patients? Many thanks, and thanks so much for the hugely valuable information you share on your channel.
As a follow up to this question I would like to add another! I am so disappointed because I was thrilled to be prescribed HRT...and almost immediately my hot flushes, night sweats and sleep were revolutionised. However, all my life I have really struggled with PMS and this had faded but now, in the progesterone phase, it’s all come crashing back. I feel as though I have an impossible choice; just for context I am using oestrogen gel and 200mg progesterone vaginally. My GP is very naive about this. I read a research paper that found that paradoxically higher doses of progesterone can stop these symptoms.
I do hope that you can shed some light... and some hope?
Many thanks in anticipation. Liz
Hi Liz Do you have an update regarding your hrt treatment. I have the same situation that’s why I’m interested. Thx
Hi. How do I know if I need to bleed.
What do you mean by"if you need / or don't need to bleed"
DR Renee, I am wondering, if you take utrogestan vaginally in the sequential method, would taking 1 x 100mg capsule day for that duration be enough to do the job of shedding the lining of the womb, as oppose to taking 2 x 100mg capsules? If 2 x 100mg is required for the oral dose but some of that is naturally broken down by the liver and doesn't get to the uterus where it needs to be, is taking 2 x 100 mg vaginally actually necessary? I'm thinking this could be a way of avoiding possible side effects caused by the higher dose? I can't ask my GP because she isn't up on this subject, she didn't know about taking it vaginally.
No I'm afraid the dose is 200mg whichever way you take it. This is because we do not have enough evidence to ensure that the endometrium is protected with a lower vaginal dose.
Thank you.
I’m in the USA. I just started a combo patch for HRT I haven’t had a period 3 yrs. The issue is I’m having bleeding. I was worked up for endometrial issues a year ago for some mild spotting and it was negative. OB thinks it estrogen related. I want to just get an IUD. She uses the brand Lilletta. I’ve only heard physicians talk about Mirena for HRT IN Menopause. Is a different brand IUD okay?
The Mirena IUD has a higher dose of progestin, and can stay in longer. I believe that most menopause specialists recommend mirena to ensure that the uterine lining does not build up.
hi Dr. i am in Canada and taking Estrogel (17 - estradiol 0.06%) and Prometrium 100mg, i was prescribed to take one pump of the gel and 1 prometrium pill, however my symptoms are not totally gone so my question is what if i take two pumps of the Estrogel and if so do i need to increase the prometrium dose? please help my family Dr. thinks one pump is enough. i just need to know the correct balance for the two hormones. thank you so much for your vlog.
Curious about this too. Did you ever get your answer? ❤
@@Aki-wq6xh no reply yet
Hi Dr. Renée! I am a 36 years old woman with fibroids and adenomyosis. I have made a lot of changes in my diet and lifestyle in the last several years, but I got this problem. The last thing I could this of stopping was dairy and sugar (the only sugar I was consuming was a little bit of coconut sugar in my organic coffee). Despite this after a surgery for removal of the fibroids, I got two new fibroids only a few months later which was too early... My period is coming on the 17th day in the last several months (so I do not ovulate), I have been bleeding outside of it as well. Obviously I need natural progesterone to regulate the period and prevent the thickening of my uterus. The issue is that the fibroids have a lot of receptors both for estrogen and progesterone. I am estrogen dominant and I take supplements to fix it. But the ratio compared to my progesterone is 54:1. I do not want to make the fibroids grow from the progesterone. Should I not take it at all or is there a safe small dose that will help without doing a harm? I will be grateful for your reply, because many books and studies have contrary statements. Thank you!
Hi, I read your comment and I had to double check to see I hadn’t written it myself! My story is so similar to yours! Did you get any answers and how are you doing now?
@@emmierow1980 Hi dear Emily! :) This is funny and at the same time - it is a shame you are going through the same thing!... I looked for information myself and what I know is that both progesterone and estrogen have a role in fibroids development, so I never took progesterone, I was afraid. I do not know how to do it properly and if I need to do it at all. The best is to focus on natural things that regulate it: sleep, food, working on emotional and psychological state. I am taking herbs after being in doubts for years. They help with the symptoms most of the months and regulate the periods again - in most of the last few months. The issue is that the fibroids do not shrink and a few more developed. :( I was very surprised that I stopped milk products a year before the surgery and for another year after it and I still got the new fibroids within just a few months. So, I was really between "Dear God, I have to stop eating more things that could potentially cause this problem, do this and do that...!" and "I will take some cheese or yellow cheese from time to time just to have a more rich and balanced diet than before"... So, I have no idea what is really right. Let me know if I can help you in any way. How about you, how are you?
I've been on evorel conti patches for 3.5 months and suddenly started bleeding. 2 years post menopause. It stopped for a week and just started again. Doctor said it's normal, it doesn't feel normal. It's painful and I'm not sleeping well :(
Dr. Renee, what if the progesterone comes in a pill form? Can it be used vaginally like the tablet??
Thank you for the information. I had my ovaries removed age 36. Have been on HRT ever since. Now age 47. Everol 50 patch and utrogestan 100 continuous tablet. The issue is, I keep getting a thickened womb lining with this regime and irregular bleeding which is getting me down. Histology from hysteroscopies over the years has been ok, it’s just this bleeding due to an imbalance somewhere. Could increasing the. progesterone work at all or would more progesterone be potentially harmful in other ways? Or, is it too much progesterone causing this. I have never really got to the bottom of it with doctors & the bleeding is getting me down. I’m overweight, could this be a factor in the imbalance. I’m sure this regime works for most people so I just wonder why I keep getting this build up and end up with a thickened womb lining every 5 years that requires investigating. I don’t want to move to the coil because I like the body identical aspect of the utrogestan, rather than the synthetic. Any advice would be appreciated. Thank you
Hi. I am sorry to hear this. It is not an uncommon problem. If you like the utrogestan, you could increase the dose. Being overweight may be part of the problem. Please don’t do this without speaking to your treating doctor.
I always turn to your videos when I have questions
I’ve been on HRT for a year 0.5 patch
and micronized progesterone 100 mg the problem is my lining has built up and now I have to get a D&c OB/GYN suggested an IUD. I really don’t want to go that route do you have any suggestions on how, I could help my body absorb the progesterone bloodwork says I only have .7 progesterone, which is hardly anything.
She also suggested I get off HRT and take anti-depressants, which is ridiculous
Needless to say, I’m switching OB/GYN after the D&c
Hi Kathie. Sorry to hear this. This is not uncommon and there are always a few solutions for women to think about. 1. Double up the progesterone 2. Mirena coil (its how I do it and it works for me. 3. change to a non body odentical progesterone, eg provera Hope that this helps. R
@@DrRenee thanks for your reply. I’m so grateful.
OB/GYN said she could put in a marina IUD at the same time of D&c
Do you think this is wise or should I wait to heal and then have the marina put in?
OB/GYN, that’s doing my procedure is fresh out of residency
I realize she’s qualified ,but I’m a little nervous due to her lack of experience
Hello, I am 56, still have my uterus and have just started on HRT. Initially on the combined patch femseven conti and then asked to change to body identical so now I am on Progynova 50mg patch an Utrogestan 100mg. I cnat take the utrogestan orally, it makes me crazy! So started taking in vaginally every other night, but I am having a light bleed but with terrible period pains. I am going to go back to taking it every night vaginally to see if that stops the bleeding and the pain. It is mostly old blood, dark in colour. Dr Newson says every other night which is why I decided to take it that way. Am I doing the right thing going back to every night? I had a coil for 7 years and it was taken put in 2020. I didnt have a bleed at all in that time and only started HRT in Jan 22. I very much look froward to hearing from you. My Gp (Lady) is not in the surgery for a month so cannot talk to her.
Thank you
Heather
If the mirena IUD worked for you before, it might work again and would handle the progesterone component of your HRT. A lot of women stop bleeding all together with the coil.
Hello. I'd like to start taking my progesterone 100mg vaginally instead of oral. I also use estrace cream vaginally 2 nights per week. How might this combo be given best? Thank you.
I am on .075 estradiol patch and 100mg oral micronized progesterone continuously/daily. I feel like I could use some additional help sleeping. Is it ok to take 200mg OMP every day or would that be too much? I can only find protocols for 100mg continuously or 200mg sequentially. Thank you!
Same question
Hello Dr. Renee. I am 43 years old and started experiencing peri menopause. I understand that I still need contraception but I know that my estrogen is low. I have been on Yaz for 10 years and really loved that pill. But now that my own levels are low, I feel like it’s not enough. Going up to 30 mcg of Ethinylestradiol seems to cause low moods, low libido and bloating. And Yaz doesn’t cut it anymore as I get light heart palpitations and a strange feeling in my knee joint. I also read that Ethinylestradiol doesn’t bind to the estrogen alpha and beta receptors the way Estradiol does which explains why it feels a little “off”. I tried a patch 0.1 mg of Estradot with 100 mg of Utrogestan. I cramped and bled for two weeks straight, it was really hard. But at the same time, apart from these uterine side effects, I felt amazing mood wise. And I am afraid of mini pill due to being prone to acne and hair loss. That’s why Yaz worked so well for me. My question is, can I keep taking Yaz but also supplement my body with more natural Estradiol by wearing my patch but cut to half a dose, 50 mg instead of 100. If Utrogestan didn’t hold the endometrium that well, I wonder if drospirenone 3 mg will as it works in Yasmin. And Yaz and Yasmin have the same amount of drospirenone. So topping up 20 mcg of Ethinylestradiol with 0.50 transdermal Estradiol patch to get the benefits of the hormone that binds to my estrogen receptors like my own Estradiol used to do would be an ok idea or not? Since it’s transdermal, it’s still better for the liver then going up to 30 mcg of Ethinylestradiol in an another OCP. Am I on the right track at all? My doctor doesn’t feel comfortable with this scenario but they are all afraid here of prescribing hormones. My gynaecologist is 55 and she has been taking Yasmin back to back since 45 and that’s what she recommended I did. It didn’t work at all, Yasmin is so strong. Do you see my logic? Thank you very much for your help with everything you do for us!
janebirkin1000 so the quick answer is no. there is better bioavailability of oestradiol through the skin and no liver metabolism so no risk of stroke/DVt. Alongside this you need the pop for contraception. The alternative is mirena could plus gel. Also, try the bleeding: you need to persevere, it can take 3-6 months to settle.
Dr Renee thank you for your reply. Bleeding and persevering it is ))) xx
How do you know if you need to bleed ?
Thank you for your informative video about taking progesterone. I’m PM and not had a period for 5-6 years, I started 12 months ago on 2 pumps Oestrogel and continuous Utrogestan with no bleed but had to swap to patches because of the gel shortage, I was put on Evorel Conti but after 5 weeks I had a bleed which lasted 5-7 days and I get them every other week, I’ve been on the patches 3 months now. Can I take Utrogestan as well as the patches or should I ask to swap to Evorel 50 with Utrogestan, I tolerated Utrogestan quite well. Thank you so much.
Hey. You can but I would swap back to what worked well for you. There gel situation is sorted now. Also speak to your Gp and get an Ultrasound booked just for completeness. It is common to bleed within 3-6 months of a change in HrT format but I would always check things out. Good luck.
@@DrRenee thank you so much for replying. I forgot to mention that he has requested a scan. I do feel so much better on the patches apart from the bleeds.
@@DrRenee thanks for this informative video De Renee.
I am on 50 patches with 200mg Utrogestan days 15-26, but having awful symptoms 3 wks out of 4 and GP has suggested going continuous.
I’m worried about thickening endometrium as still have a very light bleed.x
Thank you for this blog I’ve just started HRT at 64 and you’ve answered a lot of questions I had. I have one query that may not be possible to answer but here goes 😊 is it better (safer, for eg to prevent BC) to use Utrogestan vaginally rather than it going through the liver etc when taken orally.
I am learning so much from your videos, they are so clear - your a star ⭐️
Orally is the licensed use.
@@DrRenee I see, I do take it orally just wondered this would not have happened if I used it vaginally ? (I’ve noticed my dark skin patches, beauty spots etc have gotten a lot darker). I realise you may not be able to answer but through your observations have you noticed any difference in this type of side effect with the two different routes ? Thank you again, this is so helpful I’m trying to advise my daughter which would be best for her xxxxx.
@@tezt8018 Skin pigmentation is not caused by progesterone but by oestrogen. Its why pregnant women suffer and those on the combined oral pill.
@@drrenee1300 Ah I was confused as hyperpigmentation is included as a side effect in both the oestrogel and Utrogestan advice leaflets. Thank you
@@tezt8018 Ah. Its the oestrogen. We really don't see it with Utrogestan but I won't say never because humans are individuals.
I'm confused.. I just listened to Dr Newson say that for any woman on cyclical progesterone , if there are no issues she should then be changed after 6 to twelve mths to daily progesterone. I was perimenopausal and still having bleeds before I began hrt. But obviously the continual progesterone will now stop the bleed?
Sorry, why are you confused? This is exactly what is done. If you are still bleeding when you start HRT then a sequential progesterone is used. It is then impossible to tell if your periods have stopped naturally because the bleed is purely hormonally driven (the same as the pill). so we assume after a year its reasonable to try continuous and this should stop the bleeding totally, if its ready. If it isn't ready, you will bleed erratically, even on the continuous. This is not dangerous, but its inconvenient and so the choice is to go back to sequential and wait another year.
@@drrenee1300 that makes sense! Thank you
Hi
I’m 57 post menopausal and I’m new to hrt been prescribed 2 x Estrogel and 200mg utrogestan continually every day ..been doing this for 8 weeks now,
I’m noticing I’m feeling worse than before I started this regime ..
Should I be taking 200mg or 100mg utrogestan? Also it doesn’t state in the leaflet that it can be used vaginally ..
thank you
I notice no-one has replied to you. Its 100mg per day if you take it continually. It's fine to use the capsules vaginally and there are less side effects that way.
Thank you dr Renee. Would taking progesterone vaginally help with acne breakouts? My cheeks and chin have had acne since I went on hrt. What can I do???? Karen xx
I guess not cuz it isn’t so much absorbed systemically.
What about increasing estrogen, i think you need more utrogestan then, to prevent a bleed, because more estrogen will lead to.more thicker lining of the womb,?
Hello Dr. Renee. Just one question. If the Utrogestan is used vaginally ,do I need an applicator to deliver as high up as possible?
jane99908 no. Just as far as you can push it.
@@DrRenee Ahh ok thank you. Also, just want to say thank you so much for your blogs. It is lovely to be able to receive information on the menopause from someone who is really knowledgeable on the subject. You are helping lots of women...Thank you.
What happens if you take the gel and utrogestan as prescribed and you don’t bleed? I was fine last month but this month no bleed but have quite a bit of abdominal pain and not feeling well. Btw, have spoken to GP and she says to continue with the utrogestan tablets on what would have been day 15 which I’ll do, but am concerned that my womb lining has bui,t up and nothing has been released. Many thanks.
Hi Fiona. Your GP is correct, it just means that your lining has not built in the first 2 weeks and the utrogestan is suppressing to the point whereby a bleed is not happening. If this continues it likely indicates that you are ready to take 100mg utroestan every day instead of 200mg for 12 days.
Dr Renee thank you. It’s just strange as my periods are still relatively normal until this month. I went on HRT due to the extreme night sweats which have got much worse over the past year but I’ve had them for about 7 years and I’m 49. I’ve also just started some daytime sweats. My mother went through early menopause which was an awful time for her so was keen to get symptoms under control. It’s just my abdomen is quite uncomfortable atm due to not having a bleed.
It was just the information you gave about not bleeding and the uterus building up could lead to a risk of cancer which I obviously want to avoid.
But night free sweats are heaven! Thank you for a quick reply, much appreciated.
Fiona Wood Hey. You may find that you will bleed any day now, hence that heavy feeling. I always tell patients to just carry on with their pattern of gel and utrogestan regardless of when the bleeding occurs. It may settle into a pattern and may not always be after you stop the utrogestan. It may also take up to 6 months to settle.
Dr Renee ok that’s very helpful. Thank you so much! 😊💕
@@fionawood7106 thank you for this i have had same problem except only 9n utrogestan 100mg sequentially perhaps I need to go to 200mg every 12 days
I’ve read that progesterone improves bone health. Is it better to take it systemically or locally?
It’s actually oestrogen that improves bones health and transdermally is beset.
Hi i very suddenly experienced severe hot flushes,anxiety,panic attacks depression wow I thought I was going mad, I was put on anti depressants and evorel sequi.I was in such a state after the doctors appointment I just stuck a patch on without reading what to do .....I thought they were all the same patch.... six weeks later i begin to feel like the old me ...no not flush of anxiety ....I go to the chemist to collect my owed patches the pharmacist explains why they are 18£ as they are two different patches oh i said i didn't know that so now I'm doing them properly i have noticed this last week on evorel conti I've had a big dip in mood hot flushes and anxiety ..what do you suggest I do I really don't want to go back to that dark space i was in its scary. Thank you
You could speak to your doctor about trying conti, but if you are having periods it may make you bleed more but its not dangerous, or changing to gel and utrogestan.
Great video - a lot of mysteries explained! I have been taking Utrogestan and Estrogel for around 24 days (prioir to that Femostan 1/5 conti but symptoms came back and bad heart palpitations). I initially started taking it orally and then switched to taking it vaginally after aboiut 10 days as I had terrible bloating and breats tenderness and irratic moods (One day I would be really happy and the next really grumpy). That did not really change very much with taking the Utrogestan vaginally so I have not taken it for the last 3 days and immediatly crashed into PMS and then a bleed. I am considering taking it sequentially, but should I try starting it conti again, but start vaginally once it has left my system? And how long does it take to clear yiour system?
When was you last natural period?
@@DrRenee I think around July 2017 (but have been on some sort of HRT since September 2017) - I am 57
@@janfreeman179 Okay. So in that case you should have had sequential HRT for at least a year and then a switch to conti as a trial. It can take 3 months for the side effects of utrogestan to settle so you likely needed to persist a little longer. If you are under 50 I would go with sequential for a while longer and if ver try conti. An alternative that night work better for your is a mirena coil and oestrogel.
@@DrRenee Thank you for your replies. That all makes sense and I think that a lot of what I have been experincing may be cause I have still been having a cycle in the backgdround! My bleeding is very heavy now (indicating significant build up?) - I think it wll be best, as you say to go on to a sequential programme for the Utrogestan and perhaps get an appointment to have a Mirena fitted (apparently it is earliest June!)
@@janfreeman179how are you doing now? Just reading your comments, I think it's not right to bleed at 57. Did you do anything about it?
hi , do u continue to take the eatrogen during the 12 day progestogen use
Julia sophia yes totally. The oestrogen is every day. No breaks.
I’m 57 and still have my womb, I have not had a period for 7-8 years. My doctor has put me on Oestrogel and Utrogestan as my menopause symptoms have worsened this past 6-12 months. She has prescribed the Utrogestan two capsules daily from days 15-26 of each cycle, I’m confused as to what a cycle is and also confused why I’m on sequential and not on continuous as I’ve read on many posts about Utrogestan. I haven’t started taking them or using the gel yet until I get clarification on this. Would be grateful for any help.
A woman who has not had a period for 1 year or more should be on continuous HRT. This would be 100mg utrogestan every single day: no break.
@@DrRenee very grateful for your reply thank you. She would only change it to 25 days Utrogestan with a 3 day break when I questioned it, because that’s what the medical ‘bible states’ I am going to take it with no break though. I don’t like going against my GP normally but on this occasion I feel I must.
I'm on continuous utrogestan because I was a year period free but I bleed a lot. I've had scans etc and everything else is fine, should I change to sequential?
Hi. This is a decision you need to make with your treating doctor because it is personal to you and your history. If it helps, here is no danger from using either too late/too early.
Hi
My gynaecologist prescribed me vaginal progesteron tabs to help with my migraines cold and pain paleness etc
Only concern
He said I should take it on the onset of migraine, which I do and it helps😊. But my migraines tend to come somewhere when I m still in the midst of bleeding 5th day or so
Should I continue till day 26? Is my cycle going to be confused? I m in perimenopause but still bleed regularly
Thank you
Very difficult to answer this for you individually I'm afraid. There is no harm in doing so but you may bleed irregularly this way. It may be oestrogen mediated and not progesterone as well.
Hi there. What about use of progesterone in women who've had a hysterectomy but also had a history of endometreosis and adeomyosis?
I have endometriosis, and it was explained to me that progesterone has a suppressive effect on lesions which can reside inside the pelvis in addition to the uterus. So no, you don't need progesterone to protect you from uterine cancer obviously, but they may be using it specifically for the endometriosis.
I was prescribed progesterone 200 mg because of my insomnia. I am afraid to try one. They may cause a loss of appetite. What if this capsule keeps me up instead. But the worst side effect will be a loss of appetite.
I have found taking utrogestan orally causes side effects. You say that I can take it vaginally 100 mg every day however another well known clinic online suggests using it every other day. I’m confused can you help?
Maribeth Walsh I am afraid using it every other day is not supported by any evidence and potentially therefore leaves you with the risk of endometrial hyperplasia which can lead to endometrial cancer. I have raised this use with the experts at the British Menopuase Society and they do not support every other day dosing.
Diagnosed with both endometriosis and early menopause. I am prescribed 200mg of Progesterone with 2.5mg of Estrogel for continuous HRT (previously on Femoston). Is it overdosage? In your video understand only 100mg of Progesterone is required for continuous HRT. Thanks!
Sometimes they prescribe higher doses of progesterone to help manage endometriosis
@@athenachloewoodrow6356 I see. Thanks for your reply.
Hello doc, I am 47 been on continuous hrt since 4 years, estrogen gel 2 pumps and utrogestan 200mg as per my gyn instructions, but recently I've started to have more anxiety so I've switched to another gyn, she prescribed me utro 100mg she said I don't need more & I even can use it as a sequential 14 days on & off but I don't have periods anymore after 1 year of using cont. hrt, I think it doesn't make sense. I need your advice plz!
Hi. So I agree with your gynae and thats what I would do, I would take it continuously, You don't need a period and if you were not bleeding through 200mg then its reasonable to have 100mg, and if you take it daily and don't bleed then all good. If you take it for 14 days, 100 mg is not enough, it must be 200mg. You may bleed this way but if you background hormones are now menopausal you may not. The periods are not real on HRT, they are hormonally made so there is no need to have one. So its 100mg daily or 200mg for 12 days a month. Hope that helps.
@@DrRenee Thanks doc so much for your quick feedback and advice as well. I appreciate your input. I just want to add that when I started to have morning anxiety I thought it's utrogestan so my doc said to use it vaginally 100mg, but I know it's half the dose this way, isn't it?! I also feel that I need more estrogen, but as per my blood test estrogen was 49,4 pg/ml, my doc said it's high I don't need more, I need 1 to 2 pumps max! How can she rely on blood test during perimenopause? I still feel anxious with heart palpitations. Any advice would be greatly appreciated. 🙏🏼
This was a great help Dr. Renee! One question: I'm not doing well with the dizziness that comes with oral progesterone. I'd like to try it vaginally. But do I need to pop a hole in it or anything or will it dissolve on it's own vaginally the way it does orally? Thank you! ;-)
It will dissolve.
The progesterone will still help with sleeping if used vaginally?
I'm on sequential HRT but I haven’t had a bleed in 3 months. Why is this?
Hi Dr have a quick question im going to start hrt treatment and they prescribed me progesterone tablet to take individually but progesterone has unwanted side effects like swelling of face hands feet and all over is it ok to administer the pill vaginally instead orally even if it was prescribed to take orally? Ive heard if u administer vaginally you wont have those yucky side effects. Thanks
Lynn If it is utrogestan then yes but this way of taking is off licence but accept by specialists as equally effective as oral.
@@DrRenee actually got my meds today its pregnenolone/progesterone 200/100mg capsules its a compound medication. What do you think? I wonder if its gonna have side effects
@@Lynn22823 This is similar to Tibilone. So no, I would not recommend vaginal use I'm afraid. Are you taking this plus oestrogen? Are you in the UK?
@@DrRenee Im also taking a cream 2 clicks daily of Bi-Est(80 20) testosterome 2/15mg/ml.Im not in the UK im in the USA
Hi. I suspected as much. I think it’s a really odd combination to be honest, we would not do that in the UK. It’s almost a doubling up of some of the hormones. But, things are different country to country. Sorry I can’t help further. R
Hi Dr Renee
I’ve just finished taking my first lot of utrogestan vaginally. I’m peri
I was expecting a bleed virtually straight away ie the next day. I was just wondering how long it takes the bleed to come? I was on the combi patches before and they came literally at the end of the second patch.
As always thank you xx
Hi. Difficult to predict. Can be a few days before you stop or after but varies from woman to woman and not all women always bleed.
Dr Renee thank you for your reply, x would it be the same if I’d taken it orally? And should I be worried if I don’t have a bleed when I’m still peri?
Thank you for again your time x
Jules Claire9 Not wanting to be vague but again it’s just impossible to predict. Women all react so differently to progesterone.
Dr Renee that’s ok thank you I really appreciate your help, when/if bleed comes on utrogestan reigime, I’m just wondering how I know when to start the next 12 day cycle of administration, first day of bleed or what if there’s no bleed?
Thank you once again for your invaluable advice.
Have a great weekend x
Jules Claire9 Whatever date you started the utrogestan on this month, start on the same date every month for 12 days. So for example, if you started on the 23rd May, then start again on 23rd June.
Hi Dr Renee
My doctor has just prescribed me progesterone micronised 200mg vaginal capsules as I said I wanted to administer my Progesterone vaginally along side Evorel 50. I asked for Utrogestan she couldn’t see anywhere on the paperwork that mentioned it can be administered vaginally so was hesitant to prescribe! Should I go back and request some to take orally but administer vaginally. Oh dear so confusing sorry for the waffle and thank you 🙏 x
So the answer is this. Firstly it is not dangerous in any way. However, neither is it licensed in HRT use (it is licensed for fertility only) so she has not really done anything different to prescribing it as 100mg oral capsules that use use x2 vaginally. Neither are licensed in HRT use but the latter is widely used. The benefit of the utrogestan is that it is much cheaper and much kinder to the environment; the vaginal pessaries have a plastic applicator and a plastic wrapper which are thrown away everyday.The capsules don't, you just pop them in your vagina.
Dr Renee Thank you once again for putting my mind at rest x
I'm on a 100mg progesterone tablet and two pumps of estrogen gel per night. I'm a life long endometriosis sufferer and I've been struggling with menopausal symptoms for three years . My Dr started me on hrt 3 weeks ago and felt wonderful for about a week and a half ...after that I started to feel very tired and then 3 days ago started a heavy period . Any advice very welcome 🙏
There is often a settling in period. Most symptoms do so by 3 months. Your GP should have warned you re the bleeding. It is possible to see bleeding for the first 3-6 months of starting HRT. If this bleeding is unusual, prolonged or you are worried, speak to your GP. Sometimes utrogestan doesn't control bleeding as well as other forms of progesterone and in endometriosis the mirena coil can work well. Good luck.
Thank you ...that's reassuring to hear . I appreciate your reply 🙂
I’ve had a hysterectomy but I really feel I do need progesterone. I take Testosterone and oestrogen. I don’t understand why a woman would not need progesterone considering its also used by other parts of the body? Also, what about estrogen dominance?
Thank you Renee. That's really helpful. Just one question, what does the progesterone pass through internally that causes the symptoms of bloating etc, that is avoided by taking it vaginally?
Hi. Well you absorb it systemically so it enters the bloodstream as it is metabolised and absorbed whereas vaginally it is mainly absorbed directly by the uterus and only a very small amount enters the systemic circulation. Same with Mirena coil.