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.
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🙏
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
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 think its because you didn't have natural periods. You were using Progestin instead of Progesterone. Women really need to have natural bleeds for a good few years. Hopefully you got it sorted out.
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.
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
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!
Great video, im doing my best as a husband to help my wife with her symptoms she’s started having in the last year, she still has her monthly periods but they’ve become irratic and other issues, her doctor put her on what we figured out now is continues hrt, her estrogen is a tablet that is only .675 mg and her progesterone is only 2.5 mg, we’re so confused as we dont see this small of a dose on any videos or podcast?, is this very low dose something we should still cycle progesterone 12-14 days once we figure out her cycle?.
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
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 ?
Hi Dr Renee so glad I found this. I have a myrena coil the end date was last month but struggling to find a doctor to replace it they are worried because of my age 57 it could pierce my womb so I’ve asked to be referred to a gynaecologist but could have to wait up to 12 months ! I asked for progesterone to protect my womb in the meantime but concerned how it would work as I won’t bleed whilst I have a coil , I have been prescribed ultrogestan 100mg should I take it ?
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 .
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.
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.
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 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.
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.
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.
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 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
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.
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.
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. 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? 😓
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.
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!
@@audrey3042 I did change to 200mg, continuous. I did not, however, do anything to help sleep. I don’t notice much difference in the change other some fluid retention. Still debating if I want to go back to 100mg. Good luck!
I got on hormones to help with insomnia and anxiety but I still have both. It’s been a struggle with sleep and it cause cortisol issues and that’s problem as well. Thanks
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!
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.
@@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.
I went on to the Utrogestan, but found on 2 occasions when I had to get up to spend a penny about an hour after taking the tablets I felt drunk, dizzy with blurred vision and couldn't walk in a straight line. I told my doc and they immediately took me off of it. I am now back on the Ecvorel Sequi patches I had before to try them again. It's a shame the Utrogestan caused this. I wonder how many other people have experienced this.
I experienced this also. It caused me to discontinue using it. I was encouraged by another doctor to try again. I had similar side effects, but after a week it went away. Maybe we just need a few days to adjust? Hope this helps!
@@TAZSWIGSNACKS Hiya wig friend. Fancy bumping into you here! I'm also struggling with Utrogestan. I've never managed to take it for a whole week yet but your post has encouraged me to persevere!
Hi I had no sleep issues until I started Utrogestan and gel. Now I get up for a wee in the middle of the night every night for past 8 nights. Also feel strong heart beat, slight headache and more recently a nose bleed and lower back pain. Will preserve for another week or so before contacting nurse. Thank you for sharing. ❤
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??
I couldn’t tolerate DAILY uterogestan (100mg), continuously, even when taken vaginally due to it still causing low mood - so went to ‘alternate’ day dosing, vaginally (with a low dose SSRI added in) and I’m managing with that. On average though, it means I take 100mg P 3 days/week, which is 12 days/ month - IS THIS ENOUGH PROTECTION FOR MY POST-MENO WOMB? I’m reluctant to take provera/MPA as it’s synthetic P.s. I’m using 2 pumps oestrogel daily
Hi, I'd love to know the answer to this too. I cannot tolerate oral progesterone either continuously or sequentially so thinking of trying vaginally at a lower dose. Taking it orally has turned me upside down 😢
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
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.
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
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?. 💕🇬🇧
I’m ‘in between the worlds’ crazy predicament: have not bled for over 2 years but my body seems to still run a cycle ( low mood & cramping but no bleeding ) the problem is the cycle is WERKLY but not monthly ( yes, when measured by home fertility monitor my hormones rose & fall accordingly, including 1-2 spike of progesterone). To level up my incessant hot flashes and mood drops I went on lowest dose E patch and it helps tremendously. It’s supposed to be taken with 50 mg progesterone and here’s the issue: if I try to override my natural cycle taking progesterone on those follicular days feels very much against the flow, sickening in fact. Also, I’ve been taking herbal formulas to bring my cycle back as my TCM doctor believes I still have a good chance to conceive. So, I’m cycling progesterone with my body’s natural flow of energies 3-4 days a week when I feel premenstrual. Will this way still protect my uterus?
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 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
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 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. 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. 🤗
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
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 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
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. 🙏🏼
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.
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.
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?
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.
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
@@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.
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?
I’m new with progestrone and estrogen tablets with no instruction whatsoever! My endo was described 30 estro. By itself…! Then I had to practically plead for the progestrone because it was dangerous taking just the estro. He then prescribed 12 prog. per 30 estro. From what I understand by doing my own research, you’re only supposed to take about 21 days of the estrogen and 12 of the progesterone simultaneously and then stop the estro for one week. Then start all over again, ongoing. Even the pharmacist did not know what to tell me and I couldn’t get ahold of the endocrinologist who prescribed this. I am 54 , full menopause, and had almost no estrogen in my body and the symptoms were outrageous. I am on lowest and feel a little better but still don t know if I’m taking it right. It seems like 30 was too many estrogen because I’ve read that the estrogen is only to be taken for 3 weeks with one week break. Am I hearing right that I can use oral progestrone vaginally?
Hi. I can't comment on your individual script and we don't prescribed this way in the UK. However, as a general point, if this is HRT, you should never stop oestrogen, that gets taken every day with no break. The progesterone should be taken for 12 days a month in owmen who are still having periods and every single day for those post menopause who don't have periods anymore. If a woman who has stopped periods naturally (usually around age 51) takes progesterone on only half the days a month she will start having periods again, that she doesn't need. A woman who has not had a period of 12 months naturally needs continuous HRT with both oestrogen and progesterone every day with no breaks.
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.
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?
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.
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
It is my understanding that If you are using progestrone vaginally, it doesn't reach your uterus, and that where you need it . That is why you have to take it orally so it goes thru your system.
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.
There isn't a video specifically covering this point, its covered in the VLOG's on menopause. Essentially however, its anyone with a uterus who is under a year from their last period. (or who has had an ablation but a progesterone bleed challenge causes bleeding).
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.
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.
You do know that women under 40 still can have these issues correct? I came to your channel for help, I had a Total Hysterectomy Oopherectomy and much more ...and have been having to use BHRT for 3 years now and I’m 38 this year. Thanks for excluding anyone under 40. Absolutely ridiculous and good this tells me you don’t know as much as you think or you wouldn’t exclude certain age groups. Thanks
What a delightfully rude comment. So, I do not say in this VLOG, or any other that I have done, that women under 50 do not have these issues. However, the average age of menopause in the UK is 51. That said, I clearly say in the VLOGs on menopause (this one on which you have commented is actually about progesterone use) that perimenopause is often seen 10 years before menopause so if that is 46 then this means 36. I also state in these that early menopause is under 45 and premature menopause under 40!! I have lectured at the Daisy Network which supports women as young as 18 experiencing menopause (giving my time freely because I am passionate about this topic). You will also note that I have not done a separate VLOG on surgical menopause, perhaps I should, but certainly, women suffer at any age for a variety of issues. BHRT is not a recommended approach but if it works for you that's good. There are safer ways of doing it and I have made a documentary about this for the BBC which you can find on here. So actually, I know quite a lot. I am sorry you have found a reason to complain and wish you well.
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.
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.
@@a_strange_life 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.
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.
I am 58 and stopped periods for 3-4 years. 2 months ago I started bio identical HRT. 2 pumps of estradiol cream and 1 x progesterone 120 mg per day for 5 days , stop for 2. I had a period! Ugh! A light one, but it freaked me out a bit. I waited a week to start taking HRT again. I have reduced to 1 pump of the cream as I’m a bit afraid 2 may be too much? The progesterone is a capsule 💊 I don’t see how it would work taking it vaginally?
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..
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.
I was told to do vaginally be abuse I was so groggy but just every other night. Now after 2 months I’m cramping ( no bleeding) I’m really worried I’ve got a build up?
You need to do them every night. Same dose vaginally to orally, despite what some say. I have discussed this with the BMS and they didn’t support half dosing.
@@DrRenee thank you so much for your reply -I am SO grateful. i have now missed 17 nights out of 42 ( due to following alternate night but going every night for last few days) and am cramping without any bleeding at all. I am imagining scary thickening because it feels like a period be starting but isn’t. Do I need to go and pay for a scan to be sure? Or if cramping stops and no bleed comes an i safe to do no more? I’ve only been on hrt 3 months.I cautious because I know from others experience timing can be everything but am really happy not to panic unnecessarily too. Thank you so much again x
@@DrRenee If it’s absorbed much closer to the world surely the half dose makes sense? You absorbing much higher doses of it? So every second night would make sense? There’s a few opinions on this please can you clarify
Progesterone does help bones along with the thyroid. Oestrogen protect the density of the bones. VitD3 and K2 daily for even more protection and proper absorption.
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?
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
Very informative. I am concerned that I have been prescribed Utrogestan 200mg pessary capsules. When watching the video you state that the pessary should never be used in HRT, only for fertility. This explains the lack of info in the leaflet for my situation, it only mentions women trying to get pregnant. When I picked up the medications there was no label on how to take them, so I queried this with the pharmacist, he wasn't sure so he sent me back to my GP. I saw a different GP than the one who prescribed it, she seemed confused and said it was complicated so she referred me back to the pharmacist. I am still waiting for this appointment, so I popped into another pharmacy, and again my concerns were heightened by the fact she said she had not seen the 200mg prescribed for HRT before. I am trying to get back in to see a GP, but if I am still unhappy, where do I go from here?
Please don't panic. It will do the same job, its just much more expensive for the NHS! Anything licensed for fertility is expensive and these fall into that. There is no difference in the content or way it work. x
@@dawnturton8402 It shoul;d be 2 x 100mg capsules if you are only taking it for 12 days. It is only licensed for oral use but there is enough data to know that vaginal use is efficacious but is off licence.
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 ⭐️
@@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.
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
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
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.
I have watched many " What is like inserting IUD" on UA-cam. But they are all young women . Probably 20s or 30s? and they all said It was horrible and so much pain or gained weight ,cramps, acne..... I am postmenopausal woman and have been thinking about IUD for HRT. But those stories make me so scared to try IUD. I would like to know If experiences are different for older women??
I have read reviews from all ages, seems like there are always a percentage of women that have these experiences and then others that don't. You can always ask the doctors to give you a mild sedative and numbing before insertion if you're worried about that being painful. And then just remember that it's very easy to remove the coil if you find your body just doesn't get on with it. But you do need to wait long enough for it to settle in, most people experience a surge of hormones initially that can cause symptoms.
@@athenachloewoodrow6356 I just realized your message now. I did IUD without sedative and yes it was painful but I did it!!!! it has been over 1 year since IUD.I have had spotting for 6 months but like it now.BUT since I got IUD, my TSH got high. I do not know if IUD causes or not. Thank you so much for replying for me.
Absolutely not. Without withdrawal from progesterone they would not bleed and the lining would still build. Progesterone is needed either cycled or full time.
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,?
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
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 :(
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! ;-)
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.
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. ❤
Find a better one.
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!
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🙏
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 think its because you didn't have natural periods. You were using Progestin instead of Progesterone. Women really need to have natural bleeds for a good few years. Hopefully you got it sorted out.
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.
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 🌷🙏🏻
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 ?
Great video, im doing my best as a husband to help my wife with her symptoms she’s started having in the last year, she still has her monthly periods but they’ve become irratic and other issues, her doctor put her on what we figured out now is continues hrt, her estrogen is a tablet that is only .675 mg and her progesterone is only 2.5 mg, we’re so confused as we dont see this small of a dose on any videos or podcast?, is this very low dose something we should still cycle progesterone 12-14 days once we figure out her cycle?.
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
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 ?
Hi Dr Renee so glad I found this. I have a myrena coil the end date was last month but struggling to find a doctor to replace it they are worried because of my age 57 it could pierce my womb so I’ve asked to be referred to a gynaecologist but could have to wait up to 12 months ! I asked for progesterone to protect my womb in the meantime but concerned how it would work as I won’t bleed whilst I have a coil , I have been prescribed ultrogestan 100mg should I take it ?
Hi. You don’t need to bleed, just to keep the lining suppressed and 100mg utrogestan every night is sufficient until the mirena change. R
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 .
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.
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.
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 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.
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.
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.
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 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
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.
Don't go near the coil... Try the transdermal cream. Did you try it vaginally? The Utrogesten...
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.
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. 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? 😓
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.
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
Great question! Did you change to 200mg? If so, how is it going? I’m on 100mg and would like to increase to 200 as well
@@audrey3042 I did change to 200mg, continuous. I did not, however, do anything to help sleep. I don’t notice much difference in the change other some fluid retention. Still debating if I want to go back to 100mg. Good luck!
I got on hormones to help with insomnia and anxiety but I still have both. It’s been a struggle with sleep and it cause cortisol issues and that’s problem as well. Thanks
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.
The best viideo on youtube
Definitely! So pleased I came across this.
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.
Dr Renee, can I burst the utrogestan capsule and take it orally. I’m on sequential regime. I can’t invest the gelatine.
I went on to the Utrogestan, but found on 2 occasions when I had to get up to spend a penny about an hour after taking the tablets I felt drunk, dizzy with blurred vision and couldn't walk in a straight line. I told my doc and they immediately took me off of it. I am now back on the Ecvorel Sequi patches I had before to try them again. It's a shame the Utrogestan caused this. I wonder how many other people have experienced this.
I experienced this also. It caused me to discontinue using it. I was encouraged by another doctor to try again. I had similar side effects, but after a week it went away. Maybe we just need a few days to adjust? Hope this helps!
@@TAZSWIGSNACKS Hiya wig friend. Fancy bumping into you here! I'm also struggling with Utrogestan. I've never managed to take it for a whole week yet but your post has encouraged me to persevere!
@@essanjay8604 Yes, persevere! I’m doing fine on it now. The digestive issues and bloat have now gone. And I am feeling a bit better. Hugs! 🩷
Hi I had no sleep issues until I started Utrogestan and gel. Now I get up for a wee in the middle of the night every night for past 8 nights. Also feel strong heart beat, slight headache and more recently a nose bleed and lower back pain. Will preserve for another week or so before contacting nurse. Thank you for sharing. ❤
Also if I take the progesterone pill vaginally should I wait a while before sex?
I'm on sequential HRT but I haven’t had a bleed in 3 months. Why is this?
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??
I couldn’t tolerate DAILY uterogestan (100mg), continuously, even when taken vaginally due to it still causing low mood - so went to ‘alternate’ day dosing, vaginally (with a low dose SSRI added in) and I’m managing with that.
On average though, it means I take 100mg P 3 days/week, which is 12 days/ month - IS THIS ENOUGH PROTECTION FOR MY POST-MENO WOMB? I’m reluctant to take provera/MPA as it’s synthetic
P.s. I’m using 2 pumps oestrogel daily
Hi, I'd love to know the answer to this too. I cannot tolerate oral progesterone either continuously or sequentially so thinking of trying vaginally at a lower dose. Taking it orally has turned me upside down 😢
I hope Dr Renee gets round to reading our comments/ questions, as she does say in the video to post them!
So glad I found your comment as I am in the EXACT EXACT SAME SITUATION!!!
Opting for once every two days vaginal gel, post menopause, and wanna know 😢
Ps I also have awful side effects from P- think my GABA system is sensitive by nature so P just makes me drowsy and sluggish
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
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’m ‘in between the worlds’ crazy predicament: have not bled for over 2 years but my body seems to still run a cycle ( low mood & cramping but no bleeding ) the problem is the cycle is WERKLY but not monthly ( yes, when measured by home fertility monitor my hormones rose & fall accordingly, including 1-2 spike of progesterone). To level up my incessant hot flashes and mood drops I went on lowest dose E patch and it helps tremendously. It’s supposed to be taken with 50 mg progesterone and here’s the issue: if I try to override my natural cycle taking progesterone on those follicular days feels very much against the flow, sickening in fact. Also, I’ve been taking herbal formulas to bring my cycle back as my TCM doctor believes I still have a good chance to conceive. So, I’m cycling progesterone with my body’s natural flow of energies 3-4 days a week when I feel premenstrual. Will this way still protect my uterus?
Question if you are on 3 pumps of Lenzetto is 100mg of utergestan enough??
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 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
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 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. 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. 🤗
Organic Maca powder daily for 4 months if not contraindicated.
Magnesium Glycinate at night and Indian Ginseng.
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
The progesterone have to be taken in the #15 day or day one together with estradiol? (Day one of the period)?
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 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
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. 🙏🏼
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
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
Has progesterone something to do with histamine? Can you suffer allergy like symptoms when taking progesterone?
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!
Thankyou x
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?
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.
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
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.
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?
Nope... that's peri...
I’m new with progestrone and estrogen tablets with no instruction whatsoever! My endo was described 30 estro. By itself…! Then I had to practically plead for the progestrone because it was dangerous taking just the estro. He then prescribed 12 prog. per 30 estro. From what I understand by doing my own research, you’re only supposed to take about 21 days of the estrogen and 12 of the progesterone simultaneously and then stop the estro for one week. Then start all over again, ongoing. Even the pharmacist did not know what to tell me and I couldn’t get ahold of the endocrinologist who prescribed this. I am 54 , full menopause, and had almost no estrogen in my body and the symptoms were outrageous. I am on lowest and feel a little better but still don t know if I’m taking it right. It seems like 30 was too many estrogen because I’ve read that the estrogen is only to be taken for 3 weeks with one week break.
Am I hearing right that I can use oral progestrone vaginally?
Hi. I can't comment on your individual script and we don't prescribed this way in the UK. However, as a general point, if this is HRT, you should never stop oestrogen, that gets taken every day with no break. The progesterone should be taken for 12 days a month in owmen who are still having periods and every single day for those post menopause who don't have periods anymore. If a woman who has stopped periods naturally (usually around age 51) takes progesterone on only half the days a month she will start having periods again, that she doesn't need. A woman who has not had a period of 12 months naturally needs continuous HRT with both oestrogen and progesterone every day with no breaks.
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?
Then get Progesterone. You need it.. Progesterone is a very needed hormone. It calms and aids in sleep. It also keeps Estradiol in check.
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.
What if I’ve had an ablation? Do I need progesterone with my estriol?
Is progesterone cream harmful or beneficial if someone has varicose veins?
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
It is my understanding that If you are using progestrone vaginally, it doesn't reach your uterus, and that where you need it . That is why you have to take it orally so it goes thru your system.
Not true.
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
Can you point us to the video explaining who needs to bleed? I can't find it specifically.
There isn't a video specifically covering this point, its covered in the VLOG's on menopause. Essentially however, its anyone with a uterus who is under a year from their last period. (or who has had an ablation but a progesterone bleed challenge causes bleeding).
Hello dr,
When using the progesterone vaginally as you mentioned instead of orally is it ok to use vaginal estrogen at the same time?
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.
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.
You do know that women under 40 still can have these issues correct? I came to your channel for help, I had a Total Hysterectomy Oopherectomy and much more ...and have been having to use BHRT for 3 years now and I’m 38 this year.
Thanks for excluding anyone under 40. Absolutely ridiculous and good this tells me you don’t know as much as you think or you wouldn’t exclude certain age groups.
Thanks
What a delightfully rude comment. So, I do not say in this VLOG, or any other that I have done, that women under 50 do not have these issues. However, the average age of menopause in the UK is 51. That said, I clearly say in the VLOGs on menopause (this one on which you have commented is actually about progesterone use) that perimenopause is often seen 10 years before menopause so if that is 46 then this means 36. I also state in these that early menopause is under 45 and premature menopause under 40!! I have lectured at the Daisy Network which supports women as young as 18 experiencing menopause (giving my time freely because I am passionate about this topic). You will also note that I have not done a separate VLOG on surgical menopause, perhaps I should, but certainly, women suffer at any age for a variety of issues. BHRT is not a recommended approach but if it works for you that's good. There are safer ways of doing it and I have made a documentary about this for the BBC which you can find on here. So actually, I know quite a lot. I am sorry you have found a reason to complain and wish you well.
You sound very angry. She meant no offense. She's just trying to help people.
I agree women suffer at all ages. And it's way before 40
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.
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.
@@a_strange_life 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.
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.
I am 58 and stopped periods for 3-4 years. 2 months ago I started bio identical HRT. 2 pumps of estradiol cream and 1 x progesterone 120 mg per day for 5 days , stop for 2. I had a period! Ugh! A light one, but it freaked me out a bit. I waited a week to start taking HRT again. I have reduced to 1 pump of the cream as I’m a bit afraid 2 may be too much? The progesterone is a capsule 💊 I don’t see how it would work taking it vaginally?
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'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
I was told to do vaginally be abuse I was so groggy but just every other night. Now after 2 months I’m cramping ( no bleeding) I’m really worried I’ve got a build up?
You need to do them every night. Same dose vaginally to orally, despite what some say. I have discussed this with the BMS and they didn’t support half dosing.
@@DrRenee thank you so much for your reply -I am SO grateful. i have now missed 17 nights out of 42 ( due to following alternate night but going every night for last few days) and am cramping without any bleeding at all. I am imagining scary thickening because it feels like a period be starting but isn’t. Do I need to go and pay for a scan to be sure? Or if cramping stops and no bleed comes an i safe to do no more? I’ve only been on hrt 3 months.I cautious because I know from others experience timing can be everything but am really happy not to panic unnecessarily too. Thank you so much again x
@@DrRenee If it’s absorbed much closer to the world surely the half dose makes sense?
You absorbing much higher doses of it?
So every second night would make sense?
There’s a few opinions on this please can you clarify
My doctor put me on progesterone only for 10 days a month.
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.
Progesterone does help bones along with the thyroid. Oestrogen protect the density of the bones. VitD3 and K2 daily for even more protection and proper absorption.
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?
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.
Very informative. I am concerned that I have been prescribed Utrogestan 200mg pessary capsules. When watching the video you state that the pessary should never be used in HRT, only for fertility. This explains the lack of info in the leaflet for my situation, it only mentions women trying to get pregnant. When I picked up the medications there was no label on how to take them, so I queried this with the pharmacist, he wasn't sure so he sent me back to my GP. I saw a different GP than the one who prescribed it, she seemed confused and said it was complicated so she referred me back to the pharmacist. I am still waiting for this appointment, so I popped into another pharmacy, and again my concerns were heightened by the fact she said she had not seen the 200mg prescribed for HRT before. I am trying to get back in to see a GP, but if I am still unhappy, where do I go from here?
Please don't panic. It will do the same job, its just much more expensive for the NHS! Anything licensed for fertility is expensive and these fall into that. There is no difference in the content or way it work. x
@@dawnturton8402 It shoul;d be 2 x 100mg capsules if you are only taking it for 12 days. It is only licensed for oral use but there is enough data to know that vaginal use is efficacious but is off licence.
@@drrenee1300 Thank you for getting back to me, this helps for when I see my GP next. Much appreciated. Dawn
Tha k you so much!!!
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.
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.
I have watched many " What is like inserting IUD" on UA-cam. But they are all young women . Probably 20s or 30s? and they all said It was horrible and so much pain or gained weight ,cramps, acne..... I am postmenopausal woman and have been thinking about IUD for HRT. But those stories make me so scared to try IUD. I would like to know If experiences are different for older women??
I have read reviews from all ages, seems like there are always a percentage of women that have these experiences and then others that don't. You can always ask the doctors to give you a mild sedative and numbing before insertion if you're worried about that being painful. And then just remember that it's very easy to remove the coil if you find your body just doesn't get on with it. But you do need to wait long enough for it to settle in, most people experience a surge of hormones initially that can cause symptoms.
@@athenachloewoodrow6356 I just realized your message now. I did IUD without sedative and yes it was painful but I did it!!!! it has been over 1 year since IUD.I have had spotting for 6 months but like it now.BUT since I got IUD, my TSH got high. I do not know if IUD causes or not. Thank you so much for replying for me.
From what you say would not women just need to take a break from estrogen every month instead adding too much chemicals ( progesterone)?
Absolutely not. Without withdrawal from progesterone they would not bleed and the lining would still build. Progesterone is needed either cycled or full time.
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,?
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
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 :(
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?
Will the coil stop a period? I have been prescribed the coil for hrt but i still have a regular period. I want to keep my period.
You should be using the mirena coil with HRT, not copper and it may stop your period.
@@DrRenee thank you!
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.