Question About Utrogestan

[Poppy]

Hi Everyone!
Not posted for some time, but I've enjoyed catching up with all your posts this afternoon.
Got a few questions re Utrogestan that I'm hoping someone can answer.

For the last 18 months, I've been on Estadot 75 & 200mg Utro vaginally for 12 days per month. Had to persuade my gp for this regime, he thinks I'm taking it orally & discussing vaginal route is not an option with him.

I really like the patches & generally am finding this hrt to be the best I've tried. The withdrawal bleeds are regular, very light. However, I'm now experiencing very painful cramping/period pain on the 2nd day of the bleed. It really is becoming a problem & quite unlike anything experienced previously. Without being too dramatic, it almost feels like constant labour pains for a couple of hours, until it suddenly stops & then I'm ok again.
You might wonder if this really is so big a deal, but for example, during the 2nd period day next month, have to travel to large hospital with daughter & will be there all day - I'm already planning not to take the utro, thus avoiding bleed as I know that I couldn't cope feeling like that on top of everything else that day (wouldn't be able to drive etc)

I'm beginning to wonder if I'm taking too much progesterone?
Do you know if we absorb more vaginally than orally?
Did try to discuss this with gp & also asked about continuous hrt, so I could try 100mg utro. He said that would only be possible when I'm 52 (thought the recommendation was 54??) & I'll be 51 in a few weeks.
However, in the next breath he tried to persuade me to have a Mirena (which I don't want) as my progesterone - surely that would be continuous??
Also fed up that he wouldn't discuss estrogen cream for external use as the 'estradot should be giving you all the estrogen you need & wait until you're sore next time & I'll examine you.' Well great advice dr!

I've been so down & unsure about all this that I've considered coming off hrt & have started to cut pieces off the patch, but am still in the same position re. the utro.
(then I read some of the info that you ladies have posted & feel sure that I should remain on hrt for ever!)

I feel fine during the first week of taking the prog, but by the time my bleed ends, I'm generally depressed & tearful.
Does this mean that I'm prog intolerant, taking too much, not enough??

Also, if Jacks reads this- do you take utro orally?
Dr stressed it must be taken on an empty stomach, but I found it gave me heartburn & digestive discomfort that's mainly why I started vaginal route.
Has anyone else noticed that the instructions for Prometrium in the states suggest that it should be taken 'with food?'

Sorry if this is too rambling & too many questions, but I'd love some input from you all.

Thanks, poppy xx
ps. thanks to pinky for the virtual 'kick up the bum' earlier!

[jacksfullofaces]

Feb 20, 2013 17:47:33 GMT Poppy said:

Hi Everyone!
Not posted for some time, but I've enjoyed catching up with all your posts this afternoon.
Got a few questions re Utrogestan that I'm hoping someone can answer.

For the last 18 months, I've been on Estadot 75 & 200mg Utro vaginally for 12 days per month. Had to persuade my gp for this regime, he thinks I'm taking it orally & discussing vaginal route is not an option with him.

I really like the patches & generally am finding this hrt to be the best I've tried. The withdrawal bleeds are regular, very light. However, I'm now experiencing very painful cramping/period pain on the 2nd day of the bleed. It really is becoming a problem & quite unlike anything experienced previously. Without being too dramatic, it almost feels like constant labour pains for a couple of hours, until it suddenly stops & then I'm ok again.
You might wonder if this really is so big a deal, but for example, during the 2nd period day next month, have to travel to large hospital with daughter & will be there all day - I'm already planning not to take the utro, thus avoiding bleed as I know that I couldn't cope feeling like that on top of everything else that day (wouldn't be able to drive etc)

I'm beginning to wonder if I'm taking too much progesterone?
Do you know if we absorb more vaginally than orally?
Did try to discuss this with gp & also asked about continuous hrt, so I could try 100mg utro. He said that would only be possible when I'm 52 (thought the recommendation was 54??) & I'll be 51 in a few weeks.
However, in the next breath he tried to persuade me to have a Mirena (which I don't want) as my progesterone - surely that would be continuous??
Also fed up that he wouldn't discuss estrogen cream for external use as the 'estradot should be giving you all the estrogen you need & wait until you're sore next time & I'll examine you.' Well great advice dr!

I've been so down & unsure about all this that I've considered coming off hrt & have started to cut pieces off the patch, but am still in the same position re. the utro.
(then I read some of the info that you ladies have posted & feel sure that I should remain on hrt for ever!)

I feel fine during the first week of taking the prog, but by the time my bleed ends, I'm generally depressed & tearful.
Does this mean that I'm prog intolerant, taking too much, not enough??

Also, if Jacks reads this- do you take utro orally?
Dr stressed it must be taken on an empty stomach, but I found it gave me heartburn & digestive discomfort that's mainly why I started vaginal route.
Has anyone else noticed that the instructions for Prometrium in the states suggest that it should be taken 'with food?'

Sorry if this is too rambling & too many questions, but I'd love some input from you all.

Thanks, poppy xx
ps. thanks to pinky for the virtual 'kick up the bum' earlier!

Hi Poppy
It sounds as though you are not absorbing enough progesterone for your body's requirements. Heavy monthly cramping is associated with low levels of progesterone. I experienced this myself when I was using Pro Gest so switched to Utrogestan 100 mg daily (orally) and I'm fine.
As for being 54 before taking continuously I have been doing this since I was 50 without ill effect and I still get regular periods. I know this protocol is not usual but my uterine lining has remained stable and I'm happy with it.Many forms of the birth control pill work in this manner and doctors are happy with that.
Re vaginal estrogen cream - you may well need it in addition to systemic HRT I certainly do.
Your feeling miserable and under the weather post bleed probably means your estradiol levels are slightly low. This is the time when I usually raise mine for a few days with my oestrogel.
Inhouse Pharmacy can help supply you with vaginal cream and I recommend buying a tube of oestrogel for that time when you need slightly more oestrogen.

[Poppy]

Thanks for such a quick reply Jacks.
I'd never considered low levels of progesterone!

Thanks also for your recommendation of Inhouse Pharmacy, I'll certainly look into that.

Jacks, do you take utrogestan on an empty stomach? If so, don't you find it restrictive regarding evening meals?

poppy x

[jacksfullofaces]

Poppy
We have a light evening meal - our main meal is at lunch time. However I don't generally take it on an empty stomach and it is recommended for use in the evening so would be rather impractical.
Meanwhile I can recommend raspberry capsules for nasty cramps.
Jacks

[Poppy]

Thanks Jacks, I'll give them a go.
xx

[jacksfullofaces]

Progesterone is known to relax the oesophagus and during late pregnancy many women suffer reflux due to high levels. I have a small hiatus hernia and always have Zantac in the house for the occasional bout of reflux. You can just double the dose to get prescription strength.
Jacks

[Poppy]

Thanks Pinky & Jacks,
There's much to think about here.
I'm going to give the progesterone a break for just this month & then have to see what happens. Need to decide whether to continue as I am or try taking it orally again, without worrying to much about empty stomach.

I suppose I'd assumed that taking it vaginally might result in more being absorbed, as it's bypassing liver, but this may not be the case.
Does anyone know of any comparative studies?

No pinky, the dreaded VA is not a problem (yet!), although things don't feel quite the same, if you know what I mean.
I'm determined not to suffer in that way & thought my gp's suggestion of letting things get worse, was quite outrageous.

poppy x

[jacksfullofaces]

Feb 21, 2013 17:29:53 GMT Poppy said:

Thanks Pinky & Jacks,
There's much to think about here.
I'm going to give the progesterone a break for just this month & then have to see what happens. Need to decide whether to continue as I am or try taking it orally again, without worrying to much about empty stomach.

I suppose I'd assumed that taking it vaginally might result in more being absorbed, as it's bypassing liver, but this may not be the case.
Does anyone know of any comparative studies?

No pinky, the dreaded VA is not a problem (yet!), although things don't feel quite the same, if you know what I mean.
I'm determined not to suffer in that way & thought my gp's suggestion of letting things get worse, was quite outrageous.

poppy x

Poppy
yes it is outrageous and can weaken your pelvic floor. I had a stupid gynaecologist who advised only using estriol cream for three months. I asked her if my vagina would magically rejuvenate itself and she shut up and put me on repeat prescription.
Jacks

[Deleted]

I changed using Utrogestan orally to vaginally and use every other night. I have abnormal LFT readings so anything that bypasses the liver must be a plus. I have to say on the 'utro' nights I tend to sleep quite well - at least compared to the insomnia issues I have had in the past. I hope it doesn't mess with the pelvic floor - it's one problem I could really do without.

[rusalka]

Thank you for this informations! This helps in my case a lot, because I can't tolerate 200mg P at all. And I will stay by the vaginal route.

[rusalka]

Thank you too! What makes me wonder- they wrote if you take 200 mg you daily, you will get a similar P levels like in the first trimester of the pregnancy! I mean- do wee need such high P levels in the peri or menopause??

[rusalka]

Feb 24, 2013 8:41:13 GMT @lainey1976 said:

Hi ladies,

I ended up in hospital a few days ago because there were huge chunks of flesh coming away from me. I don't have my hysterscopy results back yet but panicked a little and gp sent me to hospital. I currently use 200mg of cyclogest and the doctor who ran a few tests said my womb lining was still a bit thick (1.4mm) and to stop the bleeding i should increase my P levels and recommended 600mg of P for 3 weeks. sounds crazy to me.

Lainey xx

Lainey, I'm sorry to hear that! I hope you are o.k. OMG, 600mg of P, this really sounds crazy... Did I get you right- 1 cm and 4 mm, or 0.4 cm?

[rusalka]

Feb 24, 2013 9:52:49 GMT @lainey1976 said:

Hi rusalka,

It was 1.4mm.

Lainey xx

Mine was 2 weeks ago 6 mm and the gyno said is perfectly ok. so now I'm confused..

[jacksfullofaces]

Ligaments and sphincters are relaxed by progesterone. I have to watch this because of my Ehlers Danlos Syndrome. I dealt with it by taking DHEA to strengthen them.
Jacks

[rusalka]

This are good news! Happy to hear that!

[jacksfullofaces]

Lainey
They have gone through their protocol now the answer can be sought
Jacks xxx

[Poppy]

Lainey, so pleased to read about your biopsy results xx

Candy, thanks for all the info you've posted. xx

[Poppy]

Candy, oh for an enlightened doctor...

Or at least one with some interest/knowledge of hrt.

xx