Do I kill myself or give in to the uge to kill others? That’s what it ultimately came down to when I weighed up the difference between taking Utrogestan or Cyclogest natural progesterone.
A year ago I wrote a post HRT and Me: Progesterone Intolerance in which I described the problems I had been experiencing with progesterone. Thanks to the responses to that post I realised I am not alone and that there are many women out there who are suffering from progesterone intolerance and battling to find a solution.
Since then I have changed the type of progesterone I was taking and in this post I share my experience of the differences between Utrogestan and Cyclogest natural progesterone.
Utrogestan Natural Progesterone
The first type of natural progesterone I took was Utrogestan which comes in the form of oral capsules and is available on the NHS. Utrogestan is a micronised form of progesterone that is bioidentical, which means it is structurally identical to the progesterone produced by a woman’s body.
Because it is bioidentical it is meant to produce fewer side-effects and, unlike synthetic progesterone like Provera and Climanor, does not increase cell proliferation in breast tissue in postmenopausal women. Unfortunately if you are progesterone intolerant, as I am, then any amount of progesterone, natural or synthetic, is going to upset the apple cart.
Utrogestan Side-effects
I took Utrogestan 200mg for 12 days a month, on days 15 to 26 of my cycle. On those days I became extremely bloated, my libido disappeared, I suffered from migraines, my breasts were often tender, and I became very antisocial. I was too tired to want to do anything much and felt so fat and ugly I just wanted to hide away from the world and wait for my period to be over with. I was an absolute ‘joy’ to live with and my poor partner never knew when I was going to over-react to something and snap at her. Work became more difficult as I often struggled to think straight and focus. On the plus side, because I took the Utrogestan before bed and it has a calming effect, I did sleep a lot better.
My periods usually started on day 6 of the progesterone cycle and continued for up to 10 days. They were excruciatingly painful and so heavy that I ended up with iron deficiency anaemia yet again. The period pains felt as if my womb was being slowly scraped clean with a medieval torture implement made of spikes and nails. My days and nights revolved around mega doses of Ibuprofen which had little effect, hot water bottles, towels in the bed to mop up leakage at night and increased spending on sanitary products. It was nothing if not exhausting.
Utrogestan and Depression
But the worst symptom in the lead up to my period was the depression. With each successive day of Utrogestan treatment I sank further down the black hole of despair. Some days I had suicidal thoughts which really frightened me as I knew I didn’t really want to kill myself but I couldn’t stop the thoughts.
That’s when I knew I had to change my progesterone treatment.
Alternatives
My consultant enthusiastically recommended having the Mirena coil inserted as it can actually stop periods altogether but I was not keen on the idea of having something inside me permanently releasing progestogen.
The other option was to increase the Utrogestan from 12 days to 14 days a month. Yay! Two extra days of bloating and depression. What was there not to be happy about? But I opted to give that a go. Better the devil you know, right?
However, I was confused. I knew that Professor John Studd, a well-known London gynaecologist and menopause expert, often prescribes Utrogestan 100 mgs daily for the first 7 days of each calendar month for women who have difficulty with progesterone and yet I was being prescribed double that dose. When I asked my consultant about it he said that reducing the dose can reduce the symptoms of intolerance but you may have more of a problem with heavy and prolonged bleeding. It also increases the risk of endometrial hyperplasia (thickening of the lining of the womb) which can develop into womb cancer in some women.
After two months on 14 days of Utrogestan I felt ready to give in to the suicidal thoughts. Although my periods had been lighter and less painful, my depression had gotten worse. The discovery that I had fibroids, an endometrial polyp, adenomyosis and a thickened endometrium did nothing to lighten my mood. And after a hysteroscopy and polypectomy I was ready to throw in the towel on HRT, menopause, the whole damn lot.
Out of desperation, I made an early appointment to see my consultant to discuss changing my progesterone. As expected, he enthused about the Mirena coil again. Every time I hear about the Mirena I get a bad feeling and wince at the thought of having it inside me. Instinctively I know that it will not be good for me and all the persuasion in the world is not going to change my mind.
When I asked my consultant about the possibility of taking Utrogestan vaginally instead of orally he said that it was the same product and would have the same side-effects. But he did prescribe progesterone in the form of Cyclogest vaginal pessaries 400mg to be taken for 14 days each month.
Cyclogest Vaginal Pessaries
Like Utrogestan, you need to take Cyclogest just before bed to benefit from progesterone’s calming effect. Take it during the day and you’ll be drowsy. But unlike Utrogestan which is a capsule you swallow with water, Cyclogest needs to be inserted in your vagina the way you would insert a tampon with your finger. It looks like a wax bullet, but it is actually solid vegetable fat and once inserted the fat melts and the progesterone centre is then absorbed into your uterus. This means that you need to lie down as soon as you’ve inserted it, otherwise it could slip back out again, and it also means that you will be slightly messy in the morning once all the melted vegetable fat has dribbled out of you during the night. Just be prepared. If this doesn’t appeal, there is also the option to insert the pessary in your rectum.
Cyclogest Side-effects
Cyclogest is natural progesterone, just as Utrogestan is, and I hoped that by taking it vaginally instead of orally I may lessen some of the side-effects.
That did not happen. I still got bloated each month to the point where I could no longer fit into most of my jeans. And in place of depression I became extremely irritable, unreasonable and angry. Instead of having suicidal thoughts about wanting to kill myself I was having murderous fantasies about killing others. Let me be clear, I had no intention of acting on my fantasies but I felt irritable and angry enough to attempt serious damage if provoked. I still had swollen, painful breasts occasionally and felt even more tired than usual which added to my sense of overwhelm.
Periods from Hell
Two days after I completed my first 14 days of Cyclogest my period began. The period pains were the worst of my life. I have never given birth so I can only imagine what it’s like and this is how I imagined childbirth to be; mindblowingly painful. Enough to cancel out everything in the world except the pain. The cramps had me doubled over, unable to move, moaning like a cow in labour. I writhed and sweated and panted and cursed everything and everybody I could think of and nothing helped.
For several months in a row I actually PASSED OUT from the pain. Twice I happened to be at home, which was lucky, and on one occasion I was in the hairdresser’s. On all occasions, I lost sight and vision, the world went black and silent and I crumpled to the floor. When I came to, I was ghostly white and sweating, barely able to breathe from the pain and the cramping. It was terrifying.
It got to the point where I was too afraid to leave the house on the first two days of my period. What happened if I passed out on the train or in the supermarket or in a busy London street? It was too risky.
On the plus side, my periods only lasted for about 5 days, with two to three of those days being extremely heavy. And, like with the Utrogestan, I slept well.
That’s the long story of it. If you’d like a summary, here’s a table with the main comparison points between Utrogestan and Cyclogest.
| Utrogestan 200mg | Cyclogest 400mg |
|---|---|
| Oral capsule | Vaginal pessary |
| Take for 12 - 14 days | Take for 12 - 14 days |
| Side-effects include: breast tenderness, tiredness, bloating | Side-effects include: breast tenderness, tiredness, bloating |
| Main side-effect: Depression and wanting to kill myself | Main side-effect: Irritation and anger and wanting to kill others |
| Period starts on day 6 of 12 - 14 day progesterone treatment | Period starts 2 days after completion of 12 or 14 day progesterone treatment |
| Period lasts for 10 days | Period lasts for 5 days |
| Period pains, but don't pass out | Pass out from period pains/cramps |
| Period is heavy for approximately 3 days | Period is heavy for approximately 3 days |
| Makes me sleep better | Makes me sleep better |
It’s obvious that neither of these forms of progesterone is ideal. The alternative offered by my consultant was to try a synthetic form of progesterone such as Norethisterone or Provera, but after my experience with Prempak-C I was not keen. Also, synthetic progestins are more likely to cause breast cancer.
I’m Sticking with Cyclogest
I decided to stick with the Cyclogest mainly because I hate feeling depressed so much that I preferred passing out to feeling as if life was not worth living. Also, I decided it was better to want to kill others than to kill myself and I preferred having a 5 day period as opposed to a 10 day period.
In the past few months I have gradually reduced my dosage of oestrogen, I’m currently on an Evorel 25mg patch twice a week and I’ve noticed that the less oestrogen I have in my system, the less severe my period pains are. I guess that’s because there’s less build up of endometrial lining.
The situation is far from perfect and I feel stuck between a rock and hard place. Because of my progesterone intolerance I have decided to come off HRT altogether – more of that in a later post.
In the meantime, I am soldiering on and looking forward to a time in my life when I will be progesterone and period-free.
How about you? Have you had a similar experience? If so, I’d love to hear from you. Please leave a comment in the box below.
Further reading:
HRT and Me: Progesterone Intolerance
Hello Angie,
I came across your blog as I’m researching hrt options & it’s given me food for thought, thank you.
I’m peri menopausal, I have a fibroid in my uterus & slight thickening there & had a uterus infection & bled heavily for 7 weeks, currently my periods are erratic. I’m at high risk of osteoporosis, I also am in remission with Non Hodgkin lymphoma and diagnosed with M.E. Being peri menopausal is now another thing to deal with.
I have ordered some bio identical natural progesterone cream to try to stop the hot flushes, cold shivers, lack of sleep etc — I would like to know what your (or others here) take is on using the cream?
Hi Eden. I’ve never tried natural progesterone cream so I can’t comment from experience. I know some women say it helps. As far as I’m aware it’s not very strong and so should never be used with oestrogen as an alternative to progesterone HRT. If you don’t get any relief it may be worth your while to think about taking body identical HRT (oestrogen patches or gel and Utrogestan capsules) as this will definitely help with your menopausal symptoms. Oestrogen also helps with the fatigue that accompanies both perimenopause and M.E. as well as the brain fog and muscle aches common to both.
Hi, I’m currently taking cyclogest 200mg but get terrible anxiety and nervousness esp early hours and intermittently during the day. Been advised to take every other day to help but thinking of I taking 1/2 pessarie wouldn’t that be better? Plus recently finding I’m really tired. Also on evogel 100mg for the last 2 months, was on 3 pumps of estrogen.
Hi Kam. If you’re post-menopausal it’s worth trying 1/2 a pessary at night – that would be approximately 100mg every day – and seeing how you get on. Monitor your symptoms and let your doctor know next time you see them.
Thank you Angie, I just received estrogel & utrogestan today. I’m told to take 1 pump a day of estrogel and 200mg of utrogestan a day but I don’t have regular periods (last one was 4mths ago). When should I take the utrogestan?
I’m told to swallow the tabs but some people say you get fewer side effects by placing it in vaginally. What do you think I should do? I already have terrible bloating before starting this & many UTIs & swollen inflamed vagina too
I appreciate your advice, thank you kindly!
Hi Eden. One pump a day of estrogel is very little – equivalent to a 25mg patch – so monitor how you go and you may need to increase it if you’re not feeling much better. The average dosage is 2 -3 pumps a day, some women go up to 4. I think you may need more than one pump a day particularly if you’re having UTIs and vaginal inflammation. If this persists it might be worthwhile asking your doctor for some Vagifem pessaries as well to help settle the inflammation.
If your periods are still irregular you need to take 200mg Utrogestan for 12 days a month and then you’ll have a period. Take the Utrogestan just before bed as it can cause drowsiness. The good thing about this is it really helps with sleep! In my experience I definitely experience fewer side-effects taking it vaginally – I do still experience some bloating but I no longer have the depression that I used to get when taking it orally. I hope this helps.
Hello, forgive me if I am repeating someone else’s comments – didnt have the strength to read them all!
I think, like me, you are sensitive to the change in hormone secretion that happens naturally in your cycle each month. If you are told to take a hormone for a set number of days, break, and then start again… you are still fluctuating the hormones and their reaction on your body and mind will continue. What I needed was to “flatten” the hormones so that my mind and body didnt become triggered each month. This was only possible through continued use of HRT across the month to suppress my cycle.
My diagnosis was PMDD if you would like to read more about it online.
Hope that helps!
Hi Laura. Thanks for this – I have come across PMDD and did try continual HRT. Unfortunately it gave me a non-stop period for almost a year!
I am in the US and found your blog by accident and just want to say it’s SOOOO refreshing to see so many women having the same issues with progesterone!!! I would pay HUGE money to just have my uterus removed and not have to deal with it. I do FANTASTIC on JUST estradiol (patches, which I get online actually since the brand that I don’t have issues with is MADE in the US but NOT sold in the US.. go figure). But I have a uterus and need the progesterone (which frankly because I’ve done so poorly with it I have NOT used consistently over the 2 years I’ve been using HRT).
I started out on pill estradiol in January 2019. Switched to patches in Nov/Dec that year. Had my highest estradiol in February last year at 115 pg/ml. Was using a 0.025 estradot. Was feeling more symptomatic so upped myself to 0.05 in June 2020. By Halloween was feeling awful (and was late for period) so reran labs and my estradiol level had dropped down to 20pg/ml and my FSH had risen to 38 (had been 14 in February). So I went on bi-est bioidentical compounded cream. 1mg/ml. Instant bleeding. Was given vaginal progesterone cream which is nearly impossible to use when you’re bleeding all the time. Was then given medroxy.. didn’t tolerate that. Recently switched myself back to patch… given progestin in the form of norethindrone.. NOOOOOOO.. That’s awful. Prior to was using a progesterone oil which.. doesn’t protect the uterus (which I find VERY odd because it regulates bleeding like a Swiss watch. Like literally can time bleeding down to the exact start day/time based on how I dose the oil). I’ve tried to the prometrium vaginally. Same insanely hungover/narcoleptically tired feeling as if taken orally for me. I’ve even tried piercing the stupid things and squeezing out smaller amounts and just rubbing it in vaginally. Nope. (plus it’s a pain in the neck to do that). I find when I use too much progesterone I also get more fuzzy thinking, difficulty seeing clearly (like it’s like hazy/filmy). Just everything seems to slow down systemically/functioning EXCEPT.. depression, anxiety, fear ramps up 10,000 fold. Supposedly progesterone is the “chill” hormone but not for me. Want to stress me out entirely? Give me some of that. conversely give me some estradiol and it’s all chilll man. The other thing is weight. I seem to balloon like a tick when estradiol isn’t dosed high enough and then adding in progesterone just makes it much worse. I’ve gained 20 pounds in just a few months and climbing steadily literally every few days it seems (I was 182 Sunday I’m now 186 today… if the rate of increase keeps going I’ll be 210 before May). My NORMAL weight my entire life including post pregnancy is like 135. So I’m vastly vastly vastly overweight now. My cholesterol numbers are awful, blood pressure is high.. tachycardia.. vision depreciation and forget skin.. like literally I take off black yoga pants and they’re entirely white inside from the dry skin coming off my thighs. My abdomen is the same way.. just the sahara.
I have a grandmother who is passed now, she died at 80. She was about 48 when she started walking with a cane. Snow white hair and totally disabled by 50. Lived in a hospital bed for 30 years. I am absolutely convinced menopause caused her disablement as I have many many many of the same symptoms and fear I will end up that way (the only way I function now is I work entirely from home and can hide “bad” days better.). There’s a part of me that almost wants the uterine abnormality so they have to remove it and solve the problem since for me ANY days of using progesterone in ANY form is near disabling. But.. my life is like normal with enough estrogen. Just sucks. I’d gladly have had a period the rest of my life than dealt with this nonsense.
Oh my goodness, Dawn, what an absolute nightmare! There are some doctors in the UK who make allowances for women with severe progesterone intolerance like yours and prescribe progesterone for only 7 days a month instead of the usual 12 or in some cases prescribe it only every 3 months so that at least you have a bit of a break from all the unpleasant side-effects. Not sure if you can find similar in the US? Weight gain as you describe means that your hormones are definitely out of balance! Given your high cholesterol I’m wondering if there isn’t an additional hormonal problem with your thyroid function. It may be worth checking out as it’s all part of the same endocrine system.
I thought that heavy periods are a symptom of too high oestrogen levels.. for which dongquai could be good.
Heavy periods can also be a sign of endometriosis, adenomyosis and fibroids. It’s best to have it properly investigated before self-medicating.
I take 200mg of Cyclogest 10 days a month. 400mg seems an awful lot to be taking vaginally when you were given 200mg orally (you need more orally to get through your digestive system). I hope you found the right combination for yourself in the end!
Lily Rose, you’re absolutely right! 400mg was way too much – double what I actually needed and I found that out the hard way. A couple of years down the line and I have finally found the right combination for me – 200mg of Utrogestan taken vaginally for 12 days a month. It took a while before my consultant was prepared to prescribe Utrogestan vaginally but I think he is definitely aware of the advantages now, especially when it comes to women who suffer with progesterone intolerance.
Hi all. im 2 months into hrt, oestrogel and utrogestan 100mg capsules. ive gone very depressed!!
Do i need to give this combination longer to see if it gets better ?
intrested in considering taking progesterone vaginally either coil or inserting the capsule
can i insert the utrogestan capsule.? ive looked at it, its white soft outer covering and inside is a white creamy liquid, is that suitable for inserting into vagina? or do i need to go back to gp and get another form of it???
any thoughts
Hi Dawn. In my experience, if the progesterone is making you depressed now it will not get better with time if you continue to take it orally. I have been taking the Utrogestan capsule vaginally. It is the same capsule that you take orally – exactly the same as the one you describe. Taking it vaginally has resulted in far less depression and irritation for me. Many women have reported the same positive effect. This is because the effects of the progesterone are localised and don’t affect the rest of your body so it is much better for women who are progesterone intolerant. I hope it works well for you.
H Angie, have you taken the exact same dose vaginally as you were orally? and did you change to the ones designed to take vaginally, or just insert the oral capsules vaginally?
Hi Suzy. Yes, exactly the same dose vaginally as orally – 200mg Utrogestan (2 x 100g) for 12 days a month currently. They are the same capsules that you take orally. Once inserted, the outer coating melts very easily and the progesterone is released.
Hi
Just got off the phone with my gynae NHS consultant. I’ve exhausted every HRT variety there is ! I think I have a progesterone intolerance for sure. Last oestrogen tablet suited but then started taking provera !!!! oh my ! hiddeous bloat / anger/ breast tenderness … came off it all together. Now consultant suggested progesterone pessaries. I constantly suffer from UTIs if I dont have HRT (oestrogen) . To top it all my hunger was off the scale and I have now put on 6 lbs in 8 weeks. She did recommend (5 times) the mirena coil but like you, the thought of progesterone ongoing fills me with dread. At least I can stop taking oral progesterone. It was reassuring to read alot of other women have an intolerance too and I’m not just expecting a miracle drug!
Hi Michelle
I can sympathise with your predicament! Since I started using Utrogestan tablets vaginally I have been a lot better and feel that things are under control. My consultant said it was fine to take the Utrogestan tablets that are meant for oral use vaginally as this way the effect is localised and doesn’t affect the rest of the body as much. I take 2 x 100mg for 12 nights a month and then have a period. This is because I didn’t want to take it every day as that way I had a continuous period.
Based on my experience of progesterone intolerance I highly recommend you try taking Utrogestan vaginally. Utrogestan is a body-identical form of progesterone so it is the safest form. I take oestrogen via Evorel patches. Again, the safest form of oestrogen is via patches or gel as this form is body-identical and safer. Taking oestrogen in pill form is more likely to increase the risk of gall stones and thrombosis.
I stopped HRT for a while and immediately put on a stone so I’m back on it now and plan to stay on it until I breathe my last breath!
I wonder what pessaries your doctor is recommending? I did not have a good experience with Cyclogest as they come in 400mg and that is double the maximum amount you need. I hope that helps. Good luck!
Hi Angie. I’ve not read your blogs since I started on my HRT as prescribed by Professor Studd in May 2015 .. Which was thankfully a life saving experience! Other than noticing your struggle with progesterone intolerance as I was struggling with them too. I have since discovered my sensitivity and intolerance to Utrogestan, which I used to refer to as my “7 day ratty tablets” .. Has 90 percent disappeared … post menopausal but more so I believe since I became teetotal. I used to consume excessive and dangerous quantities of wine to numb the symptoms of depression, suicidal thoughts, pmt, stress and anxiety etc. Now I understand I have an allergy to alcohol I can’t help notice I don’t have the added symptoms that came during the 7 days of swallowing the Utrogestan tablets! Worth sharing I thought if any one else feels the need to drink away their symptoms, like I did and then in hindsight discover it was most likely exaggerating the problem. With best wishes.
Hi Suzanne. That’s a really interesting observation about the effect of alcohol on your symptoms. Thank you for sharing. I think a lot of women, myself included, are partial to a glass or two of wine to take the edge off their menopause symptoms and all the other stresses of midlife.
I am back on the Utrogestan 100mg which I take every day as I am now postmenopausal. This time I am taking them vaginally and I am really pleased to report that I am experiencing none of my usual symptoms of depression, suicidal thoughts and irritability/anger. It’s because the effects of the progesterone are localised rather than systemic. Unfortunately, there are other symptoms like bleeding. You win some, you lose some…
Hi, thank you for sharing your thoughts and experiences with Utrogestan. Can I please ask how long it took for you to feel better when taking it? I have been on it for a month and am feeling lethargic, sluggish and foggy. I am curious to hear your thoughts on whether this is likely to subside. Thank you.
Hi Ruth. It’s hard to say if I feel better taking Utrogestan. I think I feel best on my oestrogen only days. I can certainly say I have fewer side effects taking it vaginally. My main side-effect at the moment is serious bloating! Also, I take it sequentially, so only for 12 days a month and then I have a period. Taking it daily did not work for me because I bled constantly. Do you take it at night? It is best to take it before bed as it does have a calming effect and I find I sleep better on the nights I take it. Are you taking it every day? It may be that it is too much for you. If you’re taking it continuously it’s usually only 1 100mg capsule daily and if you’re taking it sequentially then 2 capsules for 12 days a month. Generally, the body takes 3 – 4 months to adapt to any new hormonal treatment. I hope that helps.
Hi Angie, I stumbled across this post by pure accident and read with a great deal of interest, your experiences with regard to Utrogestan. I have been on HRT for eight months and initially felt really down, anxious, unmotivated, lacking in energy etc. After discussions with my GP, we decided it maybe down to the progesterone element of my treatment. To cut a long story short, I am (clinically, according to blood test results at least) postmenopausal, even though up until the point of having the tests, I was still having periods albeit irregular. We decided to try taking the Utrogestan capsule vaginally instead of orally and hey presto, as I have read from someone else on here, it was a game changer, an overnight sensation. However, I struggled with the mess that is created by taking the pill this way, especiallyIn view of the fact that I have been lucky enough to meet a really nice man and as it’s a new relationship, I hope you can understand how awkward it feels to get intimate when there is the potential for mess in that area. I just wondered if you’ve experienced this and how you have dealt with it? I do recognise that the amount of mess will be considerably less than using the pessary you describe, however It still makes me feel a bit anxious and unconfident.
Hi Alison, thanks for your comment. I have replied to you via email.
Two things jump out at me from this account. First, using utrogestan vaginally does not offer the same side effects as taking it orally.
When taken orally, utrogestan is first processed by the liver where it’s broken down into various metabolites, which can cause a host of side effects that can be extremely troubling for some women. I was only taking 100 mg and in addition to a variety of nasty physical side effects, I thought I was losing my mind. Crushing depression, rage, confusion, and more. Switched to taking it vaginally, no more problems at all! No kidding!
Second, 400 mg as a pessary is double the standard vaginal dose if you’re on a sequential regimen. You should have been given 200 mg and for this you could have simply used the utrogestan vaginally.
I really don’t think you’re in good hands with that doctor.
Hi LR. You’re right about the 400mg pessary – with hindsight I should never have been prescribed such a high dose. I recently tried to persuade my consultant to prescribe vaginal Utrogestan. He said that I am obviously intolerant to natural progesterone and so it doesn’t matter whether I take it orally or vaginally, I will still have the same side-effects and would not prescribe it. But I still want to try Utrogestan vaginally and will push for it next time I see him.
Can you please tell me if you take the actual vaginal form of Utrogestan, which I believe comes in 200mg pessaries, or if you are inserting the 100mg oral capsule vaginally. Do you take it every day or just 12 days a month? Thanks.
Hi Angie,
I am using 100 mg daily, and it’s the same gel capsule you can take orally. You could not pay me enough to try it orally again as the side effects were so terrible. I was seriously terrified to continue with it when my doc told me to try it vaginally, but the difference for me was night and day. I almost can’t believe it’s the same pill.
The main down side is the messiness but if you’re accustomed to a pessary it’s nothing in comparison.
Note I am in Germany and we’re only offered this gel capsule, so I’m not sure if you have other formats in the UK. The capsule is firm but pliable. If you poke a hole in it you’ll find a white creamy substance inside.
I hope this helps and also wish you the very best in sorting this out!
Hi LR. Thanks for getting back to me. I am really encouraged by your positive experience using the 100mg Utrogestan capsules vaginally. You’re right – compared with the large Cyclogest pessaries I was taking – which were the size of bullets and very messy – the Utrogestan capsules look tiny. I hope I can convince my consultant to change my prescription. Thanks for your advice.
hi angie
your comment really helps me and has given me hope.
yes, im in UK ,utrogestan 100mg are white capsules, i cut one open and yes a white creamy liquid inside ,so sounds the same as yours !
ive only been on hrt 2 months but have feeling very depressed, so im going to try inserting vaginally. dont know whether to start now or another 4 months????
LR my post was in response to your comment
I hope you are still receiving comments on this post as it’s now a few years later… Following this thread I wondered a few things. You link all your symptoms to one problem – the use of progesterone. Your hormones work in symphony with each other with exacting timing. Most doctors are not trained in endocrine and prescribe without really knowing anything other than what it says in that book they refer during your appointment. The natural Progesterone is a mother hormone and has the ability to change into other hormones. Synthetic progesterin – spelled differently because it is a drug – has not that ability; just fyi. Natural progesterone is the main hormone that keeps the symphony operating smoothly within the sea of movement. You actually cannot take too much progesterone. Hospitals give it in doses over 2000mg to stroke victims. When your body is short on estrogens – and you have a few – it will transform itself into estrogen. If you have not enough progesterone it cannot act its part as a mother hormone. We have outside xeno-estrogen influences that have a massive impact on the body and disrupt the endocrine system out of all proportion. xeno-estrogens are in so many products and these are very bad estrogens and probably the cause of many of the problems you and the people who comment here have experienced. I would suggest you look at the overall picture rather than think you are progesterone intolerant. It’s a term that is an easy option for those who have not done their homework – specifically doctors who like to be right. Fibroids are generally caused by an overload of estrogen. You can get a testing kit that will show where all your hormones are at. Incidentally, the hormonal system is very much attached to emotion and how you feel. The hormonal system can affect your metabolism and thyroid gland, it can slow down your entire body’s systems so they do not work efficiently. It is not necessary the problem of one particular hormone so broaden your outlook. We give too much credit to doctors and that can sometimes shorten our perspectives. They give a pill – you have a reaction to the pill but it’s not the pill it’s the overall problem. Hope you don’t mind me saying this. I do hope you extend your research to outside your own feelings and look at your body with a new view.
Hi Anne. Thank you for your comment. I agree that hormones are part of the larger endocrine system that also includes the thyroid gland and so need to be seen in context. However, because I felt great when I was taking oestrogen only and very depressed/suicidal or irritable ONLY when taking natural progesterone, it is only natural to conclude that I am progesterone intolerant, especially when confirmed by my doctor, a Gynae-Endocrine consultant. I also have a history of PMS, which is progesterone related. As I am one of many, many women experiencing this reaction to progesterone, I feel it is safe to say natural progesterone is the problem, for me, anyway.
Interestingly, I have recently gone back on HRT after a more than two year break and this time I am taking a synthetic progestin with oestradiol. The remarkable thing is that I am not experiencing any of the usual depression/irritation that I felt with natural progesterone. I feel great! All bodies are different and it seems at this stage of my life my body reacts better to progestin. I do not like this fact, as progestins increase the risk of breast cancer, but I was feeling so terrible without HRT that it feels worth it for now.
Hi Angie
Just reading your update that you’ve gone back on HRT. Glad to hear that you’ve found a tolerable progestin, amazing eh! – long may it continue. intrigued to hear about your new regime, do you mind me asking – is it sequi and is it Provera. (Still struggling wretchedly with the ghastly Utrogestan and toying with idea of hyster but too fearful, ugh).
Joanna
Hi Joanna. I’m on Evorel Conti patches. Because I am now postmenopausal I can have a continuous HRT regimen which means progestin all the time with oestrogen, not just 12 days a month. The aim is that after a few months I should no longer have any bleeding. At first I felt great on it but now I am wondering if it is contributing to my depression. Hard to tell as life has been difficult lately. It does have side-effects – I have been bleeding/spotting continuously for 4 months now, have swollen, tender breasts and am more bloated than usual. On the plus side, after two years of hardly any sleep I am finally sleeping really well! That alone makes it worth it.
hmm … wonder if you’re maybe experiencing a ‘cumulative’ effect as the progesterone builds up / stores in the system over a period of time contributing to feeling a bit more low – what do I know, just a thought, time will tell. Interesting that your body seems to cope better with the ‘more harsh’ Norethisterone, maybe because it’s transdermal. Guess you are also further along on the meno journey and intolerance/tolerance can change. All the time it’s about finding the ‘least bad’ option, isn’t it. Here’s hoping your improved Zzzzzzzzzzz continues – that is a true prize! The spotting/bloating doesn’t sound great though, swings and roundabouts, maybe will settle with time. It’s trial and error all the way, this HRT game. Always interesting to read your updates Angie.
Thanks, Joanna. Yes, I think you may be right about the cumulative effect. I am seeing the consultant again in November – the 6 month mark – so will have to discuss options again with him, maybe try vaginal progesterone again. I really hope I’ve stopped bleeding by then! It’s getting me down. Regarding your earlier comment about toying with the idea of a hysterectomy, I know some women swear by them, but I think it’s worth exploring different types of progesterone first. You don’t know till you’ve tried. All the best. Angie
I tried Evorel Sequi, Femseven Sequi and now I’m using Evorel oestrogen only patches plus adding in Utrogetran for the last (supposedly) 14 days of the cycle… except I only last 12 as I feel sooooo bad on these caps. I couldn’t tolerate the progesterone in Evorel Sequi as it gave me such bad side effects and I couldn’t keep the Femseven patches on as and they kept falling off after showering!
I’m now going to get in touch with the surgery this week as I honestly feel like I am slowly dying… I feel so ill. I ache everywhere, feel sick, am exhausted, can’t think straight and just cant cope. All starts when I take utrogestran. I have around 10 good days each month.
I’m just wondering if any of you lovely ladies have tried any other form of progesterone and it was better tolerated than norethisterone or the utrogestran… anyone tried dydrogesterone or other with success?
I too do not want the mirena coil!!!
I am seriously thinking maybe HRT is not for me… although the oestrogen does make me feel better.
Hi AJacynM. Unfortunately, progesterone intolerance is the main reason women stop taking HRT. Your experience is so similar to mine. I have fared much better on Evorel Conti – the progestin is norethisterone, but still have side-effects like permanent bleeding so it is far from ideal. From what other women have described, I wonder if vaginal progesterone may be worth trying. The effect is meant to be more localised. You can get vaginal Utrogestan 200mg and some women use the oral capsule vaginally.
I have tried so many types of HRT, & have had all of the problems mentioned here. I have found that transdermal gels make levels fluctuate as the dosage is not exact. The best type of progesterone for me seems to be via transdermal patch. The best one is FemSeven which contains levonorgestrel BUT, this is is devastating bit, they are not making this product at the moment. So I have a combined patch with the same oestrogen but norethisterone but this is definitely not suiting me. I am considering trying a Mirena cool next as this contains the levonorgestrel. If only they would produce femSeven but the frug company cannot tell me if/when that will happen. OMG having HRT or not having it is so dreadful when it doesn’t suit & the suicidal thoughts can be dreadful but, as you say, they are more thoughts than a definite plan.
Hi Janice. I’m sorry to hear about the supply problems with FemSeven. Unfortunately, this is a recurring problem with various forms of HRT: pharmaceutical companies suddenly decide to cease manufacturing and countless women are left in the lurch. I am finding that taking Utrogestan 100 vaginally works the best for me as far as the psychological side-effects are concerned – much less depression, irritability and suicidal thoughts than on all the other forms of progesterone/progestin I have tried. So, I would really recommend giving that a go if you are unable to source a different form of levonorgestrel. Good luck!
It is so reassuring at last to read your posts as I too have been suffering from progesterone havoc in my life for 4 years now.
I rub oestrogen gel into my arms every day and take the Utrogesteron 100mg for 7 nights. Except the symptoms are so so bad that I usually stop after 3/4 days. I have the worst depression, am irritable and cannot think straight. This month I am taking them vaginally, but still, am feeling off balance and lousy, like the world, is on my shoulders. Occasionally on a month, I do not take them at all but then bleed heavily for 3 weeks. I have suffered from PMT and migraines around my period my whole life, I used to dread having periods for that reason. Anyway off to see someone new in 2 weeks, maybe I will find a different approach. The one great thing is I do sleep well.
Hi Josephine. Apologies for taking so long to reply to you – I have been ill. I’m so sorry to read about your progesterone havoc and can empathise. Have you had any luck with the new person you saw?
Hi Josephine, are you feeling any better now? I have been taking them vaginally and have noticed a real difference in my lethargy levels. I wondered how long, if it has, taken for things to improve for you.
Hi, I have been told that I am sensitive to hormone inbalance, hence, bad PMS and bad menopause.
It may be just a Dr phrase to iliminate further investigations.
I too, have tried both progesterones and I also feel uncomfortable using estrogen. Anyway, my drs are not interested in further investigations so I read a lot. I would rather take cyclogest everyday as if my mind/body is sensitive to imbalance, it makes sense to take it all the time.
I wish the scientist would work a bit harder in finding a magic pill. X
Hi Karen. Yes, a magic pill would be nice. Bad PMS is very common in women with progesterone intolerance. Unfortunately, one of the downsides of taking progesterone all the time is that if you are intolerant then you will feel permanently depressed and/or irritable rather than just for 12 days a month. Unfortunately, there is no simple solution.
I imagine that you may be very confused by all the various opinions. I knew dr. Katharine dalton well. She was the endocrinologist whe researched and promoted natural progesterone. What i dont u understand is why you were taking cyclogest as well as oestrogen. Progesterone needs to be taken at least twice a day but some people need mjch more. It also has the ability to turn some of it to oestrogen in the body so very few people need oestrogen as well. In fact it seems you may be suffering from oestrogen dominance. I cannot e
Explain it all here but 2 important things are that you need to eat every 3 hours as part of the condition is hypoglycemia and you really should obtain a copy of one of her books which should help you. I have been on cyclogest for 30 years .good luck.
Veronica
Hi Veronica. Thanks for this. I was suffering from progesterone intolerance, which meant I felt fantastic when I was only taking oestrogen and terrible on the days I took progesterone. Because of that I would not want to take progesterone every day as I fear I might become permanently depressed and suicidal. I’m glad the Cyclogest has worked for you. We are all very different. I have heard of Dr Dalton and will investigate further.
Hi Angie,
Great to read your posts it makes me feel less alone. I’m also progesterone intolerant,I’m postmenopausal and looking for the least damaging option. I stood the Mirena coil for a week, but lately have been using progesterone cream from the internet which the Drs don’t approve of. The first month after stopping I had a bleed but this month after stopping no bleed. I started the cream again this morning and think i must have applied too much as I had a really awful reaction like a panic attack. I built the cream up very slowly last month and although I didn’t feel great I didn’t get this reaction.My gynecologist says there is not enough Progesterone in it to protect the uterus so he has given me a prescription for Urtrogestan 200mg pessaries every other month which I’m picking up tomorrow. I’m dreading using them, so I am thinking of trying to ween off HRT altogether. I also take a large amount of antidepressant which is complicating things with side effects ( poor concentration ,losing train of thought and memory loss).
From personal experience I think a continuous regime is better if you are intolerant I was on Noriday and Estraogel continuously during my perimenopause and antidepressants without too many mental problems. and no hot flashes or night sweats. When I first took it my symptoms got worse before they got better and I wanted to stop it but was encouraged to carry on.
My opinion is that it is better not to disturb the balance of the hormones by coming on and off them, once you get a semblance of balance stick with it,
It’s all so confusing!
Hi Maggie. Sorry to hear about your battle with progesterone intolerance. Your gynaecologist is right – progesterone cream has no protective effect at all on the endometrium if you are taking oestrogen. At least you have been prescribed the Utrogestan every other month – it sounds like a good compromise. It sounds like your antidepressants are cancelling out the cognitive benefits of taking HRT – would it be possible to reduce them I wonder? I agree it’s good to stick with a semblance of balance if you can get it – I seem to be getting there with Evorel Conti but it is not perfect. Evorel Conti is a continuous regimen and contains the same progestin as in Noriday. If you got on fairly well with it before it might be worth giving it another go now with the Evorel Conti. Also, now you are postmenopausal you can have a continuous regime. Try the Utrogestan first as it is better to have natural progesterone but if you find it intolerable there are a few other options. Good luck and let me know how you get on.
Hi, are you taking just progesterone without estradiol?
Hi Masa. No, I was taking progesterone with oestradiol patches – Evorel 50. The only reason I was taking it was because of the oestrogen – the progesterone is a preventative measure against endometrial cancer.
I’m a GP just doing a little updating on natural progesterones, and I like the frank no holds barred write up of your experiences.
For women reading this I would suggest if you are having problems with HRT, and it’s almost always the progestogen, then you should seriously think about using an IUS as your consultant suggested. Yes it needs a fit, but gives ultra low dose progestogen just to where it’s needed for endometrial protection and results in painless and usually no periods. You should give it some time to work but can be taken out at anytime.
Hi John. Thanks for your comment. It’s always helpful to get different perspectives on the issue of progesterone intolerance.
Just a side note this is NOT necessarily true. Been there done that in an earlier time of life and permanent uterine scarring from the UID and ended up with an extremely premature baby after 6 weeks of hospitalized hemorraging. I think it’s a HUGE mistake to tell women “oh you’ll just need to give an IUD time”.. That’s what I was told and ended up with a$875,000 17 week hospital stay for me and my child who now has lifelong sensory issues due to her prematurity (and never mind the growth/developmental issues). Several gyns have confirmed them allowing me.. and really I should say MAKING me (I had to hunt for a doctor who would remove the IUD after months of heavy bleeding being told EXACTLY what you are saying). Horrible advice. And for those of us who are progestone intolerant? Having it just be constantly be emitting into our uterus? Is NOT a solution.. same side effects. Been there done that part of it too.
Sorry if this replicates info given…. I went to see Prof Studd as I wasn’t getting anywhere after 7 years of awful night sweats/brain fog and rage!
I am on oestragel, provided by my GP now, and am about to go onto Utrogestan, also from my GP. As directed by Prof Studd, I only take progestagen for first 7 days of every month. Periods are a little variable, but fine. I have my life and my brain back. Could not be happier.
Thanks for sharing this, Charlie and glad to hear you have your brain and life back.
Hi
I too have been suffering with this intolerance and it seems that my gp and gynaecologist don’t know what to do with me. I am waiting for an appointment with a menopause clinic after being referred a couple of months ago. I have had so many problems with hrt and being batted back and fourth doesn’t help. I’ve tried the same as you in the form of progesterone and also have the same feelings about mirena coil. I’ve felt so alone in my struggle until I found your posts.
My mood is low and I am close to giving up but the oestrogen makes me feel better. I’m confused on what to do. Thank you for writing about your experience it has helped me.
Hi Ellen. Thank you so much for your comment, it is heartening to know that reading about my experiences is helpful. I wish I had an easy answer for you but I’m afraid I don’t. Progesterone intolerance is the main reason why women abandon HRT. Some gynaecologists, I’m thinking of Professor Studd in particular, advise their progesterone intolerant patients to take Utrogestan 100mgs for only 7 days a month. This is probably the lowest possible dose you could get away with without risking endometrial cancer as the recommended dosage is 200mg for 12 – 14 days a month. Women on the lower dosage have to be monitored regularly with vaginal ultrasound to check the thickness of their endometrial lining. I stopped taking HRT over a year ago now and I have to say, although I felt absolutely awful for the first 6 weeks or so, my mood has been so much better. I no longer have monthly PMS and feel on a more even keel. I also love not having periods regularly – I have had one in the past 7 months. These days I rely on exercise, walking mainly, to keep me happy. Let me know how you get on at the menopause clinic. I’m interested to hear what they recommend. Good luck!
Hope this can be of help to people. It may not be the natural progesterone you react to, but the “extra” ingredients. They both contain soy (lecithin), peanut (oil) and yellow colouring (cyclogest). Even if you are not allergic to these ingredients, they can cause an elevation in histamine from mast cells. My experience with patients (working as a nutritionist) is that migraine is one of the very strong indicator of high histamine levels.
Hi Bodil. Thanks for sharing this very interesting information. I had not made that connection before.
Hi, I was diagnosed with HIT due to menopause symptoms for Yrs
I found out last year that it was my tvt bladder mesh which has been causing most of my problems hives/dry eyes fibromyalgia pain . When they got half of this plastic poison out of me it was tested and came back with Giant Mast Cells I’ve now been diagnosed with foreign body rejection symptoms causing auto immune disorders . It’s been a nightmare. I did all the hit diets nothing worked no meds worked. I’m waiting to get the rest out of me. ❤️
Charlie, what a nightmare! I hope that your body is able to heal once all the tvt bladder mesh has been removed.
Angie, I’m just stopping by to see if you are ok? I notice you haven’t posted in a while. Did you decide to stop your HRT? I know you’ve been struggling. I’m in surgical menopause, aged 47 and managed 16 months post op. with no HRT at all. I was 3 years perimenopausal before this, again no HRT. I have just started the HRT but am going very slow with it. I’m using Estrogel to start, and reviewing after 6 months to maybe start the Testosterone. I just wanted you to know I’m thinking about you, after finding you blog some time back.
Hi Marie. Thank you so much for your lovely message. How very thoughtful of you. I did indeed stop my HRT at the end of March. It was horrendous to begin with, especially the first six weeks. I have been meaning to write a blog post about my experience. The migraines have finally stopped and I am used to the hot flushes and night sweats now – although it does mean I haven’t had a decent night’s sleep in months. It has been a very ‘interesting’ experience this time round. Another reason I haven’t posted is that I’m working on a book about menopause so that is taking up all of my writing time and energy at the moment. I think it’s a good idea that you’ve started on the Estrogel and to take it at least until you are natural menopause age, around 51. I hope you get on well with it. Let me know how it goes. And thanks for the nudge – I do have a few blog posts that I have been wanting to write for a while so I need to just get on with it.
Hello Angie, I am having the same problems as you but no bleeding! But have only used it for a couple of months. I am having blood tests again tomorrow. I split the dose because 2 pills at bedtime made me feel drunk and sickly! I use a little testosterone and used to use DHEA and felt fantastic but got hair shedding. Think I was taking too much! Getting back to normal but have read that you can use bio identical Estriol without progesterone and any problems, this is the gentle estrogen produced when women are pregnant. Maybe this is worth looking in to?
Hi Lorraine. Thanks for this, I haven’t come across anyone who has been prescribed bioidentical Estriol without progesterone. Interesting! Will certainly look into it. Hope your blood tests uncover the reason why you haven’t had any bleeding.
You can take Utrofestan 100 vaginally too. In fact, the U.K. Is the only place it is taken orally. This is due to the licence but leading experts on HRT advise inserting it Vaginally.
I would recommend the Studd protocol as it greatly reduces the suffering of those intolerant to Progesterone and achieves a satisfactory withdrawal bleed
Hope this is helpful
Hi – by saying utrogestan vaginalky do you mean insert the same tablet you would swallow?
My utrogestan are hard round tablets , I can’t see how they would dissolve ???
Hi Binks. I think some women do use the Utrogestan that you swallow, vaginally but you can also get a vaginal form of Utrogestan, available on the NHS, so you would need to ask your doctor to prescribe the vaginal version.
Afraid not. I’m in the US and my new doc is not in favor of vaginal progesterone in combo HRT. Probably because it isn’t licensed this way.
I’m in a quandary as I seem obviously “intolerant” if you will, yet vaginally every other day I am managing well,
Except I still see high respiratory effect of progesterone in my training runs which is disappointing, (sucking air like I’m out of shape) but question if I could just take a short break from it prior to a marathon or two each yr. my mid luteal phase prior to pms had this exact same deleterious effect on performance so I’m pretty sure progesterone just isn’t my friend. I also miss the sedative effects by not taking orally but it isn’t as big of a deal as my reaction to the pill…Had some scary mild tachycardia (130-140 bpm) at rest, twice after my 3 rd day of oral 100 mg micronized progesterone and simply couldn’t keep trying.
Took a few days off and started up a vaginal protocol of 2x week after reading many reports of users in other countries and similar medical advisements of this off label use. I also scanned many scholar articles with reports of great studies of this administration and efficacy of uterine protection .
Oral has such poor bioavailability, you actually need fat less vaginally and there is a “first pass uterine effect “ allowing most of it to go right where it’s needed vs your liver and systemic metabolites It BAFFLES me to no end to see it hasn’t been licensed for vaginal use and more utilized … for me, this seems the only way and hope I can stay on HRT. Oral progesterone seems like the worst PMS of my life with added racing heart beats.
I’m enjoying everyone’s posts on the topic. Just not sure I want to go forward not being truthful with my doctor but feel like patch/pill combo is far better for me than and IUD or oral combo pills
Hi Angie
I first started taking one pump Estrogel and 100mg three times a week when I lived in Switzerland and was 52. The gyno I had in Geneva was celebrated surgeon and told me that all over continental Europe, Utrogestan is taken either vaginally or orally and three times a week when on one or even two pumps Estrogel.
Used this way, all is fine for me bar the weight gain. And there is no bleed. My lining was recently checked and remains thin. I would rather take 100mg Utrogestan three times a week – Tues, Thurs and Sunday is my regime, than Cyclogest, higher strength at 400mg.
Anyone being told Estrogel and Utrogestan are not available on the NHS must fight for it. It is fully available from my GP in Acton and from the menopause clinic I attend at Hammersmith Hospital. The clinic is led by Dr Nick Panay, “Mr Menopause” in the UK as he and Dr Studd are considered the leading specialists on matters menopause.
Hi Susan. Were you already postmenopausal when you started on the Utrogestan 3x a week? I have never heard of it being used this way before and I think there are different approaches for peri and postmenopausal women. I totally agree with you regards the availability of Estrogel and Utrogestan on the NHS. I think many doctors don’t realise that these are bioidentical hormones and are flummoxed when their patients ask for BHRT.
I wud prefer to take less progesterone but Mr Panay in Chelsea said I have to insert every night. Have done for last few years. I’m beginning to think that it may be contributing to my symptoms of my TVT mesh poisoning.
I am going to come off for two weeks I think to see if anything calms down did any of u try this? ❤️
Hi Susan,
may I ask when you first started this regime – how many years have you been on it and how often do you have scans? I have been on continuous utrogestan for 6 years now without major problems although low mood has dogged me for alot of this time but so much else was going on in my life I never made the connection with the utrogestan. I am now concluding that 100mg a day is just too much. Recently I have started to take the utrogestan vaginally – same pill just insert it in vagina at night – but I suspect this in fact means I get more progesterone because it doesn’t have to go through my digestive system. Last week I stopped altogether and had a wonderful week but then crashed on Sunday and panicked myself to going back to a daily dose. Since then Inhave had a migraine like headache, low energy and low mood. I am tempted to try your regimeand if necessary pay for scans myself. My GP is listening and I am fortunate in that to date I have no problem in being prescribed oestrogel and utorgestan on the nhs (I was referred to Nick Panay’s clinic in 2006 which is how I ended up on this regime). What I don’t understand is that if this is normal treatment in Europe why not here?
Hi Susan, I am responding to your information. I am under a nurse led clinic at Oxford but I am not happy (because I feel soooo shit). How easy was it to get a appointmentin Hammersmith? what is the procedure? Love to hear how you are a year and a bit down the line.
Hi Sarah Martinez, I recommend you visiting the NHS Jericho health centre in Oxford, and book an appointment with dr S Harper. She researches in this area and has helped me survive my peri-menopause and I cannot recommend her enough!
She prescribes bio-identical HRT on the NHS.
Thanks Susan, your letter really answers a lot of my questions.
Interesting. I was told @ Kings that bio-identical hrt was too expensive, no proof it works & that so it wouldn’t be prescribed on the NHS! I specifically asked my GP to refer me to Kings due to the articles about bio-identical hrt being prescribed there! Thankfully I’d bn tinkering with homemade herbal infusions but that’s not an exact science. Do I make a formal writing complaint now or what please?
How mysterious! I was prescribed bioidentical HRT at King’s without even asking for it. The bioidentical HRT prescribed on the NHS is still made by fairly large pharmaceutical companies and it comes in the form of Oestradiol patches or gel such as Evorel patches or EstroGel, micronised progesterone such as Utrogestan capsules or Cyclogest pessaries and Testim testosterone gel, if you are prescribed it. Did they think you were asking for the bioidentical HRT that is in the form of a cream usually and made up by a compounding pharmacy? Personally, I think there is so much ignorance around bioidentical HRT that many doctors don’t even realise that the patches and gels they’re prescribing are bioidentical. If I were you I would either ask your GP to prescribe the HRT in the forms I mentioned or go back to King’s and have another chat. Were you referred to the Gynae-Endocrine clinic? That’s where you want to go. They are very good there.
Interestingly my GP (in Herts) refused to prescribe it on the NHS. He said he didn’t think the trust would pay for it! However, I have a friend who also lives in Herts, but a different GP who gets it on the NHS. Not without a lot of fuss and bother first, I might add! As it isn’t hugely expensive, I’ve decided just to pay for it myself. However, I don’t really see why I shouldn’t be entitled like others.
Hi Kate. It sounds like your GP fobbed you off. It isn’t fair that you are denied something that is approved by NICE and is regularly prescribed to other women. You could try and do some digging, aka Googling, and see if you can find out if your GP was correct. Find out the name of the Clinical Commissioning Group for your area. These replaced Primary Care Trusts. Some of these CCG’s publish notes of decisions online so you will be able to see if certain drugs are ‘blacklisted’. Testim testosterone gel is often blacklisted as are Intrinsa testosterone patches for women. If there is nothing online, you could try contacting them directly. If Sandrena, Utrogestan and Testim are not blacklisted then your GP should be able to prescribe them for you. Also, if your consultant originally prescribed this combination for you, I presume he would have written to your GP asking him to prescribe this for you?
Hi, Angie, sorry to bother/hijack, but you seem to be having no problems getting testosterone. My GP, although she admits that my distinct lack of libido should be treated, is refusing to prescribe it because she insists that it’s not licensed for women? She’s not happy about referring me to the menopause clinic either? Any suggestions?
Hi Mags. Your GP is right, testosterone gel is only licensed for use by men so doctors have to prescribe it ‘off-label’but I gather that this is a fairly common practice. I had no problem being prescribed testosterone in a menopause clinic probably because the doctors there are used to dealing with women with low libido and other symptoms of hormone imbalance all the time. It’s a bit odd that even though your GP says your low libido should be treated she is not prepared to do anything to help you and refer you to a menopausal clinic. If I were you I would insist on being referred to a menopause clinic, if you are of menopausal age (between 40 and 60). You could also point out to her that the recent NICE Menopause Guideline states that doctors should ‘consider testosterone supplementation for menopausal women with low sexual desire if HRT alone is not effective.’ http://www.nice.org.uk/guidance/ng23/chapter/Recommendations#managing-short-term-menopausal-symptoms Are you on HRT? If you’re not menopausal, then perhaps a referral to a sexual medicine clinic to see if you can be diagnosed with Hypoactive sexual desire disorder (HSDD). Also, has your GP had you tested for other things that can cause low libido such as low thyroid and iron deficiency anaemia? If your low libido is causing you distress then it needs to be treated and your GP is the first person who needs to decide on a proper course of action. You could also try asking her if she would be prepared to prescribe it for a trial 6 month period to see if it does in fact make any difference to your libido, but bear in mind that it is normally only prescribed in conjunction with oestrogen and progesterone (if you still have a womb) to ensure hormonal balance.
I have now been on Utrogestan, Sandrena and Testim for around two years. Like yourself, I also could not tolerate synthetic hormones. Initially the bio identical hormones seemed to work very well, but after a few months, it was discovered my uterine lining was too thick. This would not shed and eventually it was found I had a polyp – also like yourself, this was removed. I regularly have blood tests to check on my hormone levels. I am now on 200 utro, 200 Sandrena (2 sachets) and the tiniest amount of Testim. Things seemed to have settled, but over Christmas I experienced the most terrible ‘period pains’. I am on the hormones continuously with no break, so never have a period – so this was extremely strange. Since then I have had these pains a few times (spreading down my legs) and very bloated. I am also worried that my lining may be thickening again. I am also due to have an op this week to remove a fybroadenoma from my breast. My consultant (who is eminent in this field) assured me this is unlikely to be due to the hormones. However, after the polyp experience, I am not convinced. At the moment I am not sure what to do. I’m beginning to think I may too have an intolerance as I had huge bloating problems whilst on synthetic hormones. I will have to discuss this with the consultant, but trying to get to see him is a nightmare as he is always so booked up for months. I may have to simply write an e-mail to him. At the moment, I just hope I am going to keep well enough for my op later in the week. I’m feeling so dismayed, as I felt so good on these hormones before – aches and pains gone, no more palpitations or hot flushes and before the daily bloating, I was able to sleep well at night. Now I am so full of ‘wind’ it’s painful! I am also worried to come off HRT because of the palps – my mother had heart problems and osteoporosis as she got older, and I don’t want the same!
Hi Kate. Thanks for getting in touch and I’m sorry to hear that the bioidentical hormones are no longer working so well for you. It sounds like the sooner you see your consultant the better. From what you say it may be worthwhile discussing reducing your oestrogen dosage as this may be affecting the thickness of your endometrial lining or experimenting with the Utrogestan so that you do have a period. I don’t know what the answer is, but it’s worth discussing options. I hope your fybroadenoma op later this week goes well. Good luck.
I think you could be right re. the oestrogen. I was originally using only one sachet per day. However, I was having a lot of skin problems so after blood tests which showed my oestrogen to be on the lower side, my consultant doubled it. I do still have skin issues, so it hasn’t really helped there, so I think I may try reducing it before I see him. I’m also not happy about taking two progesterone tablets daily without any break. However, on one tablet only I was getting some break through bleeding. I am surprised to hear that side effects can be the same whether taken orally or vaginally. I thought that by avoiding the liver and gut, it may be a preferable way to take it. As you say, I will have to discuss all this at my next appointment – I’ll let you know the outcome!