Guidance on Progesterone cream and Utrogestan - Thyroid UK

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Guidance on Progesterone cream and Utrogestan

SandraCC profile image
35 Replies

Hi all,

I am potentially due to be prescribed hrt. Has anyone been prescribed Utrogestan by their gp and continued to use progesterone cream? I have been told that I can continue to use the progesterone cream until it finishes as there is only a small amount of progesterone in it.

Whilst the cream is not cheap and is rather not waste it, I don't want to create any further issues for myself by doing this as I'm sure you will all understand

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SandraCC profile image
SandraCC
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35 Replies
Mugs19 profile image
Mugs19

I use Utrogestan. I have in the past used various forms of natural progesterone. What I do know is that it is virtually impossible to overdose yourself with it. So plaster it on without fear.

SandraCC profile image
SandraCC in reply to Mugs19

Thanks for your response Mugs19 .

In the meantime i have how been prescribed Utrogestan and Oestrogel. The guidance is to take the Utrogestan in cyclical manner is recommended:-

( so taking it for days 1-25 of 28 day cycle) which is likely to create a cyclical bleed each month.

So, bearing in mind I haven't had a period since April and before then not since July 19' , would i need to wait til September on the first day of when my period would "normally" be to start both the oestrogel and the Utrogestan?

Also do many of you experience the cyclical bleeding? I wasn't expecting to experience that!

Polly91 profile image
Polly91 in reply to SandraCC

I have been taking utrogestan 200mg every day without a break in cycle and I take 2 pumps of estrogel

I think the estrogel increased my need for thyroid hormone so that’s something to watch out for.

SandraCC profile image
SandraCC in reply to Polly91

Hi Polly

So, the oestrogel states I can take on any convenient day.

The Utrogestan guidance from gp is day 1 -25 of my 28 day cycle. If my period starts on the 4th of a month, do I need to wait until that time to start taking the Utrogestan?

If I started the Oestrogel now, and continued the wellsprings progesterone cream , would i become oestrogen dominant again?

Polly91 profile image
Polly91 in reply to SandraCC

Hello SandraCC

I don’t know to be honest but I do know oestrogen dominance is quite prevalent and its the reason why I stay on utrogestan throughout the cycle.

The progesterone cream may be quite a low dose which could result in oestrogen dominance.

Can you start the utrogestan at the same time as the oestrogel?

SandraCC profile image
SandraCC in reply to Polly91

I need to speak to my gp i think. From what I have gathered I should start this on the day my cycle would Normally begin so this means I should wait until September to start both then. I've put a call in to the gp and am waiting for her to call back

Neeta-K profile image
Neeta-K in reply to Polly91

I thought this type of estrogen doesn’t affect thyroid hormones?

Polly91 profile image
Polly91 in reply to Neeta-K

I’m afraid I don’t know for certain but I assumed any oestrogen whether it’s natural or even endogenous increases the body’s demand for thyroid hormone.

130396 profile image
130396 in reply to Polly91

has the Utrogestan made any difference to your thyroid levels? Has it given you constipation? Do you take it orally?

Sorry for all the questions… just worried as since using estrogen patches I’m constipated and had to increase my levothyroxine

Polly91 profile image
Polly91 in reply to 130396

I don’t know for certain as I didn’t test at exactly the right time but my sense is the utrogestan didn’t increase my need for thyroid hormone as much as oestrogen did. I think it did affect it a little but not as significantly.

Do you take magnesium citrate- that helps with any constipation.

130396 profile image
130396 in reply to Polly91

I am now taking 4x300 magnesium citrate a day. Flaxseed. Prunes.

Mugs19 profile image
Mugs19 in reply to SandraCC

Dear SandraCC. I have no medical expertise and am not an advisor just a member. I was always progesterone deficient and you may be different. I could not tolerate oestrogen. was treated by Dr Katharina Dalton for PMS. Progesterone lengthened my cycle. Kitty said it doesn't matter when or if you have a period, just keep taking it and stop for 7 days if you do have one. I stayed on it as per her instruction through my menopause and it was brilliant. I didn't know it was happening. She told me to stay on it afterwards and it would prevent osteoporosis. My doctors stopped it. I have had a thirty year battle trying to stop them but they succeeded inspite of Nick Panay(Chairman of NAPS and BMS)writing to them to say I could not possible do myself any harm. So he prescribed what he thought, rightly, would be more acceptable to them, Utrogestan. He assures me it is Natural Progesterone but micronised. Personally I don't think its as effective but it is better than nothing. If you are not sure you are being treated properly I suggest you visit the BMS website. It has a list of recommended by them doctors who are qualified to treat menopause. You can find one near to you on their map. thebms.org.uk. There is also a link to a Women's Health Concern, run by them

Polly91 profile image
Polly91 in reply to Mugs19

Which progesterone did you find more effective Mugs19?

Thanks

Mugs19 profile image
Mugs19 in reply to Polly91

Gestone injections 100 mg daily. But doctors who don’t know about it think it is strong and dangerous and will try to stop you having it. There is the problem of acquiring needles and syringes and bins to dispose of them. You need a cooperative practice nurse. I ended up buying my own equipment and getting the local pharmacy who dealt with the drug addicts to renew my bin. You also need to be willing to do your own injections. I had no trouble usually fixing a mirror up where I could see my buttocks but some people can’t face it. Thyroid disease isn’t the only women’s problem that doctors make difficult.

Polly91 profile image
Polly91 in reply to Mugs19

Goodness. You were serious that it was the better formulation for you!

Not sure I would be able to brave the needles!

Thanks for your response

SandraCC profile image
SandraCC in reply to Mugs19

Like Polly I don't think I could brave the needles either but fairplay to you for taking control

Polly91 profile image
Polly91 in reply to Mugs19

Is utrogestan considered natural or bio identical progesterone ?

That’s what I had understood?

Mugs19 profile image
Mugs19 in reply to Polly91

Nick Panay assures me that it is Natural Progersterone. (Chairman NAPS and BMS.

Polly91 profile image
Polly91 in reply to Mugs19

That’s good. Thanks for the message.

FancyPants54 profile image
FancyPants54 in reply to Polly91

Utrogestan is BODY identical (important distinction) micronised progesterone. It's the only regulated body identical progesterone we have.

Polly91 profile image
Polly91 in reply to FancyPants54

Good to hear this. Thanks for your reply.

magsyh profile image
magsyh

I refused estrogen and use only bio identical progesterone. Utrogestan is only available on prescription in England.

Was there a reason you needed estrogen? Have you had your levels tested before you started? I've only ever used progesterone and have never had a hot flush and have never had any menopausal symptoms. Is there a reason they want you to continue having monthly bleeds? I had fibroids and Adenomyosis. The progesterone saved me from a hysterectomy and now the fibroids have shrunk and Adenomyosis has gone. Problem is docs are happy to hand out HRT without proper supervision and tests. It's not ok just to use hormones without proper tests you need to know what you're doing and not just slap it on. It depends on what stage of your life you're at.

SandraCC profile image
SandraCC in reply to magsyh

Hi magsyh , its not particularly that I want to have monthly bleeds, to be honest I only realised that was one of the things that taking these products do. My overriding desire is to get better. I recently saw a consultant after having numerous blood tests etc and it is she who recommended this and thyroid support. I have managed to get my gp to provide the hormone treatment and have independently sourced thyroid treatment.

So in response to your post im not self medicating but under the care of consultant. I thought the question I was asking was standard and that I might get some responses based on the benefit of people's experience but I realise that its probably best to go back to gp/consultant for advice

magsyh profile image
magsyh in reply to SandraCC

Everyone is individual that is the problem so the approach must also be individual. My best advice is insist on testing. Your p:E2 ratio must be correct. Be very wary when any GP or consultant says oh we go by how you feel! It tells you they don't know how to read test results so they avoid them! I have had all my hormones tested and I make sure I know what I'm doing it's not something to take lightly as it all works together and must be finely tuned.

FancyPants54 profile image
FancyPants54 in reply to SandraCC

Hi Sandra

Your consultant has recommended a cyclical dosing of the progesterone so that you continue to have a period each month because you haven't gone a full 12 months without a bleed (the marker for having entered menopause). You could take it continuously now to avoid the bleeds, but because your own hormones are still unpredictable in the background, you might get a breakthrough bleed. However, it is possible to do it. If you would prefer not to get a bleed if possible, check with them that they are happy for the increase in Utrogestan prescription that you will need.

As for can you start the oestrogel now, yes you can. You have been prescribed 2 pumps a day I think, but do start on 1 pump a day for 2 weeks and then perhaps add another half a pump for a week and then try the 2. Any obvious side effects from the increase, drop back to the last dosage until it settles, give it another couple of weeks and try again. By the time we reach menopause many of us have had erratic oestrogen levels for years so it can take a while for our bodies to get used to it being there every day again.

Personally I could not tolerate Utrogestan orally. So I inserted it vaginally. Much less symptoms and more direct access to the womb. This is not a licensed method in the UK, but is widely used on the Continent (same product, same exact capsules) and our specialist menopause doctors in the UK will prescribe it to be taken that way if you get side effects from taking it orally. Progesterone is very sedative (always take it before bed and on an empty stomach), it's the PMS hormone, and some women feel much better taking it vaginally.

Also, remember that some women sail through menopause with no issues. They don't feel 100 at the age of 50. They don't suffer so much joint pain and muscle weakness that walking becomes difficult. They don't experience massive mood swings and suicidal thoughts. They don't loose the ability to think and process information, remember or calculate simple maths. And I have found over the years that these women have no concept of what a bad menopause is. It seems we can only judge it by our own experience. So don't be deterred by those who think you don't need HRT etc. The input of oestrogen, once the body is used to it again, is marvellous. Don't be sidetracked by the American concept of oestrogen dominance. I don't know how they thing pregnant women survive, as they have oestrogen levels that are sky high and they bloom. They are sick in the months when progesterone is highest. What I'm trying to say is that you paid to see a consultant specialist and now you should follow their advice (with the ability to go back and question if you could try continuous progesterone from the start if you want to do so) and ignore the rest of us. Each of us is very different.

SandraCC profile image
SandraCC in reply to FancyPants54

hey FancyPants54 , apologies for the tardy response but somehow I missed this nugget earlier. Thank you so much for taking the time to give such an informative and insightful response, I truly appreciate it. You are also correct, many women have vastly different experiences which we can see by logging on to any post in thia community.

Its interesting to know that this can ne inserted vaginally too so depending on how things go orally at least that is an option.

I have been on quite a journey already and spent a significant amount of money so I am looking forward to some respite for my poor mind and battered feeling body so I am approaching this treatment with an open and optimistic mindset and hope to see the benefits

Your post has given me hope for which I'm grateful

😊

FancyPants54 profile image
FancyPants54 in reply to SandraCC

Just seen this. Exactly the right attitude to start the treatment with. It's not medication, it's replacing what is lost. We were never meant to live 30 years post menopause with really low levels of oestrogen. But we have worked out how to live longer and nature seems to be moving the age of puberty forward and with it the average age of menopause, so we really are facing a long time without the hormone that keeps our bones growing and our hearts running.

Mugs19 profile image
Mugs19 in reply to FancyPants54

Sorry but I’m sure you are mistaken in some of this. Women are sick in the early months of pregnancy because they don’t make enough progesterone. Gradually the placenta starts to manufacture vast amounts of progesterone. The mid trimester is much more comfortable as aresult. Low progesterone causes miscarriages. A pregnant woman develops many times more level of progesterone than when not pregnant. This is why you can’t overdose yourself with it: you are exposed to more than you can take when pregnant. It is an immunosuppressant and nature’s antidepressant- without side effects.

FancyPants54 profile image
FancyPants54 in reply to Mugs19

images.app.goo.gl/Td3ZSWzmN...

A graph of the pregnancy hormones.

I’ve been around the menopause groups favouring HRT a while now. Long enough to know that the women on HRT love oestrogen and the oestrogen phase if cyclical, but if they are going to have problems with any of it, it will be the progesterone. Depression, brain fog, crying spells, fatigue, sometimes sickness. I myself tried higher dose bioidentical progesterone cream at one point and became hideously bloated but unable to pee, and so, so tired. It’s known as the PMS hormone after all. Oestrogen gives us energy progesterone slows us down.

Mugs19 profile image
Mugs19 in reply to FancyPants54

When you say 'women who are on HRT' you are confusing the issue by lumping all women together. Yes they like oestrogen because they are oestrogen deficient. I was not oestrogen deficient, but progesterone deficient and for a lot of women like me the answer is definitely not oestrogen treatment. But are they that happy if they experience all the problems you mention like depression? You have inadvertently put your finger on the problem when you say it is the progesterone they are given to make them bleed that makes them ill. Unfortunately most of them are given a synthetic progestogen for this purpose. They are not natural progesterone and that is why they cause all those nasty side effects. We have just had the NHS apologising to women for using one of these progestogens, Norethisterone as a pregnancy test. Its molecule resembles testosterone more than progesterone. It caused abnormalities in the foetus. Drug companies keep trying to pass off these synthetic drugs as natural but when they are used in pregnancy they cause abnormalities. Norethisterone casuses masculinisation of the female foetus. This information was known to Katharina Dalton in the 70s when her books were written which makes it even more of a scandal . Natural progesterone on the other hand is used in IVF. It does not damage or make the mother ill, but helps to establish the pregnancy . My daughter has two healthy babies as a result..Progestogens made made my PMS much worse.

I had assumed that some one using Utrogestan was not one of these women who are on HRT but someone who is in need of progesterone. Anyone can take natural progesterone. Dr John Lee used it to treat osteoporosis in both male and female patients and postmenopausal women. It converts to oestrogen in the body. This worked for me. My bones were healthy till my GPs stopped my progesterone injections. Now I have osteoporosis.

This is my last word on this subject. I was just trying to help someone by reassuring her that she cannot overdose with progesterone. There is a negligible amount in the cream anyway. But reliving all this from decades of trauma, banging my head in the same brick wall is doing me no good. I have been very unwell for some time and have no wish to set myself up as target for someone with an axe to grind. The right information is out there if you look for it. Try reading what the doctors who are respected by hypothyroid sufferers like Gordon Skinner and John Lowe said about natural progesterone.

130396 profile image
130396 in reply to magsyh

are you still using Utrogestan only? Did it give you any side effects? Did it make you constipated? Thank you

magsyh profile image
magsyh in reply to 130396

Hi no I only use pregnenolone now that im post menopausal. I didnt hit menopause till 61 so I weaned myself off progesterone with pregnenolone and im still doing well. Im off everything even my thyroid medication and feeling better than I have done for many years

SandraCC profile image
SandraCC

Ok I have just been advised from the gp to have today as day one of the cycle. So I will start both the Utrogestan and Oestrogel today. In a month I need to get tested/advise her of my blood pressure and if all good she will prescribe more.

FancyPants54 profile image
FancyPants54 in reply to SandraCC

A month is too quick, but it will do, just tell her then that you would like another review 2 months later. That will take you to the 3 month review period most specialists carry out. At 1 month you will probably only have been on 2 pumps for a couple of weeks. But whatever happens don't let her reduce your dose then. Even if you secretly keep using 1 pump for longer. It's good to get a few bottles in hand so that you can experiment later. I did it by ordering my prescriptions online every 3 weeks until I had some spare and then went every 4 weeks.

Lindseywalsh profile image
Lindseywalsh

Hi,I am jumping on this post since it seems to discuss utrogestan and progesterone cream.

I am 57 definitely menopausal. I use oestrogel and love it, but need to take progesterone to make sure the lining of my uterus doesn’t get too thick. This is where the problems begin. I am very adversely sensitive to the progesterone. Can leave me barely functional. If I take the full dose, and even when I cut right back, I feel very bad half the time. Having said that I do like the calming effects and know that I need to take enough to be safe. I would ideally like to take 50mg of utrogestan, but this isn’t available. SO I am wondering about using a cream instead. Does anyone have any experience of using oestrogel plus a progesterone cream? Also how do I know what amount of cream will give me approx 50mg equivalent of the utrogestan?

I hope I am making sense?

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