Body-identical progesterone (Utrogestan) has become a popular progesterone option over the past few years, due to a lesser breast risk compared to synthetic progesterones. This article describes how to take Utrogestan depending on your type of HRT and your own personal risk factors.
Utrogestan, otherwise known as micronised progesterone, is a natural progesterone hormone derived from plants which is identical to our own body’s natural progesterone hormone. Utrogestan is used in combination with oestrogen (tablet, patch, gel or spray) as part of HRT. Oestrogen is the main hormone required to treat menopausal symptoms, however using oestrogen by itself can cause thickening of the lining of the womb, therefore it is important to take progesterone as part of your HRT to protect your womb from the oestrogen.
Utrogestan comes in capsule form and should be taken at bedtime, as it is mildy sedating. For this reason, many women find it can help with their sleep.
The evidence we have has shown there is no increased risk of breast cancer with body-identical progesterone, at 5 years of use. Beyond this 5 years, there may an ever so slight increased risk of breast cancer, though less than synthetic progesterones.
You can find out more about the evidence behind body-identical progesterone (otherwise known as micronised progesterone which is summarised well on this BMJ response with links to further evidence. The balance menopause website also has a good factsheet on micronised progesterone.
When considering how to take Utrogestan, we determine where you are with your periods and this helps us decide on the correct regime.
If you are still having periods or have had a period in the past 6-12 months, you may use Utrogestan in a cyclical pattern which will give you a regular monthly bleed. This means taking Utrogestan capsules for 2 weeks of each month. We would expect a bleed toward the end of these 2 weeks or shortly after stopping the capsules.
The usual dose of Utrogestan is 200mg (2 capsules) when taking cyclically and the capsules should be taken with food. The information leaflet may state that it should be taken on an empty stomach, however we now know that it is better absorbed with food and therefore many specialists recommend taking with a light snack in the evening.
If it has been more than 6-12 months since your last period, you may want to try taking Utrogestan continuously throughout the whole month. With this regime we would not expect a regular monthly period, however occasionally you can have some irregular bleeding in the first 3-6 months after starting a continuous HRT regime. If the bleeding is troublesome or persists beyond the 6 month mark, then you should speak to your doctor or menopause specialist.
The usual dose of Utrogestan is 100mg (1 capsule) when taken continuously, and the capsules should be taken with food. The information leaflet may state that it should be taken on an empty stomach, however we now know that it is better absorbed with food and therefore many specialists recommend taking with a light snack in the evening.
There are certain situations where we would recommended taking a higher dose of Utrogestan even with medium doses of oestrogen, due to the risk of changes to the lining of the womb. We recommend higher doses of Utrogestan for the following:
