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Utrogestan for HRT
Utrogestan pessaries (or vaginal capsules) are small capsules that are inserted directly into the vagina. They can be used as part of a HRT regimen to protect the lining of the womb if you have not had a hysterectomy.
Utrogestan Vaginal capsules can be purchased from The Independent Pharmacy following an online assessment if you are already prescribed HRT by your doctor as part of an HRT treatment plan.
What are Utrogestan Vaginal Capsules?
Normally women would use Utrogestan 100mg oral capsules as part of their HRT regime. Currently, there is a shortage of this product from the manufacturer Besins. However, the 200mg strength is still currently available.
Though the 200mg pessaries are normally used for IVF. Their formulation (make-up) other than being higher strength is identical.
Therefore it is possible to use both treatments either orally or vaginally. Though this is off-label it is a common way of supporting women when there is a medicines shortage in the supply chain.
What is Utrogestan 200mg used for?
Though licenced for vaginal use for IVF, during the shortage of the 100mg strength, we have sourced some of these pessaries for use as part of HRT, as the body identical micronised progesterone is the preferable treatment, compared to the synthetic progesterone found in Provera or Utovlan.
Utrogestan is suitable for women with an intact uterus or womb when taken with oestrogens (i.e. combined HRT), such as Elleste Solo, Zumenon, or patches such as Evorel and Estradot.
Is Utrogestan a contraceptive?
Utrogestan is not a form of contraception.
How does Utrogestan work?
When taking oestrogen alone it causes the cells of the lining of the womb, the endometrium, to thicken, which can lead to some women developing cancers of the womb. Taking Utrogestan opposes this process, causing the womb lining to shed every month, just like during a menstrual bleed, lowering the risk of developing cancer.
Utrogestan 200mg Vaginal Capsules Patient Information Leaflet: https://www.medicines.org.uk/e...
How to take Utrogestan Vaginal Capsules
There are two ways you may be directed to take Utrogestan:
- For women who are still having periods within the last 6 to 12 months: Insert 1 capsule into the vagina every day from day 15 to day 26 of your 28-day monthly cycle. This regime will create an artificial monthly bleed.
- For women who have not had a period for over a year: Insert 1 capsule into the vagina every other evening without a break - this will provide an equivalent dose of 100mg daily
To take Utrogestan, gently insert the capsule deep inside the vagina (as far as it will comfortably go). You can do this by lying on your back with your knees bent, or standing with your knees bent and your feet a few inches apart. If you require an applicator to make insertion easier, this can be purchased separately*.
*If using an applicator, follow these steps:
- Place the capsule onto the end of the applicator.
- Hold the applicator by the opposite end, and gently insert the applicator into the vagina as far as it will comfortably go.
- Press the applicator’s plunger to push the capsule into the vagina, then gently remove the applicator.
- Clean the applicator after each use if using a reusable applicator (otherwise, discard the applicator).
After inserting the suppository (whether using an applicator or inserting it by hand), wash your hands with warm water and soap.
It is recommended that Utrogestan is used just before bed. This is for 2 reasons, the act of lying horizontally will reduce any leakage due to gravity and also this treatment can cause sedation so it is best taken prior to sleeping.
The make-up of the 200mg pessaries and the 100mg oral tablets are identical. If you did not wish to use these vaginally it is possible to take the treatment orally. While the drug is not licensed to take in this way, it is perfectly safe to do so and there is good evidence to support its use this way.
How far do I insert a progesterone suppository?
If you are using an applicator to insert a suppository, insert it gently into the vagina as far as it will comfortably go. If you feel any pain or discomfort, you have inserted the applicator too far. The same applies if you are inserting the tablet by hand — it’s important that you only insert it as far as feels comfortable.
What if I forget to take Utrogestan?
If you miss a dose of Utrogestan, take it as soon as you remember. However, if it’s nearly time for your next dose, skip the missed dose and carry on as normal from your next scheduled dose. Do not take a double dose of Utrogestan to make up for a missed dose.
Utrogestan 200mg ingredients
The active ingredient in Utrogestan is progesterone. Each capsule contains 200mg.
The other ingredients are sunflower oil and soybean lecithin. The ingredients in the capsule shell are gelatin, glycerol, titanium dioxide (E171), and purified water.
Utrogestan 200mg side effects
As with all medicines, some people may experience side effects when taking Utrogestan Vaginal Tablets, though cases are rare.
The most likely side effects of Utrogestan include:
- Vaginal discharge
- Vaginal haemorrhaging
- Vaginal itching
If you experience these or any side effects not listed here, speak to your doctor or pharmacist for advice.
Utrogestan 200mg warnings
Before taking Utrogestan, you should be aware of the following warnings and precautions.
- You should always talk to your doctor or pharmacist before using Utrogestan tablets
- Utrogestan is not a contraceptive
- Utrogestan is not for use by children
Do not use Utrogestan Vaginal Tablets if any of the following apply to you:
- You are allergic (hypersensitive) to soya or peanuts
- You are allergic to progesterone or any of the other ingredients listed below
- You have severe liver disease
- You have unexplained vaginal bleeding
- You have mammary or genital tract carcinoma
- You have thrombophlebitis
- You have or have had thrombosis (blood clots in a vein), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism)
- You have cerebral haemorrhage
- You have a rare blood problem called “porphyria” which is passed down in families
If you are unsure whether Utrogestan is safe for you to take, or you need some more advice about this medication, speak to your doctor.
Taking Utrogestan with other medications
Utrogestan can affect the way some medications work — and vice versa — so it’s important to tell your doctor or pharmacist if you are taking, has recently taken, or are planning to take any other medications alongside Utrogestan. This includes non-prescription medicines and herbal remedies.
In particular, tell your doctor or pharmacist if you are taking any of the following medicines:
- Bromocriptine (used for Parkinson’s Disease or problems with the pituitary gland).
- Ciclosporin (used to suppress the immune system).
- Rifamycin (used to treat infections).
- Ketoconazole (used to treat fungal infections).
Taking Utrogestan during pregnancy and breastfeeding
- Do not use Utrogestan Capsules if you are breastfeeding or pregnant