Hormone Replacement Therapy (HRT) is given to relieve the symptoms of perimenopause and menopause and involves the replacement of one or more of the hormones oestrogen, progesterone and testosterone. It is important to understand how to take the hormones prescribed to you and this article covers how to use Utrogestan or Gepretix, both of which are prescribed in the UK as forms of micronised progesterone which can be taken as part of HRT.
What are Utrogestan and Gepretix?
Utrogestan and Gepretix are names for a medicine which contains a type of progestogen called ‘micronised progesterone’. They are identical in structure to the hormone progesterone produced by the ovary after ovulation. Because of this, they are referred to as ‘body identical’. They are given to women with a uterus (womb), and to some women after hysterectomy, as part of their HRT. They are only available on prescription and are taken as oral capsules at night usually, as they can cause sedation. They can be taken on an empty stomach, or with food.
Why do I need to take a progesterone as part of my HRT?
Women who have a womb (uterus) and some women who do not have a womb need to take a progestogen as part of HRT. If given alone, oestrogen-only HRT causes the lining of the womb to thicken. It is like applying a fertiliser to the lawn, with an increased risk of abnormal cells developing or a womb cancer. The progestogen keeps the lining of the womb thin, like using a lawn mower, and prevents the cells from thickening and becoming abnormal.
It is very important you take your Utrogestan and Gepretix in the dose as it has been prescribed, and for the duration in the month it has been prescribed, so that it can protect the womb lining.
If you do not have a womb usually you do not need to take a progestogen, but there are some cases, such as after a hysterectomy for endometriosis, where you are usually asked to take a progestogen to protect the endometrial like tissue which could remain after the operation.
What dose of Utrogestan or Gepretix do I take and when do I take it?
This is individual to you and you will be guided by your prescriber. It is important to understand how to use Utrogestan and Gepretix.
Progesterone is given cyclically for at least 12 days of each 28 day cycle, or continuously, every day. The dose depends upon how it is being given, what dose of oestrogen you are taking, and may be increased by your Dr if you are experiencing bleeding on HRT.
These medications are best taken at night, as they can make you feel sleepy. They are usually taken orally but they can be used (after discussion with your prescriber) vaginally if you have side effects with oral use.
What are the possible side effects?
Common side effects include changes in your periods, including spotting, or bleeding between periods, breast tenderness, headaches,a dip in mood.
These symptoms usually improve in the first few months of treatment.
Some women do not tolerate taking Utrogestan or Gepretix, they may experience more serious side effects, the symptoms they experience can be very similar to PMS or PMDD. They may experience symptoms which include problems sleeping, breast tenderness or pain, feeling tired / dizzy or change in energy, swelling, bloating or fluid retention, mood changes: mood swings, irritability, anxiety, or depression, vaginal bleeding, abdominal pain, acne or oily skin, nausea, indigestion or changing bowel habit, mild rash.
If this happens please speak with your Dr, as they can advise you about changing the way you take the Utrogestan or Gepretix, or trying a different progestogen, which you may tolerate much better.
Why do some women have side effects?
Micronised progesterone is metabolised in the body to allopregnanlone, which plays an important role in neurological resilience. It exerts a neuroprotective, antidepressant and anxiolytic effect, via GABA receptors in the brain. For some women this produces a calming effect, for others they experience side effects, which can be severe.
Are there other types of progestogen I can use instead as part of HRT?
Yes, it could be that using a different progestogen might be better tolerated as the synthetic progestogen act upon different receptors in the body. Usually we find one that you can take and tolerate well, there are lots of other options.
It’s important to see your doctor at least once a year for a check-up if you take HRT.
For more questions about how to use Utrogestan and Gepretix and what HRT might be right for you, please book an appointment at Rowena Health Menopause Clinic and we will be delighted to help. We offer online menopause and women’s health care appointments if you are in the UK.
Last updated October 2025 – Carys Sonnenberg – BMS Menopause Specialist
Patient resources:
IV just started on this and a patch was on fem seven now on evrol ,,,50 twice a week and tablet every night.
Fem seven made me bleed every 2 weeks .
Want to give this a go but I’m 62 and worry about the bleeding at my age
Please can you chat with your GP if you have concerns and they can advise you, with the benefit of having your medical records.
Have been given these hrt capsules they do not agree with me I feel anxious strange side effects like flu aching limbs burning sensations Im not taking these again going back on my usual utrogestan as gepretix isn’t for me, anyone else feeling like this.
Dear Marcia, Please can with your doctor if you are having side effects to Gepretix and ask to be prescribed Utrogestan, if that is what you previously took and were happy with
Best wishes