Hormone Replacement Therapy 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 take Utrogestan or Gepretix.
What are Utrogestan and Gepretix?
Utrogestan and Gepretix are names for a medicine which contains a type of progestogen called ‘micronised progesterone’. They are derived from plants, including yam, the root vegetable. 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?
If given alone, oestrogen 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 do I take and when do I take it?
This is individual to you and you will be guided by your prescriber.
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.
What might the side effects be with Utrogestan?
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?
Utrogestan 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?
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.
It’s important to see your doctor at least once a year for a check-up if you take HRT.
For more questions to see if Utrogestan 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 if you are in the UK and have a clinic in Guildford if you prefer an in person consultation.
Last updated June 2024 -Carys Sonnenberg -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.