Micronised Progesterone or Utrogestan (fact sheet)

What is Utrogestan?

Utrogestan is a type of progestogen called ‘micronised progesterone’. It is derived from plants, including yam, a root vegetable. It is identical in structure to the hormone progesterone produced in our bodies. Because of this, it is often referred to as ‘body identical’. This is different to unregulated, compounded bioidentical hormones.

Women who take HRT and still have their womb (uterus) are required to take a type of progestogen, in addition to oestrogen. This is because taking oestrogen can lead to a build-up in the lining of your womb, over time. Taking a progestogen, such as Utrogestan, prevents this occurring and reduces associated risks.

How is Utrogestan taken?

Utrogestan is given as a 100 mg capsule. There are two ways of taking Utrogestan.

  • For women who have still had periods in the last 6-12 months, the usual recommended dose is two 100mg capsules, taken together each evening, for two out of four weeks, on a repeating basis.
  • For women who have not had a period for over a year, the usual recommended dose is taking one 100mg capsule every evening, without a break.

The dosage information that comes with the medication differs slightly to this, but it is far more straightforward to take it in this way and easier to remember. It is completely safe to take it in the way we have described.

Utrogestan is a natural sedative so can cause drowsiness in some women. It is therefore recommended you take it at bedtime. It is best to take Utrogestan on an empty stomach because eating food can actually increase its absorption.

Some women use the progesterone vaginally rather than taking it orally, which can be associated with less side effects. Evidence has shown that using 100mg progesterone vaginally alternate evenings as a continuous (no bleed) preparation or 100mg progesterone vaginally every evening for 12-14 days each month as a cyclical (leading to periods) preparation is safe.

Many women use the oral Utrogestan capsules vaginally or some women use Cyclogest pessaries (these contain 200mg progesterone and can be cut in half). Progesterone is not licensed to be used in this way but there is evidence to support that this is safe. Women who use it in this way should seek individualised advice from their doctor.

What are side-effects with Utrogestan?

Some women experience side-effects initially, which can include vaginal bleeding, abdominal bloating, lower abdominal pain or discomfort and breast tenderness. Bleeding can be intermittent or continual and last for 3-6 months after starting HRT. If your bleeding worsens or does not improve with time, you should seek guidance from your menopause doctor or GP.

Some women find that their mood is lower when they take Utrogestan. This side-effect is less common nowadays as medication improves, but can still occur in around one in ten women. If you experience this side-effect and it does not improve, there are alternative ways of taking Utrogestan and this can be discussed with you by your menopause doctor. Some women use the progesterone vaginally rather than taking it orally, which can be associated with less side effects. It is not licensed to be used in this way but there is evidence to support that this is safe.

What are the advantages of Utrogestan compared to older types of progestogens?

As Utrogestan is a body identical hormone, women usually experience less side-effects compared to the older types of progestogens.

The older types of progestogens given as tablets or as a combination patch, can be associated with a slightly higher risk of blood clot and heart disease. Studies have shown that women who take Utrogestan however, do not have a higher risk of clot or heart disease.

The small increased risk of breast cancer in women who take HRT, is related to the type of progestogen in the HRT. Taking Utrogestan does not appear to be associated with an increased risk of breast cancer for the first five years of taking it. After this time, the risk of breast cancer is very low; studies have shown the risk to be lower than the risk for a woman taking the older types of progestogens.

Even for women taking the older types of progestogen, the risk of breast cancer is very low. The level of increased risk with the older types of progestogen is similar to the level of risk of breast cancer in women who are overweight, or women that drink around two glasses of wine every day.

Last updated: November 2019

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