Utrogestan for menopausal hormonal treatment

Sounds like 'UR-trow-gest-an'

Key points about utrogestan for menopausal hormonal treatment

  • Utrogestan is a medicine used together with oestrogen, as menopausal hormone therapy, for people who still have a uterus (womb).
  • Utrogestan contains the natural female hormone progesterone.
  • Find out how to take it safely and possible side effects.
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Utrogestan belongs to a group of medicines called progestogens and is used, together with oestrogen, as menopausal hormone therapy for people who still have their uterus (womb). As you approach menopausechanges or fluctuations in oestrogen levels can cause symptoms such as hot flushes, vaginal dryness, and mood and sleep changes.

Menopausal hormone therapy (MHT) can help to ease symptoms such as hot flushes and night sweats. Read more about menopausal hormone therapy.

If you have a uterus, taking oestrogen alone can cause thickening of the uterus lining (endometrium) which can increase the risk of endometrial cancer. The progestogen in Utrogestan helps to prevent the thickening of the lining and therefore reduces the risk of cancer. 

Is Utrogestan different to other progestogens?

Utrogestan is considered a bioidentical hormone therapy. ‘Bioidentical’ or ‘body-identical’ hormones have the same chemical structure as those produced in the human body. Utrogestan contains the natural female hormone progesterone. Evidence suggests that this formulation has fewer long-term side effects.

Utrogestan is available as capsules (100mg). 

Always take Utrogestan exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it, and any special instructions. Here is some guidance.

  • If you haven't had a period for over a year: Take 1 capsule each evening at bedtime.
  • If you have had a period within the last 12 months: Take 2 capsules each evening at bedtime for 12 consecutive days every month. For example, on days 15 to 26 of your cycle. You may have bleeding (like a period) for a few days, after this time.

The reason for taking 2 capsules a day for part of the month instead of 1 capsule every day, is that in the early stages of menopause you could get irregular bleeding on the lower dose. The higher dose for part of the month is more likely to give you a predictable light period rather than unexpected bleeding.

  • Take Utrogestan capsules on an empty stomach. This means  about 1 hour before or 2 hours after food.
  • Timing: Utrogestan can make you drowsy, especially when you first start taking it. It's best to take it at bedtime. Avoid driving and doing other tasks where you need to be alert until you know how this medicine affects you. 
  • Swallow the capsules whole with a glass of water. Don't crush or chew them.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, just take it at the right time. Don't take double the dose.

Every person is different and the length of time you will have menopausal symptoms is unknown. You will need to keep taking Utrogestan for as long as you are using oestrogen. It’s important to have regular check-ups with your doctor to assess whether ongoing Urogestan is right for you. 

Most people stop taking it after a few years, when their symptoms resolve. It's usually best to reduce menopausal hormone therapy gradually rather than stopping it suddenly. This may reduce the risk of menopause symptoms returning.

Here are some things to know when you're taking Utrogestan. Other things may be important as well, so ask your healthcare provider what you should know about.

  • Utrogestan is not a contraceptive and does not prevent you from getting pregnant. Although fertility falls during perimenopause, people are not fully protected from pregnancy until they have reached menopause, which means 12 straight months without a period. Even if you have a few months without a period, you can still get pregnant. You will need to use an appropriate method of birth control until menopause is confirmed. 
  • Utrogestan can interact with some other medicines and herbal supplements, so check with your doctor or pharmacist before starting Utrogestan and any new products.
  • If you're having an operation or dental treatment, tell your healthcare provider that you're taking MHT

Utrogestan is not suitable for everyone. You shouldn't use Utrogestan if:

  • you've had severe liver problems
  • you've had bleeding in your brain
  • you have any unexplained vaginal bleeding
  • you've had breast cancer or any lumps in your breast 
  • during a pregnancy you've had problems such as severe itching and blistering of your skin, yellowing of your skin or the whites of your eyes (jaundice), or any involuntary jerky movements
  • you have a rare inherited blood disorder known as porphyria.

If you have a history of depression, or migraine let your healthcare provider know.

NOTE: Utrogestan is used in combination with oestrogen, as menopausal hormone therapy (MHT). Read more, menopausal hormone therapy is NOT recommended in certain situations. 

If you have an allergy to soya, don't use Utrogestan as the tablets contain soya lecithin. If you have an allergy to peanuts, use Utrogestan with caution. Although Utrogestan doesn't contain peanut oils there's the risk of a cross reaction and a few people with peanut allergy may also be allergic to soya. 

Like all medicines, Utrogestan can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Risk of blood clots

The risk of blood clots increases with increasing age, increased body weight, smoking, and with illnesses including cancer and some autoimmune diseases.

The risk of blood clots with micronized progestogen such as Utrogestan is low. However, Utrogestan is used in combination with oestrogen which does increase the risk of blood clots. Taking oestrogen tablets has a higher risk than oestrogen patches, gel or cream.

If you're worried about the risk of blood clots, talk to your doctor. If you get symptoms of a blood clot such as chest pain, shortness of breath, calf pain or swelling in one leg or arm, seek medical advice immediately.

Other side effects

Side effects What should I do?
  • Light headed or dizzy
  • Drowsy or sleepy
  • Take your dose at bedtime. 
  • Be careful when driving or using tools until you know how this medicine affects you.
  • Feeling sick (nausea)
  • Headache
  • Runny poo (diarrhoea) or constipation
  • These are quite common when you first start taking Utrogestan and usually go away with time.
  • Tell your doctor if these side effects bother you.
  • Changes in weight
  • Difficulty sleeping
  • Bloating 
  • Swollen feet and ankles (fluid retention)
  • Breast tenderness
  • Changes in sexual desire
  • Low mood
  • Skin reactions such as itch, rash, acne 
  • Tell your doctor if they bother you.
  • Vaginal bleeding
  • Bleeding can be intermittent (come and go) or continuous and can last for the first few months.
  • If bleeding worsens, or doesn't improve with time, tell your doctor.
  • Signs of jaundice such as yellowing of the eyes 
  • Tell your doctor immediately or ring Healthline 0800 611 116. 
NOTE: Utrogestan is used in combination with oestrogen, as MHT. Read more about the side effects of MHT. 

Did you know that you can report a medicine side effect to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)

Utrogestan factsheet
Healthify He Puna Waiora, NZ, 2023
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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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