What is Utrogestan used for?

• Utrogestan capsules are used as part of hormone replacement therapy (HRT) for the menopause in women who still have their womb. They are prescribed to be taken alongside oestrogen-based HRT to oppose the effect of the oestrogen on the womb lining.

Taking progesterone with oestrogen is known as combined HRT.

How do Utrogestan capsules work?

• In women who still have their womb (ie if you've not had a hysterectomy), oestrogen-based HRT can stimulate the growth and build-up of the womb lining (endometrium). This can lead to a slightly increased risk of developing endometrial cancer if the growth is unopposed.
• The progesterone in Utrogestan capsules works by opposing oestrogen's effect on the womb lining. It causes the womb lining to be shed, like a period, which reduces the risk of developing endometrial cancer. Utrogestan capsules are taken as part of each monthly oestrogen cycle.

Key facts about Utrogestan capsules

• Utrogestan capsules are not a contraceptive.
• Utrogestan is a brand name for progesterone.
• You take Utrogestan on a few days each month: either two capsules every day on days 15 to 26, or one capsule every day on days 1 to 25.
• The capsules may make some women feel dizzy or drowsy, so they are best taken at bedtime. Avoid driving or operating machinery if affected.
• The most common side effects of Utrogestan are a change in your period and headaches.
• You should see your doctor at least once a year for a check-up and to review your need for HRT

Who should not take Utrogestan capsules?

Combined HRT using an oestrogen plus Utrogestan capsules may not be suitable for some women. Make sure your doctor knows if:

• you have abnormal vaginal bleeding that hasn't been investigated by a doctor
• you have ever had ovarian cancer, endometrial cancer, endometriosis or fibroids in your womb
• you, your mother, sister or grandmother have ever had breast cancer
• you have ever had benign breast lumps (fibrocystic breast disease)
• you or a close family member have ever had a blood clot, eg deep vein thrombosis or pulmonary embolism
• you have ever had angina pectoris, a heart attack or a stroke
• you smoke, are overweight, have severe varicose veins, or have any other condition that increases the risk of getting a blood clot
• you have high blood pressure (hypertension)
• you have liver or kidney problems
• you have ever had gallstones
• you have diabetes
• you have epilepsy
• you suffer from migraines or severe headaches
• you suffer from asthma
• you have a history of depression
• you have a rare metabolic disorder known as porphyria
• you are pregnant or breastfeeding. Remember, it's still possible to get pregnant while you're on HRT. You should use a non-hormonal method of contraception (eg condoms or contraceptive foam) for two years after your last period if you are under 50, or for one year if over 50.

How do I take Utrogestan capsules?

Utrogestan tablets can be taken in one of two ways each month, as described below. Follow the instructions given by your doctor for which method you should use.

• Either: Take two 100mg Utrogestan capsules once daily at bedtime for 12 days from day 15 to day 26 of each 28-day cycle of oestrogen. This usually results in a withdrawal bleed (similar to a period) the following week.
• Or: Take one 100mg Utrogestan capsule once daily at bedtime on days 1 to 25 of each 28 day cycle of oestrogen. This usually causes less spotting and breakthrough bleeding.

Utrogestan capsules should be swallowed whole with a drink of water. They should be taken without food on an empty stomach.

If you forget to take a dose take it as soon as you remember, unless it's nearly time for your next dose. In this case just leave out the missed dose and take your next dose as usual when it is due. Do not take a double dose to make up for a missed dose.

What are the side effects of Utrogestan capsules?

• Change in your menstrual bleeding pattern, including spotting or bleeding between periods.
• Headache.
• Feeling sleepy or dizzy.
• Breast pain or tenderness.
• Feeling sick or vomiting.
• Constipation or diarrhoea.
• Itching.
• Acne.
• Jaundice. See your doctor if you notice any yellowing of your skin or eyes.

Women on HRT should have regular breast examinations and mammograms. Examine your own breasts regularly and see your doctor if you notice any changes in your breasts.

Stop taking your HRT and see your doctor immediately if you get any of the following, as they could be symptoms of a blood clot: stabbing pains or swelling in one leg; pain on breathing or coughing; coughing up blood; unexplained breathlessness; sudden chest pain.

Can I take other medicines with Utrogestan?

It's important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start taking HRT. Similarly, always check with your doctor or pharmacist before taking any new medicines while you're taking HRT, to make sure that the combination is safe.

Some medicines may increase the breakdown of progesterone in the body, which could make it less effective. These include:

• barbiturates such as amobarbital
• some antiepileptic medicines, such as carbamazepine and phenytoin
• griseofulvin
• rifampicin
• the herbal remedy St John's wort (Hypericum perforatum).

Ask your doctor or pharmacist for further advice if you are taking any of these medicines.

References:

https://www.medicines.org.uk/emc/product/352/pil

https://www.netdoctor.co.uk/medicines/a8720/utrogestan-capsules-progesterone/

https://www.menopausedoctor.co.uk/menopause/micronised-progesterone-or-utrogestan

https://www.ncbi.nlm.nih.gov/pubmed/15518280

https://www.nps.org.au/medicine-finder/utrogestan-vaginal-capsules