If oestrogen is given alone it can cause thickening to the lining of the womb, known as the endometrium.  Over time if the endometrium is thickened, cell changes can occur which increase the risk of cancer. Therefore it is important for anyone who has oestrogen as HRT, and has a womb, to have progesterone prescribed.

Some women may have had a hysterectomy but have a condition called endometriosis. This can result in some tissue, from the lining of the womb, being found in other areas, for example on the bowel or bladder.  These women would also need to have progesterone, even though they no longer have a womb.

We tend to prescribe Utrogestan as the safest form of progesterone.  It is a micronized, body identical progesterone, which means it mimics your own progesterone produced and reduces side effects.  It is derived from a root vegetable, the yam.

How to take Utrogestan

There are two ways of taking this.  It comes as a small, spherical capsule of 100mg.

  • For women who have had periods in the last 6-12 months, the usual recommended dose is two of the 100mg capsules, taken together each evening for 2 out of 4 weeks. So essentially 2 weeks on, 2 weeks off.
  • For women who have not had a period for over a year, the usual recommended dose is one of the 100mg each evening.

The leaflet accompanying Utrogestan suggests alternative dosing, we have found the above method easier to remember and it is completely safe.

It is best taken in the evening as it is a natural sedative and can help you sleep.  Taking on an empty stomach is advised. 

Side Effects

Common side effects include breast tenderness and some women may experience vaginal spotting, this usually settles within 3-6 months.

Some women have intolerance to progesterones, and may have experienced side effects from previous contraceptives.  If this is the case please discuss during your menopause consultation. Alternative progesterones could be considered or Utrogestan can be used off-licence and inserted vaginally.

Alternative progesterones include:

Hormone containing coil (mirena)