Description
How it works
Oestrogen in HRT helps control menopause symptoms but, when used alone in women with a uterus, it can thicken the lining of the womb (endometrium) and increase the risk of endometrial cancer.
Progesterone balances the effect of oestrogen by:
- Keeping the womb lining thin and stable
- Triggering regular shedding (withdrawal bleeding) when used in a cyclical regimen
- Reducing the risk of endometrial hyperplasia and endometrial cancer associated with oestrogen-only HRT in women with a uterus
Utrogestan uses micronised progesterone, which is structurally the same as the natural hormone produced by the body, and is usually taken at bedtime to minimise drowsiness.
Who it may be suitable for
Utrogestan 100 mg capsules may be suitable for:
- Postmenopausal women who still have a uterus, using oestrogen HRT (gel, patch, spray or tablets) and needing a progestogen to protect the womb lining
- Women who prefer a body-identical (micronised) progesterone rather than a synthetic progestogen
It is not used on its own as HRT – it is added to oestrogen therapy. It is also not a contraceptive.
Who should not use Utrogestan
Do not take Utrogestan if you:
- Are allergic to progesterone, soya, peanut, or any capsule ingredient (it contains soybean lecithin, so people with peanut allergy must avoid it)
- Have current, past, or suspected breast cancer
- Have a known or suspected hormone-dependent cancer (e.g. cancer of the womb)
- Have unexplained vaginal bleeding
- Have untreated endometrial hyperplasia
- Have previous or current blood clots (deep vein thrombosis, pulmonary embolism, thromboembolic disorders) or thrombophlebitis
- Have known thrombophilic disorders (e.g. protein C, protein S, antithrombin deficiency)
- Have active or recent arterial thromboembolic disease such as angina or heart attack
- Have acute liver disease or a history of liver disease with abnormal liver function tests
- Have porphyria or a history of cerebral haemorrhage
- Are breastfeeding
It is designed for postmenopausal women using HRT and is not indicated during pregnancy or breastfeeding. If pregnancy occurs, treatment should be stopped.
Use with extra care
You should be closely monitored if you have, or have had:
- Fibroids (uterine leiomyoma) or endometriosis
- Risk factors for blood clots
- Strong family history of breast cancer
- High blood pressure
- Liver disease, diabetes, gallstones
- Migraine or severe headaches
- Systemic lupus erythematosus (SLE)
- A history of endometrial hyperplasia
- Epilepsy, asthma, otosclerosis
- Fluid retention, heart or kidney disease
- Depression or mood disorders
- Photosensitivity
Treatment should be reviewed at least annually and continued only as long as the benefits outweigh the risks.
Side Effects
Not everyone gets side effects, but some women may notice drowsiness, dizziness or digestive upset, especially when starting treatment or if capsules are taken with food. Bedtime dosing can help.
Common side effects (may affect up to 1 in 10 people) include:
- Drowsiness / sleepiness, dizziness, headache
- Breast tenderness or breast pain
- Abdominal discomfort, bloating, nausea
- Changes in bleeding pattern:
- Irregular bleeding or spotting
- Heavier or lighter withdrawal bleed
- Changes to cycle timing (in perimenopausal women)
- Mood changes – low mood, anxiety, irritability, mood swings
- Weight fluctuation or fluid retention (swollen ankles/legs)
- Fatigue, feeling generally unwell
Less common / rare side effects reported include:
- Sleep disturbance, insomnia
- More marked depression or agitation
- Migraines or worsening headaches
- Palpitations or fast heartbeat
- Skin reactions (itching, rash, urticaria, acne, hair loss, increased sweating)
- Joint or muscle pain, back pain
- Vaginal discharge or discomfort, cramps, painful periods (in perimenopausal women)
- Liver-related problems such as cholestatic jaundice (itching and yellowing of skin/eyes)
- Very rarely, allergic reactions, including anaphylactoid reactions
When used as part of systemic HRT, there are known overall risks associated with combined oestrogen–progestogen therapy, including:
- A small increased risk of breast cancer with longer-term use
- A slightly increased risk of ovarian cancer
- A 1.3–3-fold increased risk of blood clots in the legs or lungs (VTE)
- A small increase in risk of ischaemic stroke and heart disease, particularly with age and other risk factors
These risks depend on age, personal risk factors, dose and length of HRT use, and should be discussed at regular reviews.
Seek urgent medical advice and stop treatment if you notice:
- Signs of a blood clot – painful swelling and redness in a leg, sudden chest pain, shortness of breath, coughing up blood
- Sudden severe headache, especially with vision changes, or new migraine-type headaches
- Yellowing of skin or eyes, dark urine, severe itching
- A new breast lump or nipple changes
- Sudden vision problems, double vision, or eye pain
- Sudden bleeding or very heavy bleeding, especially after being period-free for some time
Patient Information Leaflet
Please see HERE for the Patient Information Leaflet
Additional Info
Key points about Utrogestan 100 mg capsules:
- Active ingredient: Micronised progesterone 100 mg per capsule
- Use: Added to oestrogen HRT in postmenopausal women with a uterus to protect the womb lining and reduce the risk of endometrial cancer
- Route: Oral, taken at bedtime on an empty stomach
- Not a contraceptive: Does not prevent pregnancy and is not suitable for use as a pill
- Allergy warning: Contains soybean lecithin – people with peanut or soya allergy must not use it
- Driving and machinery: Because it may cause drowsiness or dizziness, extra care is needed when driving or operating machinery, especially when starting treatment
- Interactions: Progesterone can interact with medicines such as:
- Certain diabetes medicines (may alter blood sugar control)
- Anticoagulants (e.g. warfarin-type medicines)
- Ciclosporin, tizanidine, some statins, some antifungals, certain epilepsy medicines, some antibiotics, HIV medicines, and St John’s wort
Always tell your doctor or pharmacist about any other medicines or herbal products you use.
- Storage: Store in the original packaging, as directed on the carton, and keep out of the sight and reach of children
Directions
Utrogestan 100 mg capsules are taken by mouth at bedtime. Taking them away from food and in the evening helps reduce drowsiness and dizziness.
Standard regimens (with oestrogen HRT)
Your prescriber will choose one of two main schedules:
- Cyclical (sequential) regimen – most common
- 200 mg daily at bedtime (2 x 100 mg capsules)
- Taken for 12 days per 28-day cycle – usually Day 15 to Day 26
- Often used if you are early postmenopause and still expect a monthly withdrawal bleed
- Continuous (longer) regimen
- 100 mg daily at bedtime (1 x 100 mg capsule)
- Taken from Day 1 to Day 25 of each 28-day cycle
- A short break may be advised, depending on the regimen
- Tends to cause less bleeding but may still cause spotting or irregular bleeding, especially at the start
In both cases, the principle is that progesterone is added regularly each month alongside your oestrogen to protect the womb lining.
How to take the capsules
- Swallow the capsules whole with water, do not chew or open
- Take them at bedtime
- Take them on an empty stomach – they should not be taken with food, as food markedly increases progesterone absorption and may increase side effects such as drowsiness or dizziness
Missed a dose?
If you forget to take a dose at bedtime:
- If you remember within a few hours, take it as soon as you remember and continue as usual the next day
- If it is nearly time for your next dose, skip the missed capsule and take the next one at the usual time
- Do not take a double dose to make up for a missed capsule
Missing doses may increase the likelihood of breakthrough bleeding or spotting. If you miss several doses, or are unsure how to continue your cycle, ask your prescriber or pharmacist.
FAQs
What is Utrogestan 100 mg used for
Utrogestan 100 mg capsules provide natural progesterone as part of HRT for postmenopausal women with a uterus to protect the womb lining from oestrogen and reduce cancer risk, though they are not for solo use or contraception.
Why do I need Utrogestan if I’m already on oestrogen HRT?
Oestrogen alone causes the womb lining to thicken and increases cancer risk, so adding progesterone protects the lining and allows it to shed regularly, though it is generally unnecessary for those who have had a hysterectomy.
When will I bleed while taking Utrogestan?
Bleeding patterns depend on the regimen as the 12-day 200 mg cycle usually causes a monthly withdrawal bleed while the 25-day 100 mg cycle results in lighter bleeding or spotting, but any persistent new bleeding should be medically checked.
Do I have to take Utrogestan at bedtime and on an empty stomach?
It is recommended to take the capsules at bedtime on an empty stomach at the same time each night to reduce side effects like dizziness and to prevent an excessive spike in progesterone levels.
Will Utrogestan affect my mood or weight?
Some women experience mood changes like anxiety or irritability along with weight fluctuations and fluid retention, and if these issues persist, a dose adjustment may be necessary.
Is Utrogestan safer than synthetic progestogens?
Utrogestan uses micronised progesterone which is structurally identical to natural hormones and may have a more favorable risk profile for breast cancer compared to synthetics, though all combined HRT carries risks that require individual assessment.
Can I take Utrogestan if I have a peanut or soya allergy?
No, because Utrogestan contains soybean lecithin, anyone with a soya or peanut allergy must avoid this medicine and consider other progestogen options.
What should I do if I get new symptoms like chest pain, leg swelling or severe headaches?
If you experience chest pain, leg swelling, breathlessness, or severe new headaches, stop taking your HRT immediately and seek urgent medical advice from 24 HR Pharmacy or emergency services for an immediate assessment of potential serious side effects.
What They Say About Us...
Great service, the follow up phone call to ensure that I was getting the correct medication was appreciated. Would yes 24 HR Pharmacy again.
Excellent customer service and prompt communication. My enquiry was resolved quickly, and my order was delivered ahead of time.
The service I received was faultless. Sehar is very knowledgeable and supportive in her consultation. The service was quick and easy to use.