Utrogestan Capsules

What is Utrogestan?

Utrogestan is a hormone replacement therapy medication containing progesterone as its active ingredient. Progesterone is a female sex hormone naturally produced by the ovaries during the menstrual cycle. In menopause, when ovarian function declines, progesterone levels decrease along with estrogen.

Mechanism of Action

Think of estrogen as the hormone that "builds up" the lining of the womb (endometrium), while progesterone is the hormone that "sheds" this lining. During a natural menstrual cycle, estrogen thickens the womb lining in preparation for potential pregnancy, while progesterone stabilizes this lining and causes it to shed if pregnancy doesn't occur (resulting in a period).

In menopause HRT, estrogen is given to relieve symptoms like hot flushes and vaginal dryness. However, estrogen alone can cause excessive thickening of the womb lining (endometrial hyperplasia), which increases the risk of womb cancer. Utrogestan provides the progesterone component that counteracts this effect by:

1. Transforming the estrogen-stimulated endometrium from a proliferative to a secretory state
2. Inducing regular shedding of the womb lining (withdrawal bleed)
3. Protecting against endometrial hyperplasia and cancer

This biological pathway ensures that women with a uterus who take estrogen HRT also receive adequate progesterone protection for their womb lining.

What is Utrogestan Used For?

Utrogestan is specifically indicated as part of hormone replacement therapy (HRT) for women experiencing menopause who still have their uterus (womb).

Approved Indications

Utrogestan is used in combination with systemic estrogen therapy for:

• Treatment of estrogen deficiency symptoms in menopausal women with an intact uterus
• Prevention of endometrial hyperplasia (excessive thickening of the womb lining) that can occur with unopposed estrogen therapy
• Induction of regular withdrawal bleeding in sequential combined HRT regimens

Target Patient Population

Utrogestan is appropriate for:

• Menopausal women with an intact uterus experiencing symptoms of estrogen deficiency
• Women with premature menopause (due to ovarian failure or surgery)
• Women starting HRT within 10 years of menopause onset (typically aged 50-59)

Utrogestan is not indicated for:

• Women without a uterus (who have had a hysterectomy)
• Pre-pubescent children or adolescents
• Men
• Contraceptive purposes
• Treatment of infertility

Before Using Utrogestan

Before starting Utrogestan as part of HRT, a thorough medical assessment is essential to ensure the benefits outweigh the risks for your individual situation, as recommended by the official product information.

Medical History Assessment

Your clinician will review your complete medical history, including:

• Personal history: Previous cancers (especially breast, ovarian, or endometrial), blood clots, liver disease, heart disease, stroke, migraine with aura, diabetes, epilepsy, asthma, lupus, porphyria, depression
• Family history: Breast cancer in first-degree relatives (mother, sister, daughter), inherited blood clotting disorders, cardiovascular disease
• Gynecological history: Menstrual pattern, previous abnormal vaginal bleeding, endometriosis, uterine fibroids, ovarian cysts
• Lifestyle factors: Smoking status, alcohol consumption, BMI, physical activity level

Required Baseline Tests

Before starting HRT, your clinician may recommend:

• Blood pressure measurement - to establish baseline cardiovascular status
• Breast examination - clinical breast exam and up-to-date mammogram if appropriate for your age
• Liver function tests - if there's suspicion of liver disease
• Lipid profile - to assess cardiovascular risk
• Endometrial assessment - if there's abnormal vaginal bleeding or other risk factors for endometrial pathology

Utrogestan Contraindications

Utrogestan must not be used in certain medical conditions due to potentially serious risks, as outlined in the NHS guidelines.

Absolute Contraindications

Do not take Utrogestan if you have any of the following conditions:

Relative Contraindications (Use With Caution)

Utrogestan may be used with caution and careful monitoring in:

• Migraine with aura - increased stroke risk
• Severe hypertension - uncontrolled high blood pressure
• Hypertriglyceridemia - very high blood fat levels
• Gallbladder disease - may worsen symptoms
• History of depression - may exacerbate mood symptoms

Special Population Considerations

Elderly Patients

Women over 65 starting HRT have an increased risk of:

• Dementia: Some evidence suggests higher risk when starting HRT after age 65
• Stroke: Age increases baseline stroke risk, further elevated by HRT
• Venous thromboembolism: Risk increases with age

For women over 65, HRT is generally not recommended for initiation but may be continued if already established with clear benefit and regular review.

Renal Impairment

No specific dosage adjustment is needed for renal impairment, but careful monitoring is advised as progesterone metabolites are excreted renally.

Hepatic Impairment

Utrogestan is contraindicated in active liver disease or severe hepatic impairment because progesterone is extensively metabolized in the liver. Mild to moderate impairment requires careful monitoring of liver function.

Utrogestan and Other Medicines

Utrogestan may interact with other medications, affecting their effectiveness or increasing side effects.

High-Risk Medication Combinations

Timing Recommendations

To minimize interactions:

1. Space administration: Take Utrogestan at least 2 hours before or after medications known to interact
2. Evening dosing: Taking Utrogestan at bedtime can minimize daytime drowsiness and interactions with daytime medications
3. Regular monitoring: Have blood tests as recommended when taking interacting medications

Pregnancy & Breastfeeding

Pregnancy

Utrogestan is not indicated for use during pregnancy. It is specifically for postmenopausal women. If you are perimenopausal (still having periods or within 12 months of your last period), you may still be fertile and should use appropriate contraception if pregnancy is not desired.

Breastfeeding

Utrogestan is contraindicated during breastfeeding. Progesterone is excreted in breast milk, and the effects on the nursing infant are unknown. Utrogestan should not be used by lactating women.

Driving & Machine Operation

Impairment Potential Assessment

Common central nervous system effects that may affect driving ability:

• Drowsiness: Reported in up to 10% of users
• Dizziness: May affect balance and coordination
• Fatigue: Reduced alertness and reaction time
• Visual disturbances: Rare but potentially serious

Safety Recommendations

1. Bedtime administration: Take Utrogestan at bedtime to minimize daytime drowsiness
2. Initial period caution: Be particularly careful during the first week of treatment and after any dose increase
3. Individual response: Do not drive or use machinery until you know how Utrogestan affects you

Utrogestan Ingredients

Active Ingredient

• Progesterone: 100mg per soft capsule

Excipients (Inactive Ingredients)

How to Use Utrogestan

Step-by-Step Administration

1. Check prescription: Confirm you have the correct medication (Utrogestan 100mg capsules)
2. Timing: Take at bedtime to minimize daytime drowsiness
3. Preparation: Have a glass of water ready
4. Administration: Swallow the capsule whole with water - do not chew, crush, or break
5. Without food: Take on an empty stomach for optimal absorption (at least 1 hour before or 2 hours after food)
6. Consistency: Try to take at the same time each evening during your treatment days

Utrogestan Dosage Guidelines

Standard Dosage Regimens

Titration Schedule

Utrogestan is typically started at the recommended dose. Your clinician will aim to prescribe the lowest effective dose for the shortest necessary duration.

Administration Instructions

Oral Administration Technique

1. Remove the capsule from the blister pack just before taking
2. Place the capsule in your mouth
3. Take a sip of water (approximately 200ml)
4. Swallow the capsule whole without chewing
5. Do not take with food - wait at least 1 hour after eating or 2 hours before eating

Timing with Other Medications

• Estrogen HRT: Take at the same time as your estrogen medication
• Interacting medications: Space at least 2 hours apart from enzyme inducers/inhibitors

Missed Dose Management

Time-Based Guidance

Overdose Information

Symptoms of Overdose

• Common: Drowsiness, dizziness, sleepiness, fatigue
• Possible: Nausea, vomiting, abdominal discomfort
• Rare: Confusion, respiratory depression (with very high doses)

Management Protocol

1. If conscious and alert: Contact your doctor or pharmacist for advice
2. If symptoms severe: Go to the nearest hospital emergency department
3. Bring medication: Take the Utrogestan pack with you to hospital
4. Supportive care: Treatment is symptomatic - no specific antidote exists

In case of suspected overdose, call the UK National Poisons Information Service at 111 or seek immediate medical attention.

Possible Side Effects

Very Common (more than 1 in 10 people)

• Headache
• Breast pain/tenderness
• Abdominal pain/swelling
• Nausea
• Irregular vaginal bleeding
• Weight changes
• Tiredness, dizziness, drowsiness

Common (1 in 10 to 1 in 100 people)

• Depression, mood swings, anxiety
• Migraine
• Hot flushes
• Diarrhoea, constipation, vomiting
• Acne, hair loss, itching, rash
• Joint/muscle pain
• Vaginal discharge
• Fluid retention

Serious Side Effects

How to Store Utrogestan

Storage Conditions

• Store below 25°C
• Keep in original blister pack and outer carton
• Protect from light and moisture
• Keep out of sight and reach of children

Disposal

• Do not dispose of medications via wastewater or household waste
• Return unused or expired medication to your pharmacy for proper disposal
• Follow local regulations for medication disposal

Pack Information

Pack Sizes

• 30 capsules (one month supply for 100mg daily regimen)
• 90 capsules (three month supply)

Components

• Soft gelatin capsules containing progesterone
• Blister strips in cardboard cartons
• Patient information leaflet

Appearance

• Soft, oval, opaque white capsules
• No specific markings on capsules

Where Can I Buy Utrogestan Online in the UK