Pozdravljeni,

junij 2008 operacija mioma – laparoskopija z odprtim kavumom
junij 2011 operacija mioma – laparoskopija
junij 2012 zanositev IVF-ET – trenutno sem v 13.tednu nosečnosti

V 10.tednu nosečnosti sem zakrvavela. Kaj je vzrok krvavitve?
Imam pomisleke glede Utrogestana. Jemljem ga že od ET. Na GK LJ sem dobila Utrogestan za prvih 5 tednov, potem sem si ga kupila sama (prebrala na vašem forumu, da se lahko jemlje do cca 12.tedna oz. postopno zmanjšuj). V 9.tednu sem se odločila zmanjševati, zato sem jemala samo 1x na dan. V 10. tednu zakrvavela zvečer, ko sem pozno zvečer vzela eno tabletko je bil samo še rjav izcedek.
Ob pregledu pri ginekologu sem povedala to zgodbo, priporočal je da Utrogestan še kar jemljem do… (pozabila do katarega tedna???)
Sedaj jemljem Utrogestan 3x na dan.
V navodilih za uporabo sem prebrala da se Utrogestan jemlje do cca 12.tedna oz. ko posteljica prevzame vlogo progesterona in da slabo vpliva na jetra.

Kakšno je vaše mnenje glede mojega primera?

Hvala za odgovor in lep dan, Nataša

Spoštovani,

o tem, do kdaj bi se naj jemalo progesteron kot premostitev morebitne odpovedi rumenega telesca, ni enotnega stališča med strokovnjaki. Glede na to, kdaj tkivo posteljice začne in izloča že visoke odmerke progesterona, bi lahko z dodatkom Prometriuma ači Utrogestana prenehali že pri največ 8 tednih, vseeno nekateri še vedno predpisujejo progesteron tudi po tem. Jetrom ne škodi, imajo pa jetra z njim seveda nekaj dela, kajti vse kar pride iz črevesja v telo, gre najprej skozi jetra. Glede na to, da ste noseči že več kot 12 tednov, mislim, da lahko počasi nehate z Utrogestanom.

Spoštovani,

zahvaljujem se vam za hiter odgovor ter vas prosim za mnenje.

Ker me je strah krvavitev in grozečega splava, bi želela Utrogestan jemati še naprej… Namreč, po forumih sem prebirala, da so ginekologi v primeru krvavitev ali kakršnihkoli zapletov takoj predpisali Dabroston ali Utrogestan in počivanje. Kaj pravite, je Utrogestan lahko rešitev pred nepojasnjenim splavom?

Hvala za odgovor in lep dan, Nataša

ne, pred nepojasnjenim splavom progesteron ne rešuje. Progesteron rešuje le pred “pojasnjenim” splavom, ki ga povzroča prezgodnje popuščanje rumenega telesca, to pa je pred 7. tednom nosečnosti. Čim se vidijo plodovi utripi, progesteron v bistvu ničesar več ne rešuje. Ponovno pridobi na pomeni po 20. tednu, vendar le pri ženskah s popustljivim MV ter pretirano aktivnostjo maternice.

Pozdravljeni,

imam vprašanje glede utrogestana 100 mg kapsule.
ko sem bila v postopku umetne oploditve v LJ (IVF) sem si jih takrat po navodilih ginekologinje dajala vaginalno,3×2 kapsuli na dan, eno skatlico pred ET in še 3 škatlice po 30 kapsul, po ET (isti odmerek).
potem sem v 8 tednu zakrvavela (grozeči splav), bila 4 dni v bolnici in dobila Dabroston tablete, imela sem tudi hiperstimulacijo.
potem se je stanje umirilo, ampak sem trenutno se kar v bolniški.
zdaj sem že v 19. tednu nosečnosti, in bila sem na pregledu v pon. čez 3 tedne pa imam morfologijo.
na tem pregledu je z UZ ginekologinja ugotovila, da se maternica ne širi tako kot bi se mogla in mi predpisala te iste kapsule (Utrogestan 100 mg) 2kapsuli x 2krat na dan v nožnico, je rekla za vsak slučaj.v izvid pa je napisala bolečine v spodnjem delu telesa, ki sem jih pa res imela.
no tokrat sem se malo bolj pozanimala o teh kapsulah, ker sem v dilemi ali bi jih sploh jemala, plačala sem jih sama, dve škatlici 17 EUR, pa še v MB sem morala po njih.
glede navodil: v proizvajalčevih navodilih piše, da se te kapsule 100 mg uporabljajo le oralno. zdaj pa ne vem v čem je fora, da pa vsi ginekologi predpisujejo te kapsule, da se dajajo v nožnico, čeprav v navodilih (ki so samo v nem.jeziku) piše (Kapseln zur oralen Einnahme) torej oralno. kje piše, da jih lahko vstavljam v nožnico in da bo to delovalo.
najdla sem tudi navodila v angleščini: Utrogestan (progesteron) How does it work?

Utrogestan capsules contain the active ingredient progesterone, which is a naturally occurring female sex hormone. This medicine is used in combination with another sex hormone oestrogen, for hormone replacement therapy in women who have an intact uterus.

Women’s ovaries gradually produce less and less oestrogen in the period up to the menopause, and oestrogen blood levels decline as a result. The declining levels of oestrogen can cause distressing symptoms, such as irregular periods, hot flushes, night sweats, mood swings and vaginal dryness or itching.

Oestrogen can be given as a supplement to replace the falling levels in the body and help reduce these distressing symptoms of the menopause. This is known as hormone replacement therapy (HRT). HRT is usually only required for short-term relief from menopausal symptoms and its use should be reviewed at least once a year with your doctor.

Progesterone is needed as part of HRT for women who have not had a hysterectomy. This is because in women with an intact womb, oestrogen stimulates the growth of the womb lining (endometrium), which can lead to endometrial cancer if the growth is unopposed. Progesterone is given to oppose oestrogen’s effect on the womb lining and reduce the risk of cancer, though it does not eliminate this risk entirely. This is known as combined HRT.

An oestrogen supplement is taken on a continuous basis for HRT. Utrogestan tablets are then taken in one of two ways each month to oppose the effect of the oestrogen on the womb lining.

Either one 200mg Utrogestan capsule is taken once daily at bedtime for 12 days in the latter part of a 28 day cycle, ie from day 15 to day 26. This usually results in a withdrawal bleed (similar to a period) the following week.

Alternatively, one 100mg Utrogestan capsule can be taken once daily at bedtime on days 1 to 25 of each 28 day cycle. This usually causes less withdrawal bleeding.
What is it used for?

Part of hormone replacement therapy (HRT) for menopausal women who have not had a hysterectomy and are taking an oestrogen hormone supplement.

Warning!

Utrogestan capsules should be taken on an empty stomach at bedtime.
The capsules may cause some women to feel dizzy or drowsy, which is why they are best taken at bedtime. You should avoid driving or operating machinery if affected.
Women taking any form of HRT should have regular medical and gynaecological check-ups. Your need for continued HRT should be reviewed with your doctor at least once a year.
It is important to be aware that all women using HRT have an increased risk of being diagnosed with breast cancer compared with women who don’t use HRT. This risk needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. You should discuss these with your doctor before starting HRT. Women on HRT should have regular breast examinations and mammograms and should examine their own breasts regularly. Report any changes in your breasts to your doctor or nurse.
It is important to be aware that women using HRT have a slightly increased risk of stroke and of blood clots forming in the veins (eg deep vein thrombosis/pulmonary embolism) compared with women who don’t use HRT. The risk is higher if you have existing risk factors (eg personal or family history, smoking, obesity, certain blood disorders) and needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. Discuss these with your doctor before starting treatment.
The risk of blood clots forming in the veins (thromboembolism) while taking HRT may be temporarily increased if you experience major trauma, have surgery, or are immobile for prolonged periods of time (this includes travelling for over five hours). For this reason, your doctor may recommend that you stop taking HRT for a period of time (usually four to six weeks) prior to any planned surgery, particularly abdominal surgery or orthopaedic surgery on the lower limbs, or if you are to be immobile for long periods. The risk of blood clots during long journeys may be reduced by appropriate exercise during the journey and possibly by wearing elastic hosiery. Discuss this with your doctor.
Stop taking this medicine and inform your doctor immediately if you experience any of the following symptoms while taking this medicine: stabbing pains or swelling in one leg; pain on breathing or coughing; coughing up blood; breathlessness; sudden chest pain; sudden numbness affecting one side or part of the body; fainting; worsening of epilepsy; migraine or severe headaches; visual disturbances; severe abdominal complaints; increased blood pressure; itching of the whole body; yellowing of the skin or eyes (jaundice); or severe depression.
A woman is considered fertile for two years after her last menstrual period if she is under 50, or for one year if over 50. HRT does not provide contraception for women who fall within this group. If a potentially fertile women is taking HRT but also requires contraception, a non-hormonal method (eg condoms or contraceptive foam) should be used.

Use with caution in

High blood pressure (hypertension).
Heart disease, such as angina or heart failure.
Decreased kidney function.
Mild to moderately decreased liver function.
Epilepsy.
Asthma.
Women who suffer from migraines.
Women with a history of depression.
Diabetes.
Women whose skin is sensitive to light (photosensitivity).

Not to be used in

Known or suspected pregnancy.
Severely decreased liver function.
Women with a history of blood clot in a vein (venous thromboembolism), eg in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism).
History of inflammation of a vein caused by a superficial blood clot (thrombophlebitis).
Women who have had a heart attack.
Women who have had a stroke caused by a blood clot.
Women with a history of bleeding in the brain (cerebral haemorrhage).
Abnormal vaginal bleeding of unknown cause.
History of cancer involving the genital tract.
History of breast cancer.
Hereditary blood disorders known as porphyrias.
Women allergic to peanuts or soya (Utrogestan capsules contain arachis oil and soya lecithin).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be taken during pregnancy. If you think you could be pregnant while taking this medicine you should stop taking it and consult your doctor immediately.
Small amounts of this medicine may pass into breast milk; there are no conditions that require the use of HRT by breastfeeding mothers. tudi to ne razumem, v nosečnosti se naj nebi jemale?

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Sleepiness.
Dizziness.
Breast tenderness.
Change in menstrual bleeding.
Menstrual spotting or breakthrough bleeding.
Skin reactions, such as rashes, itching and acne.
Retention of water in the body tissues (fluid retention).
Changes in weight.
Disturbances of the gut, such as upset stomach, bloating.
Pre-menstrual symptoms.
Depression.
Hair loss (alopecia).
Decreased sex drive.
Excessive hair growth on the face and body (hirsutism).
Irregular brown patches on the skin, usually of the face (chloasma). If you experience this you should minimise your exposure to the sun or UV light while taking this medicine.
Blood clots in the blood vessels (eg, DVT, pulmonary embolism, heart attack, stroke – see warnings above).

How can this medicine affect other medicines?

It is 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 treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

The following medicines may increase the breakdown of this medicine in the body, which could make it less effective:

antiepileptic medicines, eg phenytoin, phenobarbital, primidone, carbamazepine, oxcarbazepine, topiramate
aprepitant
barbiturates
bosentan
griseofulvin
modafinil
nelfinavir
nevirapine
ritonavir
rifampicin
rifabutin
the herbal remedy St John’s wort (Hypericum perforatum).

This medicine may decrease the blood level of the antiepileptic medicine lamotrigine.

This medicine may increase the blood level of the immunosuppressant ciclosporin.
Other medicines containing the same active ingredient.

ne vem kam naj se obrnem po nasvet glede teh kapsul, v lekarni mi rečejo naj se držim zdravnikovih navodil, ginekologinja pa mi prepiše naj jih jemljem vaginalno, čeprav tega ni v navodilih.

zakaj ginekolog predpiše da se to zdravilo lahko uporablja tudi vaginalno, čeprav tega ne piše nikjer v proizvajalčevih navodilih, počutim se kot da sem eden izmed poskusnih zajcev in da naši zdravniki talajo tablete kot bonbone.

tablet še nisem začela jemati, ker še zdravnica sama najprej ni vedela ali bi mi jih predpisala, potem pa se je odločila, no pa dajmo še dve škatlice Utrogestana.

vnaprej se vam zahvaljujem za vaše mnenje ter nasvet glede pravilne uporabe Utrogestana 100 mg v kapsulah.

Ali bi jih po vašem mnenju sploh morala jemati?

Hvala in lep pozdrav

Spoštovani,

omenjene kapsule ginekologi oziroma perinatologi predpisujemo “off label”, kakor se imenuje predpisovanje zdravila izven okvira, v katerem je bilo registrirano in registrirano je bilo le za nadomestno hormonsko terapijo. Ker gre za čisti progesteron, ni utemeljenega razloga, da bi bilo zdravilo prepovedano v nosečnosti, kajti tudi posteljica proizvaja velike količine progesterona. Proizvajalec je pač navodila zapisal v skladu z registracijo in s tem odgovornost za morebitne zaplete ob drugačne uporabi preložil na uporabnike oziroma predpisovalce. Z vaginalno uporabo omenjenih hormonov imamo zelo dobre izkušnje, kajti vsrkanje je boljše, učinkovina gre pri prvem prehodu po telesu mimo jeter, ki ga sicer 90% odstranijo še preden pride do maternice in takšna uporaba vodi tudi do manj sopojavov, zlasti z utrujenostjo in slabostmi, vrtoglavico ipd. Skratka, zaradi predpisanega zdravila kot tudi predpisanega načina uporabe zdravila ste lahko povsem brez skrbi.