How to Use Utrogestan and Gepretix (Micronised Progesterone) as Part of HRT
Article written by Dr Mari Walling, British Menopause Society Registered Specialist, GP, Co-founder of Lemala Health, November 2025 This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personal guidance.
This article covers what micronised progesterone is, why it is used, how to take it, and what to expect from Utrogestan and Gepretix.
Hormone Replacement Therapy (HRT) is used to relieve symptoms of perimenopause and menopause by replacing key hormones, including oestrogen and progesterone.
At Lemala Health, we aim to make hormone therapy safe, understandable, and personalised.
What is Micronised Progesterone?
Micronised progesterone is chemically identical to the progesterone naturally produced by the ovaries. It is referred to as body-identical because it mimics the hormone your body makes after ovulation.
Two commonly prescribed forms of progesterone in the UK are Utrogestan and Gepretix.
Why Take Progesterone as Part of HRT?
If you have a womb (uterus), progesterone is essential when taking oestrogen. Oestrogen alone can cause the womb lining to thicken, which increases the risk of abnormal cells or womb cancer. Progesterone prevents this by keeping the lining thin.
Even women without a uterus may sometimes be prescribed progesterone - for example, after a hysterectomy for endometriosis - to protect any remaining endometrial-like tissue.
How to Take Utrogestan or Gepretix
These medications are only available on prescription and are usually taken at night, as they can cause drowsiness. They may be taken on an empty stomach or with food.
The case of the capsule contains soy and gelatin. If you have a severe nut allergy, some women are allergic to soy and so these may not be suitable for you.
The gelatin is usually of bovine origin and therefore not suitable for vegans/vegetarians.
Gepretix is now certified halal and kosher, as the bovine gelatin used in the capsule shell has been certified by the manufacturer. While the certificates are not publicly available, they can be requested directly from Exeltis, the manufacturer.
The dose and schedule of micronised progesterone will be individual to you. Your prescriber will determine whether it is best taken:
Cyclically: Typically taken for two weeks, followed by a two-week break
Continuously: Every day without a break
Always follow the dose and schedule prescribed by your doctor to ensure protection of the womb lining. The dose may also be adjusted if you experience bleeding while on HRT.
What are the advantages?
Micronised progesterone is body identical, and evidence suggests lower risks compared with older, synthetic types of progestogens:
Blood clots: micronised progesterone does not increase the risk of blood clots.
Breast cancer: studies show no increased breast cancer risk during the first five years of use, and after this, any risk remains very low.
What are the side-effects ?
Drowsiness is one of the most common side effects. Many women experience poor sleep around menopause, so taking it at night can be helpful.
Other side effects may include low mood, bloating, or breast tenderness. These usually settle within 8–12 weeks.
Bleeding can also occur when starting micronised progesterone. This typically improves within 3–6 months. If you experience heavy bleeding or new bleeding after six months, contact your GP or menopause specialist.
Some women experience symptoms suggesting intolerance to progestogens. In these cases, micronised progesterone can sometimes be taken vaginally. This is an off-licence option, but uses the same dose and tablet. Your specialist can discuss whether this may be suitable.
Ongoing Care
Women taking HRT should have an annual review with their healthcare provider to ensure the treatment remains safe and effective.
Further Support
At Lemala Health, we offer online consultations across the UK for menopause and women’s health. We can guide you on how to take Utrogestan, Gepretix, or alternative HRT options safely and effectively.
References:
NICE. Menopause: Diagnosis and Management (NG23).
British Menopause Society. Progestogens and Endometrial Protection (2023).
British Menopause Society. HRT and Breast Cancer Risk (2022).
MHRA. Utrogestan Capsules - Summary of Product Characteristics.
MHRA. Gepretix Capsules - Summary of Product Characteristics.
Stute P., et al. Micronised Progesterone and Endometrial Protection (Climacteric, 2016).
Stute P., Wildt L., Neulen J. Micronised Progesterone and Breast Cancer Risk (Climacteric, 2018).