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[mairmicate]

Hi there, I had breast cancer at age 25, over 18 years ago (not genetic) and was told by my oncologist at the time that I had to stop taking the Pill and also to never go on HRT.  When I was 37, my ovary failed (I'd had the other one out when I was 14 due to a large dermoid cyst destroying it) and I began going through menopause.  I'd never had chemo so it was nothing related to the breast cancer.  I knew I couldn't do HRT so I suffered through it for the last 5 or more years.  But a bone x-ray last year revealed I have osteopenia, the precursor to osteoporosis so I saw an endocrinologist who recommended that I try Estalis 50/250 patches, which I've been on since mid-Dec.  On 8 Jan, I started bleeding again and have not stopped...  I know it's normal to have a bit of spotting in the first 6 mths of being on HRT but this is now over two weeks and it's really starting to concern me.  It's like a normal period, something which I haven't had since late 2007!  When will it stop?!  I've gone back to the GP and also my breast specialist and they believe I should just halve the patches.  I did that the other day but the bleeding is still going on.  I'm over this!  Also, my ankles turned into cankles on Mon last week and that is something I've never suffered from in my life.  Starting to wonder if the HRT was a bad idea now...   Anyone else here experienced such a long bleed when starting HRT patches? 

[Cassie]

Sorry to hear about your struggles. From what I can gather Estralis 50/250 is the conti type of HRT, apparantly one can get bleeds on this in the beginning phase. At your age, I would chat to your Dr about a HRT that gives you a monthly bleed rather and that should regulate things, what about trying the gel as you can start off with as little as one pump and build up to 2 or 3 from there and use a separate, more natural progesterone, like Utrogestone. The progesterone in your patch is a synthetic one and can cause plenty of water retention. Bear in mind, that you have not been on HRT for many years and your body will take time to adjust, but I would give things time and then discuss with your Dr if you are not happy on this one, it can several attempts, to find the right HRT for your body, there are lots out there, so dont give up... all the best..

[mairmicate]

Thanks for your reply, Cassie, I think the doc put me on the continuous HRT as it's been over 6 years since I had a period. I'm most definitely post-menopausal. I went through the perimenopause a long time ago so there was not much point putting me on the cyclic one, which I understand is given to women going through peri.  I suppose I'll just wait and see if halving the patches makes any difference. 

[Taz2]

Hi mairmicate 

As has been said conti HRT can lead to bleeding in some women. I had constant bleeding on Femseven Conti and gave up after six months and went on to a sequi one as at least I knew then when a bleed would occur.

I do think you should get our cankles checked out though even though swelling of the legs is down as a side effect - that might be just me being cautious though. Let us know how you get on.

Taz x

[Cassie]

I hear you but I still think,being so young a sequi type hrt may suit you better and have less side effects, hope that you soon feel much better.. x

[CLKD]

What type of breast cancer did you have treatment for?  Mine was oestrogen dominant so I was told to avoid HRT if at all possible.  Fortunately,  so far, I haven't required much in the way of treatment. 

Quality of Life over quantity?  Can't see the point in suffering like you have when there is treatment avaialble.  It is of course, important to find a treatment which suits you!

[mairmicate]

Yes my tumour was also estrogen positive - hence why the oncologist warned me to never go on HRT - however, I was expecting menopause to happen at around age 50, not 37, only 12 years later.

I agree, re: quality of life vs possible risks... that's why I finally relented.  I couldn't take menopause any more... uggh.  I just hope I've made the right decision.  The cankles are better now, I bought some support hose (very attractive!) and kept my feet up for a couple of days.  Also took some celery seed capsules which I think helped. 

I'm still bleeding today, and it's still heavy, just like a normal period.  It's now been 2 1/2 weeks... if it doesn't stop soon I'll go back to GP.  My endocrinologist is on holidays til next week and she's booked up til April, so it will be difficult to get in to see her.

[CLKD]

Go back to your GP anyway.  There is a drug which can ease heavy bleeding.

I too had surgery: lumpectomy - twice in a week  : full body scan followed by radiation treatment for 4 weeks.  Then Tamoxifen which made me really really ill so stopped after 3/4 months.  That was in 1996.  Fortunately I haven't had hot flushes <PHEW> but did have atrophy symptoms 12 months ago so use Ortho-gynest pessaries.

[Sarah2]

There is no hard and fast rule about whether to have a no bleed or bleed type of HRT although  most GPs do stick to the 'rule' of no bleed for women post meno.
I have cyclical HRT and am 58, 4 years post meno. I prefer it this way and so does my gynae.
There is some evidence that cyclical HRT with a bioidentical progesterone is safer re. breast cancer than continuous combined HRT, especially with synthetic progestogens.

I'd discuss all of this with your specialist and if they don't know, suggest tactfully they research the papers out there on it.

[CLKD]

Ovacome web-site may be able to advise too, or send a personal message to Dr Currie here .........

[mairmicate]

It's been a while since I posted an update, so here goes:  I had to come off the patches as the bleeding was continuing and it would go for weeks on end.  The patches started turning my skin red raw and itchy as well, so something had to be done.  The endocrinologist has now advised that I go on straight estrogen gel and get a Mirena IUD put in to deliver the progestin.  I had to go and have an transvaginal ultrasound to determine why I was bleeding so much and it showed that I have a thickened endometrium which now requires a D&C to rule out endometrial hyperplasia. I'm so over this sh*t!  So I'm booked in for the D&C and Mirena insertion next Thursday.  Uggh.  I'm worried about all the scary stories out there about the Mirena.  Don't want that crap happening to me  

[Sarah2]

Try not to worry. For every one scary story about the Mirena there is another woman who is thrilled with it and doesn't bother to go onto a forum to say so- I know someone who has one and she loves it. Unfortunately, on forums you tend to only hear people complaining not singing the praises of something!

I hope the investigation goes well. I'm a bit surprised they are doing a D&C straight off because the can sample the endometrium with an out patient biopsy which is around 98% accurate- do you know what thickness your lining is because that may have been a deciding factor.

[CLKD]

You are getting sorted!  The Mirena can be removed if necessary.  Have you done a 'search' here? and read the menus, left of screen to see how others do?

Good Luck for next week.  By then I will be recovering from a visit to Mum  so everything else will be out of mind, it's not that I don't care ........ 

[mairmicate]

Yes, endo thickness was around 6mm and in a post meno woman that is 'of concern' as the report put it!

All I can feel is a heavy, aching feeling in my lower gut, the exact same feeling I got before my period used to arrive.  It's bloody horrible and I'm over it.  Bring on Wednesday the 2nd April!

Cheers

Mary

[Sarah2]

Try not to worry.
It's funny how all drs work in a different way. I have had a 6mm lining since starting HRT 5 years ago- and it's always been 'acceptable' to my consultant, because the thresholds can be higher for women on HRT. I've had 2 biopsies along the way because I had some spotting. I am sure that I read ( or was told by the radiologist) that a lining of up to 10mm can be considered 'normal' for women on HRT, as long as it shows a normal pattern of the lining with nothing suspicious.

Good luck on the 2nd and hope all turns out well.

x