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[Jolly]

Hello,
I'm new to the forum. I have been on bioidentical hrt (Estradiol & utrogestan 100mg) for 8 months. I am 53 but it took a year to convince my GP that my memory loss was so bad I couldn't function without trying hrt. He tried to give me Premarin but I had read Proff Studds website and posts on this site and knew that wasn't what I wanted. I feel a million times better on hrt but my monthly bleed is very heavy and 25 days of the month. I had previously had heavy periods and didn't pursue a hysterectomy as I thought if I persevered it would finally end. I hadn't thought At that time that I would need hrt. My GP says I'm too old to be referred for a hysterectomy    I have been taking the utrogestan 100mg 7 days a month as per Proff Studd recommendations but would like advice on what I can do to stop the bleeding. I don't mind a monthly normal bleed but continuous bleeding is making me miserable and affecting my sex life - which I'd only just got .
back!
Any advice would be much appreciated. PS I think it's terrible that GPs know so little About bioidentical HRT

[Diamonds and pearls 53]

Hello Jolly and welcome to the forum,everyone is very friendly here and there is a wealth of information to be accessed too. What dose of oestrogen are you taking alongside the Utrogestan 100 mg and how long have you been bleeding for?
Diamonds and pearls x

[Cassie]

It sounds like you are not getting enough Utrogestan. 7 days on 100mg is really not the standard dose, although I know that the Proff does sometimes prescribe that for his patients. I am currently on 100mg x 12 days a month. Perhaps, if you change to the 200mg for the 12 days per month and use it vaginally, see how that goes. It would be a good idea to get a scan of your uterus, to see what is causing the bleeding and how thick your lining is and you can then decide to perhaps take Utrogestan either continuously throughout the month, or to double your dosage and see if that does not control the bleeding. Good luck.

[Sarah2]

As D&P asked, how much oestrogen are you using?

First, your previous heavy periods are probably not connected to this bleeding if they have stopped altogether. You are now creating 'artificial' bleeds by using hormones. Your dr was right in a way to say that at 53 you don't need a hysterectomy for heavy periods because either they have already stopped or will do very soon. How long is it since you had a natural period?

I think you are not getting enough progesterone.

100mgs x 7 days is the absolute bare minimum and is really for women who are so progesterone-intolerant they cannot take any higher dose.

This is not the 'normal' dose and is usually only used by women who can access scans ( usually privately) to check the uterine lining for hyperplasia, maybe once a year.

I use gel and Utrogestan. My consultant suggests 10-11 days of Utrogestan 200mgs once a month or every 4-6 weeks, or a minimum of 15 days x 100mgs once a month . You are having less than half of this.

Your lining will be building up because you are not taking enough progesterone to counteract it, but the little you are taking will be in your system and when the levels fall ( in between taking the tablet each day) it will be enough to promote a withdrawal bleed.

This is why you are bleeding almost all the time- which is not acceptable!

NOTE - Cassie posted while I was typing so we are both saying the same thing!

[Jolly]

Thank you very much for your replies. I am taking two pumps of estradiol daily. I wish my GP knew more about Bioidentical HRT so he could advise me. As Professor Studds website is so accessible I just took his advice on the utrogestan dosage. Before starting hrt I had had two periods in the previous 10 months. The menopause had a drastic effect on me, not just low sex drive, vaginal dryness, etc but my memory was so bad that I had my car insured with two companies (I forgot I'd done this) and couldn't hold down a conversation as I forgot words or just stopped halfway through a sentence. I truly thought I had dementia and it has had a detrimental affect on my career. Hrt has changed my life so much for the better and I can't imagine life without it. I will try taking the utrogestan for longer each month. Thanks again for your posts I really appreciate it.

[Sarah2]

What you need to remember about Studd's website is that it's there to be used, presumably, in conjunction with being under his care- so he can pick up any issues if there are any. It has its limitations as   'prescribing advice' for anyone going through their own non-specialist dr because Studd is recommending doses that are not the norm.  His suggestion of 7 days of Utrogestan is really for women who are so  intolerant of it that they have no other options. There are variations on Utrogestan and all the progestins (I am on long-ish cycle HRT and for 5 years was taking progestins every 10-11 weeks) which is not the 'norm' for women post meno, but this is through my consultant and have access to scans if anything looks worrying!
Another point worth mentioning is that Utrogestan is poorly absorbed, orally, and this is another reason for erratic bleeding on it.
 So if you take 100mgs you might not absorb the full amount- which means you are getting less than you think over the 7 days.

Anyway- good luck and hope that you see some improvement.

[Diamonds and pearls 53]

Hi Jolly, both Sarah and Cassie have given you good advice-would just like to say Good luck and hope things improve for you. Do let us know how you get on.

Diamonds and pearls x