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[MichelleBerko]

I've been taking Elleste Duet Conti for over a year without problems, then about 2 weeks ago I started getting a constant, light but clotty bleed.

I can't get to my GP for a week, so wondered if anyone had pearls of wisdom in the meantime?

I've only had a couple of breakthough bleeds before, when I've taken my pill very late, but nothing like this.

The only change I can think of is my GP increased my daily dose of Thyroxine 2 months ago from 75 to 100. Could that contra the HRT?

My diet and health are otherwise normal.

Help or comments would be appreciated.

[Taz2]

Hi Michelle - can't help with the problem but wanted to welcome you to the forum. I'm sure someone else will be along soon with more practical help.

Taz x 

[peegeetip]

Hi

I think we touched on this before.

Do you take your Thyroxine and HRT at the same time?

 

[Hurdity]

Hi MichelleBerko

  from me too!

There is a thread here about women taking HRT and thyroxine where it is discussed:
http://www.menopausematters.co.uk/forum/index.php/topic,26312.30.html

This is part of one of my posts on that thread where I looked up some info:

"My notes say - 'oral oestrogen/HRT raises the circulating levels of thyroxine binding globulin (TBG) therefore increasing the bound fraction and decreasing the free ( bio-active) fraction of circulating thyroxin (T4). Therefore oral oestrogen/HRT may increase the T4 requirements of women being treated for primary hypothyroidism.' I have noted that transdermal HRT does not effect TBG levels and would not be expected to alter thyroid function and therefore may be preferable for women on HRT and thyroid treatment.

This was one paper and I don't know if this is accepted scientific/medical consensus.

Just also found this on this website about thyroid and HRT:

Thyroid disease   
    Hyperthyroidism, due to either overactive thyroid gland or over-replacement of thyroxine in under active thyroid disease, leads to an increased risk of osteoporosis due to excess bone loss. Consideration should therefore be given to screening for osteoporosis in postmenopausal women who have a history of hyperthyroidism and offering bone protective measures. HRT does not worsen thyroid disease and in fact may be particularly helpful because of the bone protective effect. However, patients taking thyroxine should be monitored by having thyroid function rechecked 3 months after starting HRT since the thyroxine dose may need to be adjusted. Similarly, thyroxine requirements may alter if HRT is stopped and thyroid function should be rechecked 3 months after stopping HRT [ref 26].

http://www.menopausematters.co.uk/atoz.php#GlossT "

I'm not sure what the position is re the converse ie if you increase the thyroxine ( hence the T4) - what the effect is on oestrogen levels.

It seems that the metabolism of both is linked so this is a reasonable explanation - as well as what StellaJane said about possibly not being post-menopausal yet.

Sounds like it's a good idea to go to your doc anyway, as you suggest.

Let us know how you get on!

[MichelleBerko]

Wow I'm touched by the replies and your sincere advice. Thank you so much!

To the first question, yes I take my Thyroxin in the morning, along with my HRT. Should I try one at night, one in morning??

To the second question, I had 5 periods in the year before going for menopause discussion with my GP. I self diagnosed I was going through menopause 4 years ago after finding this site. (Prompted by husband who took his life into his hands by wondering if.. just possibly.... ) he still lives!! I tried patches for a couple if years, had allergic rashes from the patches so my GP moved me to Conti last year.

So... what DOES happen to my periods? They were dwindling 4 years ago... Is there a lining and does the Conti store it till I miss a pill or interfere with dosage? Will I ever be 'lining free' while I'm on HRT or does it false mimic?

I'm only a layman, so much of the third contributors help went way over my head! I gleaned enough to see there's some relationship between HRT and Thyroxin. I thank you for your advice and I'll be taking these comments to my GP to work over.

Thanks again ladies x

[Hurdity]

MichelleBerko - sorry about my reply - didn't mean to blind you with science but try to put the source of info if I can - the bit in green is from this website!

Difficult to know whether or not you are post-meno from what you've said - does sound as though you were heading that way but if you go onto HRT while you are still peri-menopausal (ie having had a period in the 12 months before starting HRT) there is no way of knowing.

Continuous combined HRT means you take progestogens all the time. The prog stops the womb lining building up from the oestrogen so there is no lining usually. However if you have a cycle going on still now and again - or if there is anything amiss eg fibroids or polyps then you might also get bleeding.

Yes you should be lining free on continuous HRT. However having said that oral HRT can be a bit more unpredictable than patch HRT because it has to be absorbed through the gut and then go through the liver and other things can affect this, so perhaps this may cause a bleed sometimes. Theoretically though even if the amount of tablet fluctuates a little ( due to absorption variability) if your lining hasn't built up then you still shouldn't bleed, so good to have a quick check to put your mind at rest!

Hurdity x