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[Ju Ju]

I'd like some advice from those of you with more knowledge than I have.

 A few months ago I had a bleed soon after increasing my oestrogen prescription. Following this I had an ultra sound scan and biopsy, which showed all is well, other than the walls of my womb were thickened rather a lot. I was due to start a cycle of progesterone, which must have contributed to this. I have gone back to the original prescription of oestrogen and a progesterone cycle every 3 months. Following the original bleed I took a course of norethisterone to stop the bleeding and the following month took my progesterone (Provera) early, as I did not want to take it in September as I have been on holiday. This is following my gynaecologist's advice. I had planned to start a cycle of Provera on October 1st, then again December. (Normally start cycles of Provera March, June, September and December)

I started another bleed yesterday, after a few somewhat tiring and slightly stressful days of coming home via NYC and IBS. I have been constipated, hardly opening my bowels for a few days, then cleared them probably because of the relief of getting home. This is a pattern recently, but seems to have been aggravated by the stress of travelling. I have a rectocele which is part of that problem. I think I must a weakness, which is aggravated by such big bowels movements. ( sorry TMI?)

That's the background. I would like advice on whether I should start a course of norethisterone, which makes me feel awful, or whether the Provera, which is a bit kinder, started early would do the same job of stopping the bleed. Obviously, I need to speak to my gynaecologist or my GP, but as they both work part time, I won't get that opportunity for a week or so. I need to stop the bleed now. Thank you for any advice. I do worry that I might have to stop HRT because of this. I have been feeling so well recently. My son and his in laws all remarked how well I was, particularly after how I was 2 years before, when I had so little energy and felt so poorly. (A measure of this was marching up and down a steep hill with almost ease. It defeated me 2 years ago).

[Cassie]

Hi Ju Ju, I am no expert so can only speak from past experience....it does not sound like you are balancing your oestrogen well enough or I should probably use the word opposing! You need to take regular does of a progestrone if you are on a daily oestrogen, every 3 mths does not sound too regular to me. I also tried the longer method and got loads of breakthrough bleeding. Could you not try Utrogestan rather 100mg for say 10 days every mth, this will at least put things back into perspective so to speak, it is, in my opinion, less harsh than Provera as well. More in the end is in fact less, and I think, this certainly, would apply to trying to get the balance more in tune....all the best, hope you get sorted.
This will also help to alleviate the thickened lining.

[Ju Ju]

Sadly I feel so rough on progesterone. I have followed this regime after consulting a well respected gynaecologist, and obviously this works for some women. But maybe not for me. I will talk to her as soon as I can. The prospect of taking a course of progesterone every month fills me with dread. There may be some other alternatives that we could explore, like a mirena coil, but I'm more concerned about what to do immediately.

[dazned]

Hi Juju I'm not an expert but as I understand it maybe the reason for break through bleeding is explained by the thickening of the linning,as Cassie said if estrogen isn't balanced or opposed correctly this is what happens. Northisterone is a strong progesterone used as my consultant says to have a spring clean 
Maybe a long cycle isn't the way to go for you as it seems to bring about this thickness occurring which isn't good. Perhaps you need to adopt a shorter cycle.

[Hurdity]

Hi JuJu

Sorry to  hear this.

As the others have said - I think maybe you would be better off on a slightly shorter cycle as a compromise - say two monthly. Like you I don't like the progesterone phase although it does not debilitate me unless I get a migraine - I just don't function so well and get foggy headed, lethargic etc.

Having taken norethisterone at suggestion of my gynae GP, once a year ( have done this twice so far - just recently finished a course) I find this a difficult one. It definitely bloats me up and affects my blood sugar and for a while afterwards and I also feel tense. Maybe you could take the Provera every two months and the norethisterone on one of the cycles per year, as I do?

Sorry I have to dash as working tonight, so this is in haste!

Hurdity x

[Ju Ju]

Thanks Hurdity. Certainly a shorter cycle like yours may be the answer. What bothers me is that it is only just over a month since I took a cycle of Provera and the month before that a course of Norethisterone. I suppose I had better start a course of Norethisterone today. And I was feeling so good. I get all the symptoms of a period and PMT, breast pain etc and worsened IBS. Oh what fun! Better warn the family that I won't be good company. 

I'll email my gynaecologist for advice. I won't get an answer for a while, but obviously my regime is not suitable for me.

[Cassie]

What about trying Utrogestan vaginally for 10 days per mth the 100mg as long as you are having regular scans this is the way to go for many women who cannot handle it for too  long, it is not synthetic but I do realise of course, that it does still cause unpleasant side effects for some, all the best to you.