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[skkb]

Ok, five weeks on.....used Sandrena every day for a little under 3 weeks, now only on mon, wed, fri. Flushes and night sweats completely gone, VA gone.....no itching or soreness, anxiety levels massively reduced, sleeping almost normal. So, how much better do I feel? I'd say around 95% it's amazing how 1.5mg of Sandrena per week is enough for me to have such a huge difference to my wellbeing. Now the negative......as I'm away on a six week trip I didn't want to take progesterone as no way did I want a bleed whilst away!! So NO progesterone.......but what to do when back home? Haven't bled for over 6 years. Previously took progesterone on the 3 days with the gel, never had a bleed or any problems but that was my own "made up" regime. Just concerned as to what's happening with lining of womb!!

[peegeetip]

the doctor should have you on a conti regime. If you've not had a period in years then no point starting again now.

http://www.menopausematters.co.uk/postmeno.php

These all have estrogen and continuous prog part.

Not taking the prog over a long period of time is very bad.

However over the 6 weeks you mention thats within the 3 months of the long duration "hrt" options that give a bleed every 3 months.
You could take prog when you get back, just dont forget not to!

There is a chance that you might have a break through bleed as your body gets used to the estrogen anyway.
Nothing can be guaranteed but as long as your feeling better who cares.
Just "prep" yourself just incase and have what you need to hand on the cruise just incase.
Otherwise, hope you have a great cruise.

 

[Mary G]

skkb, that's great news and it just goes to show how HRT really does change your life!

I agree with Stellajane, don't worry about the progesterone until you get back from your trip and then, to be on the safe side, you could take it for a bit longer than usual.  After that, you can get into a routine with it and get a predictable bleed with your old regime.  I tried the long cycle but it didn't work for me but that is probably because I take two pumps of gel everyday and have high oestrogen blood readings. 

I'm an HRT lifer, you can probably understand why now.  Long may your good health continue.

[skkb]

Oh thanks so much for your replies. The womb lining thing does concern me and previously as I said I used to take progesterone just on the days I used the gel.......3 days each week. Never had a bleed in the 4 yrs I did that but having been off HRT for 12 months now that I'm back on I'm not sure what to do. If I take progesterone when I get home how many days do I take it......I'm thinking 12......then have a withdrawal bleed?? But if I do that and don't bleed am I safe to continue as before do you think, just using both on the three days? Don't think my doc would know the answer to that, more chance here on the forum. Thanks

[Mary G]

I agree, 12 days of progesterone on your return is enough to give you the protection you need and probably give you a bleed.  Your last regime worked very well for you for it would be best to go back to that you have had a period.

Don't worry, you are doing extremely well and finally found something that works so now enjoy the rest of your trip!

[skkb]

Thanks both, think that's what I'll do. Micronor is the progesterone used so will stick with it. Hopefully no bleed will happen and I can continue as before. The meno clinic is happy for my friend to continue using estrogen only so long as she goes in to have womb lining checked annually!!

[Mary G]

I have heard of private gynaecologists saying it's OK to use low dose oestrogen only with an annual scan.  The thing is, if the lining does happen to build up too much, it will often come away on its own anyway - it always does with me.  The fact is, if you have an annual scan (which all women should have regardless of whether they take HRT) then you don't have a problem.

I would adopt this method this myself but it is not possible because I take a fairly high dose of oestrogen and can only go about 6 weeks before I bleed 'naturally' (aka breakthrough bleeding) although for me it is not random or sparodic but more like a continuous slow burning period - "interesting" my gynaecologist said!

I have spoken to my gynaecologist about this many times and she said that some post menopause women have the natural ability to shed unprovoked once the lining builds up to a high level but it is uncontrolled and not a great idea and she does not recommend it.  Obviously other women who don't shed in this way can get a build up and unless you have a scan, you don't know how your body performs or how much progesterone you personally need to take. 

Progesterone is the achilles heel of all HRT preparations and if some women can find a way round it, good on them but this will only work on low dose oestrogen. 

[skkb]

Yes StellaJ it is an NHS clinic......I'm kind of hoping my doc will arrange the same for me, guess it's all down to cost. But as my estrogen intake is only 1.5mg per week perhaps the lining isn't greatly affected !! unfortunately only a scan can answer that

[Hurdity]

Hi skkb

So glad you are feeling better and enjoying your trip!

In terms of what to do when you get back - as you previously took Micronor and got on well with it, this is norethisterone which is a very powerful progestogen for thinning the womb lining, then sounds like a good plan to carry on with it.

As to whether your womb lining will have over thickened on the gel in 6 weeks - it's hard to say - but it probably is not necessary to have a bleed and surely with the low dose you are on it won't be that thick? Norethisterone is often given by docs/gynaes to thin the womb lining and research has shown also that cases of endometrial hyperplasia have been reversed after treatment with norethisterone.

If it were me, in your position I would start taking the Micronor as soon as I get home - and take it every day for a month perhaps - if you can tolerate it and then reduce down to the 3 times a week. If there is still any lining to shed then it will probably do so when you reduced the dose - but if the lining is thickened then just starting the Micronor might cause some spotting. On the other hand it might just do its work without bleeding. If you didn't want the uncertainty then take a 10 days course, have a few days break from the Micronor, have the bleed and then carry on as before. Either way I would get in some sanitary protection when you get home just in case!

Re the low dose oestrogen without progestogen. There is a commercially available ultra low dose oestrogen patch called Menostar available in US - which is 12.5 mcg so very low - and is designed to be used without a cyclic progestogen in the normal way. However the instructions recommended with an annual scan or an annual dose of progestogen - to shed any linging as a precaution (can't remember which now - maybe both?) as some women will actually develop thickened lining even on this dose. I imagine the UK gynaes will be following the US lead with this recommendation.  1 pump gel would give more than this though.

Hurdity x