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[Spangles]

Hi Ladies,
For the last two cycles I have not had a period. First of the two months I had a mild show, this month literally one spot!
I am on HRT: Evorel 50 and Utrogestan 200/12, I have taken the full doses too.
I've been on this regime for about 3 years now and I've never experienced this, I've always had a light but painful bleed, this month I've not even had pain.
Is this normal?
Can periods stop when you are using HRT?
Thanks
Shellb
xXx

[Hurdity]

Hi there yes they can! I started HRT when I was late peri-menopause just under 54. First of all I got a regular bleed but after 4 years or so they tailed off so I got no bleeding at all. This meant that the progesterone was working very well the times I was using it - as it kept my lining thin. The stats from this website are that 15% of women do not bleed on cyclical HRT. Do you use it orally or vaginally? Great that it's working though. Rest assured that if your lining had thickened you would get some bleeding.

Depending on whether you are OK on the prog phase or prefer not to be on it, you could either take Utro all the time ( lower dose) - if you like the prog, or go on a longer cycle ( with the approval of your doc - due to the no bleed on the 4 week regime) - if you are not keen on the prog part. In my case I went to a longer cycle as I don't like the prog and this works fine for me.

Hurdity x

[Spangles]

Hi,
Yes I use the utrogestan vaginally. The weird thing is though, although I'm not getting a bleed, I'm still getting all the awful symptoms. Random anxiety, change in bowel habits, low mood etc. I haven't missed the pain though.
xXx

[Hurdity]

Ah - when do you get the symptoms? You will still expect to experience symptoms due to progesterone withdrawal ie like pmt - anxiety, headache etc as the body readjusts to being without it again and reverses the physiological changes it made while you were taking it.

If you use it vaginally then the lack of bleed is definitely a sure sign that the progesterone is working, as you are using the prog (vag) for the same number of days as the licensed oral use. I take that dose (vaginally) in my 6-8 week cycle and do get a bleed.

If you are post-menopausal and go to a longer cycle with the approval of your doc, then the progesterone withdrawal symptoms (if this is what they are) will only happen for a few days every 6-8 weeks. Ideally the doc would agree to scan your uterus regularly to check whether there is any build up but in practice - in view of the absence of bleeding you could "stretch" your cycle say to 5 weeks initially and see how you get on - whether you get a bleed - and if after a few cycles this works OK then defo get your doc's approval. My (gynae specialist) GP was perfectly happy for me to do this (longer cycle).

Hurdity x

[Spangles]

Hi Hurdity,
Thanks for all the info! I'm feeling frustrated, having missed a period I feel very irritable, a little anxious, low meted, etc. It just feels like prolonged PMS, my minds so negative too.
I'm so fed up of hormones!
Most of the time when I'm on the Utrogestan phase of the cycle I feel better and calmer. A couple of years ago I did try taking the Utrogestan for 25 days and then I tried a long 8wk cycle, both of which made me feel worse.
Can your periods eventually stop on HRT then?
Thanks
Shellb
xXx

[Hurdity]

Hi Shellb - you asked that question about periods in your original post and I answered it!

I did also mean to say this would only be the case (ie they can stop) if you are post-menopausal. If you are still peri-menopausal then your own cycle may break through sometimes.  I explained that the same thing happened to me in my first post below responding to yours. The PMS should only be felt during the progesterone withdrawal phase eg a few days and maybe up to a week afterwards - so you would experience this on the oestrogen only phase. if this is the case then definitely a longer cycle might help as you would take the progesterone less often.

Hurdity x

[Spangles]

Update
It's the second month of no periods, I'm having horrendous PMT though, I'd this normal?
Shellb
xXx

[Hurdity]

Can you say at which point in your (HRT) cycle you are experiencing the PMT? Is it after starting the progesterone or after you've come off the progesterone or what? It may well be that you also have your own cycle going on although the absence of bleeding suggests that it is slight - or that the progesterone dose is doing its job! This is a high dose to take vaginally for 12 days on only 50 mcg oestrogen if you are post-menopausal. If you say when you feel these symptoms ( maybe the first few days after you've stopped the utrogestan) maybe we can suggest what you could do?

Your options are to go for a longer cycle or to change to continuous utrogestan which would be a 100 mcg dose.

What does your doc say or have you not mentioned yet? Can't remember how old you are? Do you feel well otherwise?

Hurdity x

[Spangles]

Hi Hurdity,
I get PMT before and after a bleed, I'm wondering if the one after is progesterone withdrawal?
I'm not planning to go to the doctor until I've missed 3 periods, so that should be straight after Christmas.
I will only be 49 in February, I'm generally well apart from the anxiety and depression.
Thanks
Shellb
xXx

[Hurdity]

Sounds like progesterone withdrawal if it happens for the few days after you stop the progestogen combi phase of the pills. If you feel rough towards the end of the combi pills - it may well be you are sensitive also to the progestogen itself once it has built up - and often this is to be expected - I feel this with utrogestan as well. As long as you feel well overall, for most of the time, that's all that matters. If you think you are post-menopausal then another possibility is to (ask doc if you can) take a slightly higher dose of oestrogen as you are still very young....and this might help with the anxiety side of things.

Hurdity x

[Spangles]

Oh Hurdity,
After all that I got a show on Monday, nothing worth writing about, only there when I wipe!!!
Hormones!!! Mood did lift once I saw it.
xXx