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[bloomsbury]

Hello everyone,
I've been browsing around reading all the invaluable advice on here. At 53 and still possibly v late peri I'm on 50mcg Estradot and 100mg Utrogestan continuously but my own cycle seems to be kicking in every 28 days. Previous to this I had a Mirena coil for 18 months which sent me doolally whilst bestowing the wonderful gifts of constant bleeding, teenage acne and hair loss, a great confidence booster. After it's removal I didn't have any bleeds until starting HRT. Previous to that delightful episode my periods were of biblical proportions, becoming erratic, night sweats began and all manner of mood swings, loss of memory, confidence. I tried Femoston conti briefly but the sweats returned immediately and I started to bleed constantly. The bleeds on the utro are heavy and painful, cramps starting a few days before the bleed, would 200mg daily help or make it worse? Any/all advice gratefully received.
Bx

[CLKD]

   I don't know anything about HRT but I'm sure someone will be along!

[bloomsbury]

Thank you for the welcome CLKD! 

[CLKD]

Browse round.  Make notes.  There is a search button which you can type the name of the HRT etc. and previous threads should pop up.

[Dancinggirl]

Hi and welcome to MM bloomsbury
If you are peri meno then you shouldn't be on a continuous HRT regime!!!!  This is why you started bleeding on the Femoston conti and this is probably why you are getting heavy bleeds on the Utrogestan regime.  Your womb lining will be building up too much and shedding.  Taking any progesterone every day can bring problems for many women - this is why many women choose to stay on a sequi HRT well into post meno and simply put up with a controlled bleed every month.    I would definitely change to the sequential regime of Utro 200mg per day for 12 days each month - use the oestrogen patches all the time. The only problem with this will be the chance of slightly more intense side effects on the higher dose of Utrogestan but if you've found it OK thus far then you may be OK. You should get a more controlled bleed each month which is better.  You could also use the Utrogestan capsules vaginally and many women find this brings fewer side effects and is more effective at keeping the womb lining thin. It's not licensed here in the UK for use vaginally but it is on the continent (your GP/doctor may not be up to speed on this).
I do feel you need a womb scan though - you may have fibroids or polyps that could be causing the heavier bleeds and cramps and also check the lining thickness.  DG x
 

[bloomsbury]

Hi DG,
Many thanks for your thoughts..you're quite right I do have small fibroids and a polyp. Heather Currie suggested the estra-utro conti regime as I find the drop in hormones sends me (more) crazy, and I do use it vaginally. My GP (who is sympathetic but not up to speed, which she freely admits) referred me to the meno clinic at the Radcliffe to see the excellent Jan Brockie, she didn't think the bleeding was problematic, yet, but if it is heavy again this month I agree with you that a scan would be in order. The bleed is not erratic, it arrives every 28-30 days. Really have had enough of periods but cannot tolerate the night sweats etc, tried sage which helped slightly but nothing works like HRT so loathe to give it up.
The joys of the 'change', such a little word that doesn't do it justice, sometimes feels so overwhelming but hanging on in there and talking with knowledgeable ladies definitely helps.
Bx

[Dancinggirl]

Hi bloomsbury - you are so right - ‘The Change' is such an understatement!!!
You are clearly getting some good advice from professionals.  The difficulties over progesterone are a real stumbling block for many women and if you are still peri meno ( you suspect you are) the fluctuations this brings can play havoc. I am just very surprised that you are being given conti HRT while still peri!!?? Fibroids and polyps will result in more bleeding and cramps and oestrogen will feed these - I suspect these are the cause of your problems.  It's a shame the Mirena gave you problems as this would be the natural alternative to your current regime, giving that low constant dose of progesterone to offer stability, stop the build up of the womb lining and it usually reduces excessive bleeding from fibroids etc. - did you use oestrogen alongside the Mirena?
I have tried Utrogestan continuously (I was already very post meno at the time) but got break through bleeding, spotting and cramps all the time. I also felt rather ‘high' and sedated, which was fab but I wasn't getting on with much as a result.
It's strange that you feel its your natural cycle breaking through and giving this bleed - I took HRT in my late 30s when I was still peri meno (premature meno) and the sequi HRT kept my cycle totally under control - I suspect your womb lining is simply building up to a certain level and then shedding - the cramps for days before could simply be the womb wanting to do this shed.  These are just my thoughts as I am not a professional - I speak from my 25 odd years of using HRT and having tried just about everything there is to try.  Herbs won't do anything - only placebo effect.
The meno does ‘mess with our heads' in a way that is difficult to describe.  Rational and sensible women suddenly find they can't cope and feel anxious all the time. Some find they need an AD/SRRI alongside HRT but I find reducing stress by simplifying my life has really helped - I work part time and spend a lot of time relaxing/meditating and on brisk walks with my dog. I am nearly 61 now so taking life a bit slower is acceptable but if you are in your early 50s then work must still be a priority.  HRT won't solve everything - it's often a range of strategies that will help and you simply can't expect to feel good every day of the month.
It could well be worth trying the sequi version with the Utrogestan to see if it works OK for you. I tried taking 200mg on a conti basis but felt completely spaced out all the time.  DG x
It's trial and error I'm afraid but once you are well into post meno things might settle a bit more.

[bloomsbury]

Hi DG,
Don't know why I think it's my hormones kicking in, the bleed happens like clockwork, similar to the good ol' days. The only way to test that theory is to stop the HRT and see what happens, just can't face doing that in the next twenty years, I'm sure you're right, it's the HRT firing up all those endometrial cells. I'm extremely lucky and don't have to work but have a busy life where people rely on me plus I travel quite a lot which is difficult re the heavy bleeding. The HRT has improved so many aspects of everyday life since I started taking it, and you're right again in that we cannot expect to feel good every single day. Avoiding stress is important but also rather impossible for me at the moment. I will try another month on the conti to see if the bleed is any better, the utro is starting to irritate my bladder so will have to revert to taking it orally until that calms down. It's definitely the best prog I've tried so far, the Mirena sent me off the wall but the doc and gynae wouldn't listen, they kept telling me it does not cause any prog-intolerant side effects, wrong! I used a low dose 25mcg patch in tandem for the last 6 months but that didn't help at all. Many thanks for all your thoughts DG, it's great to chat, I do appreciate it.
Bx

[Hurdity]

Hi bloomsbury

  from me too!

You've already had some great advice from Dancinggirl and would just like to add a couple of thoughts.

Firstly you did not say how long after you had the Mirena removed that you started HRT, although you did say that you had no bleeds during this time. Also I do agree with Dancinggirl re the conti HRT if you are still peri-menopausal but if you are very late peri (periods would be coming very occasionally), you shouldn't be bleeding every month on a conti regime. If your cycle is breaking though ( meaning you are not late peri) then despite the continuous utrogestan your progesterone (and oestrogen) would still be rising and falling as normal - but not quite so dramatically because of the continuous dose of hormones from the HRT. If that is the case and you feel OK then no problem. - but as Dancinggirl says I would want to know whether the bleeding is due to that (your cycle overriding the HRT and happening as normal) or due to excess stimulation of fibroids and polyps - and only a scan ( following a bleed) would determine that.

Anotehr possibility if utrogestan suits you - and I don't know anyone who has tried this - is to carry on as you are, but about 10 days before your regular bleed - take 200 mg Utrogestan for - say 8 days and see if this lessens the bleed. You would probably need to suggest this to your meno doc at the clinic! ie you would be taking 100 mg Days 1 - 18, 200 mg Days 19 - 26, 100 mg Days 27, 28. Bleed starts Day 1 (approx). Just a thought to consider and ask about! For many of us conti prog is out of the question but for you sounds like you don't mind it?

Hurdity x