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[GypsyRoseLee]

That's a good point Hurdity. My scan is on the 30th and I will start taking Utrogestan on the 1st. So it's perhaps not an ideal time.

I'm having the scan at my local Mothercare actually. I might call them and see if I can change the day.

When would be the best time would you say? I take Utrogestan from the 1st to the 7th and generally get a withdrawal bleed starting around the 11th-ish, and it lasts for 2-3 days.

[Cassie]

I would try to have it done just after you have finished your bleed that shouldl give the most accurate reading.

[Hurdity]

Yes! Then - when it's at its thinnest (the lining) just after the bleed - like I said in my first reply to you (over the page!  ). Hopefully they will be able to change the date as this will be the most useful measurement.

Let us know!

Hurdity x

[GypsyRoseLee]

Hmmmm very slightly confused now, as just had another email from Studd (apropos of nothing) telling me I need 4 pumps to suppress my cycle and I have nothing to worry about, as my lining will be thin because I'm not ovulating.

Bless him. Will still rearrange my scan though, just to check.

I am wondering though whether I will still need such a high dose when I have gone through the menopause?

[CLKD]

Get the scan sorted then review 

[dangermouse]

I think I've read here that a few women switched down to 2 pumps post menopause, as you are then adding oestrogen in rather than using it to suppress your cycle. Once you stop ovulating for real you'll have much less progesterone to protect your womb, thus the lining is more likely to build post meno.

[Hurdity]

That's an interesting question GypsyRoseLee! I mean how would you know when you were post-menopause if the level of oestrogen you are taking is suppressing your cycle - I wonder if ovarian reserve continues to decline even though follicles are not ripening to ovulation nor being stimulated? If your cycle is truly suppressed so that you don't experience any mood swings or hormonal fluctuations then unless you stopped HRT completely or had a scan of your ovaries to measure ovarian reserve (I presume this could be done) you won't actually know if you are post-menopausal would you? (Thinking aloud here...)

I don't know what effect cessation of ovarian function due to menopause (as opposed to suppression of the cycle) would have on oestrogen levels when these are being topped up with 4 pumps of oestrogel... this is a technical question and maybe one that Studd will answer for you  !!

Reducing oestrogen dose has to be done carefully anyway - even if you are post-menopausal or nearly so - as I am sure you know - because sometimes the body reacts (with flushes) even when reducing dose (eg 4 pumps to 3) after being on a high level. It will depend on how you feel!

Dangermouse - re the progesterone issue - the amount produced shouldn't make any difference at all? As GypsyRoseLee's cycle is suppressed - if this is complete ie no ovulation at all then no progesterone will be produced - just as in post-menopause - but the amount of oestrogen might be different in the two states (pre and post-menopause using the same dose of oestrogen).

Hurdity x

[GypsyRoseLee]

Prof Studd said that my withdrawal bleeds are light because my cycle is being supressed, and so my womb lining isn't ever really building up.

I do think my cycle is probably 95% supressed but every now and again, I still get 5-6 days when I feel very, very off and on edge again so assume this could be a surge/dip in my own hormones?

A fairly early menopause seems to run in my family so I would think it would be almost running its course by now as I'm 47.

[Cassie]

Just out of interest how does one suppress a cycle, by taking high doses of oestrogen? 

[GypsyRoseLee]

I don't know the science behind it Cassie but I believe the high dose tricks your body into thinking it's already pregnant so you don't ovulate?

[Cassie]

Interesting, thankyou.

[Hurdity]

Yes high levels of oestrogen inhibit the production of FSH and therefore the eggs cannot develop. During the menstrual cycle , after ovulation, oestrogen levels fall which allows FSH to rise and this starts off the whole cycle with several follicles developing until eventually you get one dominant one - when oestrogen levels are really high.

Normally HRT doesn't provide oestrogen high enough to suppress the cycle so you will still get fluctuations in FSH and ovulation ( if you are still fertile and not post-menopause). This is why HRT is not a contraceptive - because your own cycle can carry on to some extent in the background.

Sounds like there is still something going on GypsyRoseLee if you can feel off - and presumably not related to the prog phase or withdrawal from it?

Hurdity x