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[Dumpling54]

I'm 54 and have been on HRT for 4 years mainly because of night sweats I just couldn't put up with

I started off with Elleste Duet but asked to change to another HRT as my bleeding was increasing along with  headaches
I was advised that we could try to control the bleeding with another HRT so started Estradot 100 last year and bleeding stopped for 3 months. Then from September last year I started getting very heavy bleeds every 3 months. Having reached age 54 I was then allowed to swap to Evorel Conti in October last year which I was told should stop the bleeding. I had a hysteroscopy in December which showed nothing was wrong - no polyp and nothing sinister

The last three weeks (over Christmas!) have been absolutely hideous. I have felt as though I have acheing muscles and bones (as though I am coming down with some sort of fever)  horrible night sweats - even worse than when I originally had them, headaches, weeping for no reason and I am on day 21 of bleeding - the last week of which has been incredibly heavy. I've now stopped the HRT to see if I can stop the bleeding (even though I am still continuing to bleed) and am seeing a specialist in 3 weeks time. Has anyone else had any drastic reactions to HRT in this way and what is this telling me? That I am progesterone intolerant? Does this mean that all these symptoms are going to come back and bite me when the HRT is out of my system?

I don't even know whether I am menopausal yet - I reckon I'm still in peri. My mother and sister didn't go through the meno until age 55 with no symptoms to speak of!

[Dotty]

If you are still in peri than a conti regime is not suitable and will cause bleeding.

[Dumpling54]

Thanks for this. Any idea why the Estradot 100 would have been causing such excessive bleeding?

[Dotty]

Which progesterone were you using with the Estradot?

[Dancinggirl]

Hi and welcome to MM Dumpling54

Firstly, I suspect you are still peri meno so shouldn't really be on a conti HRT yet.

When you were prescribed the Estrodot 100, what progesterone were you given alongside? Estrodot 100 is a very high dose!!! I'm not surprised you started to bleed heavily!

Secondly, being on progesterone all the time (any conti HRT) can cause the symptoms you are experiencing. However the progesterone in Evorel patches is the one that often brings more side effects, especially when used continuously.

If you want a non bleed HRT regime, with minimal hassle, then I would ask to have a Mirena fitted and use oestrogen as gel or patch alongside and this might well give fewer side effects, protect the womb lining etc.

DG x

[Dumpling54]

Thanks DG

I was taking Utrogestan with the Estradot

They tried to fit me with a Mirena coil last year but it was a no go - my Cervix is just too small...:-(. I think this would have solved my problems....

Also tried Oestrogen gel for a couple of weeks but I didn't get on with it.

I think I need my body needs to settle down and I need to understand where I am at. But does this mean that HRT is no longer feasible for me? Are there natural HRT's I could consider??

[Dancinggirl]

Utrogestan isn't very powerful and some women do find their womb lining builds up because it isn't powerful enough - especially if you were on such a high does of oestrogen.
It could be good to take a break - let everything settle and see how you feel about everything.  When and if you decide you want to try HRT again, then stick with a sequential HRT ( so a monthly bleed).  A shame the Mirena fitting didn't go well - maybe they would fit this under anaesthetic?

Most oestrogen in HRT is 'natural' these days - it's the progesterone that can be a problem.  You could try a 50mcg oestrogen patch with Provera (medroxyprogesterone) for 10-12 day each month and see how that works? DG x

[Dumpling54]

Thank you so much DG - it's been such a relief to know that I am not abnormal...

So just to summarise, on Estrogel it looks like the amount of progesterone wasn't enough for me
On Conti continuous progesterone was a problem for me - is that right?
So the key is getting the balance right - is it just a case of trial and error or are there any scientific ways of determining which HRT is right for you?

Thanks again x

[Dancinggirl]

It is about the balance adn the right progesterone.  Taking any progesterone continuously can be a problem for many women as there can be more side effects - also if you are peri meno ( as you probably still are) then conti HRt is not appropriate.
If erratic or heavy bleeding is the problem, then sticking to a sequential regime and ensuring you use enough progesterone ( appropriate dose for 10-12 days each month) to ensure the lining sheds properly each month is the key.
Do look und er TREATMENTS at the top of this page for options: if you look under progesterones you will see Provera and the doses appropriate for both sequi or a conti regime.
HRT Combined patches and pills are set at appropriate doses of both progesterone and oestrogen - it's when you take them separately that problems can occur.
IF I were you I would try: 50mcg oestrogen patch with Provera (medroxyprogesterone) for 10-12 days each month and see how that works? DG x