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[sadielouise78]

Hi, I've been put on Estelle Duet to try and help with the night sweats, mood swings etc.  My periods have been irregular for a long time and have virtually stopped but I'm on Day 4 of the first pack and already I'm having some yuckiness going on down there.  Why is this happening?  Also, what really confuses me though is if these packs make you have a monthly withdrawal bleed how do you ever know what's a period and what's a withdrawal bleed made by the tablets?  How do you know when you have reached menopause and everything should have stopped?  To put it bluntly, it's all red.  If the withdrawal bleed was blue whilst period is red I'd know which is which.  I'm so confused.  I'm thinking after so long without a period do I really want to go on a tablet that is going to start it all off again??

[aspie65]

I had this exact question about periods on HRT.  My GO said the only way to tell is to observe your body mid cycle for signs of ovulation ie gel like discharge or ovulation pains.  I have actually found this quite useful.

[sadielouise78]

Hi Aspie65, thank you for your reply.  I'm glad it's not just me that's confused.  So will the tablets always create a withdrawal bleed whether I'm peri, menopause or post-menopause?  I really don't want to go back to having monthly bleeds.  It's a pain the bum I'm quite happy to do without.

[aspie65]

A monthly bleed should  always happen on sequential HRT I'm afraid.

[Hurdity]

Hi sadielouise78

If your last natural period was less than 12 months ago then you are deemed peri-menopausal still ( 12 months need to have elapsed without a period before you can say you are post-menopausal). That being the case cyclical HRT is prescribed and yes it does give a withdrawal bleed. If you don't fancy that and you really are very late peri-menopause and eg in early/mid 50's then you could ask your doc to try continuous combined (no bleed HRT) - but you might get breakthrough bleeding?

However many of us on here would recommend ALWAYS starting with a cyclical HRT even if post-menopause because it enables you to see if that dose of oestrogen works for you, and more to the point if you are OK with the particular progestogen in that HRT preparation - as there are several different types and not all women get on with them.

I still have a withdrawl bleed and I'm in my mid 60's as there is no way I want to take progesterone all the time. However I am on a long cycle ( with approval of my GP) so only take it every 6-8 weeks.

You're right you will never know the exact date of your menopause but does it matter? I don't know mine. I started HRT at just under 54 having had my last natural period at 53.5. I might never have had another one or I might have had a few more and I will never know 

Also sometimes during peri-menopause the womb lining builds up as the ovaries begin to fail and follicles start to ripen (producing oestrogen) but don't actually "pop" - so the lining can get thicker and thicker. The next time you ovulate the period would then be very heavy as there is a lot to shed. If you start taking HRT the same thing can happen - the first bleeds on sequential HRT may be quite heavy ( which is good as the lining is being shed) and even on continuous combined HRT many women experience spotting or bleeding in the first few months as the lining sheds sporadically and then eventually thins and stays thin (due to the continuous progestogen).

If you want to take HRT and you are peri-menopausal but don't want to bleed then the Mirena coil is a good option for the progestogen part and then you can add oestrogen at the dose you want.

Hurdity x