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[suziq99]

The reason for the question is, I have a check up due on Friday & the last couple of months I've had much less of a withdrawal bleed & feeling a lot more like myself a day or two before I start back on the HRT.
I'm wondering if doc will suggest a couple of months off it to see what happens. I had 8 months with no period before starting any hormone treatment, started with a conti then tried a different conti then the sequential..which has suited me much more.
Is it just another faze ? Should I just keep on with what I'm on ?

[Dotty]

Which sequential hrt are you taking?  I thought you take this hrt all the time.

[Dancinggirl]

When you say “off the HRT”, what do you mean?  You use HRT every day through the month but on a sequential HRT regime you take oestrogen every day but only take progesterone for part of the month. Are you taking a gap from taking anything each month?

HRT doesn't suit everyone and it depends on the menopause symptoms you are trying to control as to whether HRT will be worth using or not.  Progesterone often brings PMT and low mood type symptoms and this is why many women stick to a sequential HRT regime.

It could be worth taking a break from HRT to see how you feel - the benefits have to outweigh the side effects, unless you are are too young to oestrogen deficient (i.e. under 50) so need the oestrogen for your bone and heart health.  DG x

[suziq99]

Oh sorry I've misunderstood the differences then. I was on a continuous treatment, climodien then a different one same tablet everyday without a break. Now on climen with 7 days off for the bleed.
I'm 54, my main symptom was the hot flushes & night sweats.

[Dancinggirl]

Are you UK based ? - I looked up Climen and it might be an oestrogen only HRT without opposing progesterone!!!  If you still have a uterus then you need progesterone.  Can you tell us what is in Climen?  Does it have both oestrogen and progesterone?  If it has progesterone, what type of progesterone is in it? Why you would have a 7 day break, I'm not sure, as this would give fluctuations in your hormones levels!!! DG x

[suziq99]

No I'm in Spain.
It's 11 tablets valerato de estradiol 2mg
Then 10 tablets valerato de estradiol  2mg & acetate de ciproterona 1mg

[Dancinggirl]

Hi suziq - sadly I am non the wiser. This is not a standard hrt type regime but may be designed to mimic a natural cycle. I suspect it is actually a Birth Control Regime and this can sometime be helpful in perimenopause.
I would ask the doctor what is actually in your currant hormone treatment - does it have progesterone? If your bleeds are getting less then I would be concerned that your womb lining isn't shedding properly, however if you are not using oestrogen for 7 days each month you may not be getting too much build up of the lining anyway. Hopefully you will get a scan to check the lining.
Do look under TREATMENTS on this site to see the standard sequential hrt options - I'm sure most of these would be available in Spain although may be under different brand names. Many women do stick with sequential hrt to avoid side effects from progesterone, as with a conti hrt means progesterone is used every day.
A good hrt type to try is Femoston as the progesterone is kinder. DG x

[suziq99]

Thanks DG really appreciate your reply.
You know I just assumed the acetate de ciproterona was a progesterone.  having 'just' looked it up it seems to be a progesterone derivative & used to block testosterone.
Yes she always does an internal & external scan.
I am really going to quiz the doc this time.
I will ask about the femoston.
 

[Hurdity]

Hi there - the Ciproterone acetate it is an anti-androgen and progestogen so is a normal part of that HRT - so yes fine to use this product for uterus protection - it is designed as HRT as far as I can see.  No need to see doc about this ie whether it's got enough prog etc.. However the 7 tablet free days are not normally part of most UK HRT types. There is one called Cycloprogynova which has the 7 tablet free days but it is not  commonly prescribed and in fact most people would not recommend this. The whole point of HRT and repalcing oestrogen is not to have an oestrogen dip at all - taking a constant amount means you have this background dosage even when peri-menopausal and even when the oestrogen from your ovaries crashes just before your period and after ovulation.

Oral HRT also can lower free testosterone anyway (thus lowering libido and other effects) so you don't want a strong anti-androgenic progestogen as well!

I would go with Dancinggirl's suggestions ie try something like Femoston or the Spanish equivalent which will give you a constant oestrogen dose all the time and the progestogen in this one is more closely related to our own progesterone and is not testosterone derived. Can you look up a list of preparations available in Spain and what they contain so that you can say which one you want?

Hurdity x

[suziq99]

Thanks for your input Hurdity.
I don't know what's generally availability, I will go armed with this information & ask her what she recommends with the view to not having the 7 days off.
Looks like I'm having a rough month, only 2 tabs in & have a stinking headache & slight sickly feeling 😥