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[soniad]

Hi everyone.

I'm in perimenopause, taking 3mg estradiol with 14 days of micronized progesterone 14 days.

I was originally on 200mg progesterone, and my reading was 81.6.

That month, I didn't get a bleed at all. I just carried on and counted 'day one' of my cycle to be about 4 days after I stopped the progesterone (even though there was no bleed).

My doctor reduced my dose to 150mg progesterone, and on 'day 14' I began taking it.

The bleed came early that month, on day 10. It was a good bleed that lasted 3 days, and then I had spotting once a day for another 7 days (so, 10 days in total).

My question to ladies out there who are cyclical HRT - have you ever skipped a bleed like I did?

[Hurdity]

It sounds like the progesterone was keeping your womb lining thin at the higher dose so that it did not need to shed? Now you have lowered the dose you may need to shed the build-up.

Accoridng to stats on this site 15% of woemn do not get a bleed with cyclical HRT - it depends on the dose of oestrogen in realtion to the progesterone. If your womb is healthy (no fibroids or polyps) and the dose of oestrogen is low and prog high/long duration - then you are less likely to need to bleed. However your dose of oestrogen is quite high - but be guided by the bleed - despite your dose of oestrogen, you would bleed if you needed to after taking a good dose of prog and then stopping.

When I started monthly cyclical HRT at approx age 54 in late peri-menopause, I used to get a withdrawal bleed - but 3 years later these stopped despite taking prog for 11 days per month.

Also if you are peri-menopausal your own hormones will kick in some cycles so during an ovulatory cycle you will be more likely to bleed.

Hurdity x

[soniad]

Thanks Hurdity!

Even though my dose of estrogen is (technically) high, the blood reading is only 254 pmol/l.  (vs 81.6 nmol/l progesterone). I know I'm in peri and it WILL fluctuate, but that might explain why I'm not getting a bleed every time.

In one of your earlier posts you mentioned that if you're not taking enough progesterone in relation to estrogen, the lining won't shed properly, and in that case, not getting a bleed could indicate a problem; that's what I was worried about, even though the blood tests indicate the progesterone is absorbing very well into my bloodstream.

But I feel better now, knowing what you told me regarding the stats.

Thank you very much for your help:)