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[lisascottsmith]

Hi – new member here, though I've been reading the forums here for a few years so I'm really hoping one of you very knowledgeable ladies may be able to offer some advice. I've been on HRT for 3 years now and am 53 years old. I started on sequential Prempak-C which I got on well with but when it was discontinued my GP suggested I could change to continuous HRT (Elleste Duet Conti originally) which I was keen to do as I would really like not to have the faff of periods anymore after all these years! I tried for 7 months on two different types of continuous HRT and had almost continuous bleeding, period type cramps and very low moods. Eventually the GP sent me for an ultrasound scan, which showed a thickened uterine lining so I was sent for a hysteroscopy, which didn't show any issues. My GP put me back on sequential HRT and the constant bleeding did settle down – but ever since, I have been having terrible period cramps – for 2 weeks out of every 4. The pain starts about 10 days before my monthly withdrawal bleed and continues until the bleeding stops. This happens every single month and is really wearing me down.

In every other way this HRT (Elleste duet 2mg) suits me and has really helped with all the other symptoms I was getting, but this pain is so debilitating it is really bringing me down. My GP has suggested the Mirena coil which I'm really reluctant to do for a variety of reasons and I just don't know what other options may be open to me. I don't know if I am still peri- menopausal or now menopausal as I was on the mini pill before starting HRT so not having periods anyway. I am using Vagifem twice a week also, which was prescribed as I was getting constant UTIs which have now settled down.

Part of me is wondering if I should just stop the HRT and see what happens regarding bleeding/pain…surely I'm not STILL having natural periods? I have a very stressful full time job though, and don't know how I will cope if the flushes/insomnia/VA etc. all start up again!

Has anyone experienced similar or does anyone have any advice for me please?

[Conolly]

Hello lisascottsmith,

Welcome to the forum!

If you were on th mini pill before HRT, it's possible that your own hormones are still playing up. There are other options that you could try besides Mirena, such as transdermal estradiol patches or gel and oral or vaginal progesterone (Utrogestan).

Conolly X

[Hurdity]

Hi lisascottsmith

 

You have no way of knowing where you are in menopause if you were on the mini-pill before starting HRT because it stopped your natural periods. It is likely that you were not yet at menopause if you experienced such heavy bleeding when on continuous combined HRT which persisted beyond the 6 month time period.

The Mirena is the best recommendation for heavy periods especially during peri-menopause but if you are not keen on that it is difficult to find another alternative other than continuous combined HRT which you have already tried. You might like to try Evorel sequi which is the sequential version of Evorel conti - and hopefully this would give you a predictable monthly bleed - but may still involve cramps if you are prone to these. Any sequential HRT (including separate patches or gel and progesterone) will involve a monthly bleed.

Some doctors are prepared to prescribe double mini-pill with separate oestrogen - but this would be off-licence but might be worth asking given your circumstances?

Other than that I would seriously reconsider a Mirena.

Hurdity x

[lisascottsmith]

Thank you Conolly and Hurdity for your replies and the welcome. I am wondering if a blood test would be able to tell me where I am in the menopause...if I am no longer peri-menopausal surely eventually I would stop bleeding on a continuous hrt...? My GP seems reluctant to offer me a test though, she seems to think that because of my age it's unlikely I would still be having natural periods.

Lisa

[Conolly]

Hello again lisascottsmith,

Unfortunately, the blood tests may not be reliable to tell if you are post-menopausal, hence GP's reluctancy to test them. Regarding the likelihood of having periods at 54, some women (my Mum included) have periods even beyond that. Unscheduled bleeding is certainly something no one should put up with at any age. I hope you can find a suitable regimen soon.

I had heavy bleeding during one year in perimenopause but I loathed (still do) the idea of the coil. Periods eventually became more bearable and I'd have one every 4-5 months, then 9-10 months, until they stopped. They were the least of my worries, tbh.

Conolly X