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[Michelle46]

Hi everyone
I'm so confused. One person tells me one thing and another tells me something else. I take utrogestan for 12 days of the month and 2 pumps of gel every night. I am 49 years old. I went on HRT 3 years ago. I assumed that as long as I am taking HRT I will bleed. My new doctor said that eventually I will stop bleeding at menopause. Is this correct please?

[Nannyneet]

This is why I haven't taken any HRT yet, because my GP told me I would have to go on one that would cause me to have periods and I don't want them back again if I can help it,I have very heavy periods and and get severely anaemic so I don't want to go down that road again

I would have thought you would stop bleeding once you have gone through the menopause but how are you supposed to know if you are having bleeds anyway

[CLKD]

The HRT will influence bleed/not.  You could speak with a Pharmacist, or what does it say in the leaflet?

[MicheleMaBelle]

Continuous HRT regimes ie you take progesterone every day, means that you don't generally have a monthly bleed. A cyclical regime where you only take progesterone for part of the month means that you do have a monthly bleed of sorts ( can vary in length and flow )
Period free" or continuous combined therapy can be used by women who are 54 + yrs, or more than one year since last period at any age. As you don't fulfill the criteria for switching to continuous therapy, you will need to remain on a cyclical basis until you reach 54 unless of course you were period free for at least a year when you started HRT.

Some women still prefer to use HRT on a cyclical basis even if they are post menopausal as they can't cope with taking progesterone on a daily basis due to side effects.

[Michelle46]

My doctor actually said that even if I take HRT for a long time the bleeding will stop so I'll know when I reach menopause

[Hurdity]

What is it with these doctors!!!! No wonder you are confused! MicheleMabelle has already explained about the bleeding.

This doc is totally ignorant!

What your doc means and should know is that if you didn't take anything at all then you would know you were at menopause because you wouldn't bleed hence the definition of menopause. If your doc does not know what HRT does medically and biologically (ie oestrogen stimulates the womb lining which needs to be protected by progesterone) then s/he should not be practising or at least not prescribing hRT and referring you to someone who does know. Really this involves knowledge of the basic menstrual cycle which I think is covered in GCSE Biology! Scary!!!

There are 15 % of women who do not bleed on cyclical HRT (according to stats on this site) but this is very much the exception (and depends also on dosage/balance between the two hormones).

Depending how far along the menopause journey you were when you started HRT  (ie how regular or infrequent your periods were) then as you have been on it for 3 years you could do a trial of continuous combined HRT ( depends also on what your bleeds are like now) and see if the bleeding stops eventually.

However as MicheleMaBelle says you might want to stay with a cycle even when post-meno - as I do (cos I don't like the prog!)

Hurdity x

[Michelle46]

Thankyou Hurdity. So as long as I'm taking HRT I should have a bleed? I don't mind this. The way she explained it was that eventually I would stop bleeding even being on HRT

[Hurdity]

Well most likely you will continue to bleed yes if the dose of oestrogen is high enough even when you are post-meno, although actually I stopped bleeding when I was on cyclical HRT (28 day cycle) after being on it for about 3-4 years ( I was 57 or 58 at the time).  I was on medium dose oestrogen patch though 50 mcg and quite high dose vaginal progesterone at the time.

Hurdity x

[Michelle46]

Thankyou for your advice Hurdity. That's very helpful.

[Dotty]

Hi Michelle 46 If you are on a sequential hrt you should bleed every month, but not all ladies do.

If you are post menopause and on a continuous hrt then there should be no bleeding x

[Hurdity]

Clear and succinct as always Dotty

Hurdity x