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[birdlady]

Hi everyone I've been taking bio identicals for eight months or so. I currently take two pumps of oestrogen gel at night and one uteogestan vaginally because I had side effects taking it orally. I am nearly 49 and have been told I am post menopausal although I'm not convinced this is the case!

I was referred to the Menopause Clinic at our local hospital because previously I had been taking a lower amount of cyclical progesterone than was advised, and had an ultrasound in January to check the lining of my womb was ok which is was. Since then about 2months ago I had what seemed like a very light period/discharge for a few days. Then last week I had very mild period cramps and have had a whole week of very light spotting or brown discharge. The doctor at the clinic said I shouldn't be bleeding at all and any regular bleeding is a cause for concern. I'm not sure what to do - should I ask for another ultrasound to check everything is ok, or is this common? I don't want to waste anyone's time but equally if it's not right then I want to get it checked.

[Hurdity]

Hi birdlady - you are post-menopausal if you have been without a natural period for 12 months. If you start HRT before this period of time has elapsed then you won't know whether or when you become post-menopausal.

If you start continuous combined HRT while still peri then you might get breakthrough bleeding when your natural cycle occurs and overrides the HRT. This could be the cause of your bleeding. It is only a potential  cause for concern while on HRT if you have been on continuous combined HRT (as you are), and are post-menopausal (which you don't know in your case) and the bleeding persists beyond 6 months. Of course heavy bleeding that you are worried about should be investigated at any time.

If you have a  U/S scan while still peri then it won't be accurate as the lining will continue to build during your natural cycle if you are still having one, although the continuous progesterone will help to limit the build up. If the doc is going to refer you for a scan on NHS then by all means have the referral - it should be the doc sending you rather than the other way round.

Hurdity x

[birdlady]

Thank you both for your replies. The discharge has now stopped. I decided to contact the clinic and they replied saying no cause for concern as had a recent ultrasound but if the bleeding continues over the next 3-4 months then I may need to go back into cyclical progesterone. I'm not keen to do this because the continuous regime helps me sleep and I didn't tolerate higher levels of progesterone. Plus I'm happy without periods! You are right that as I started whilst in the peri (although a sky high FsH and scan showed inactive ovaries). It was just brown so yes old blood. I suspect I'm still between peri and post menopause.