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[pricey]

Hi ladies,

After a very mixed few years on HRT and trying several types, I think I need to try being off for a while to see where I am/ let my body reset. I've been trying Oestrogel and Utrogestan and while I feel quite well I'm continuing to have a heavy withdrawal bleed along with my own bleed most months. This is accompanied by headaches,  sore breasts and mood swings. I wondered if my oestrogen levels were too high so with a view to possibly tapering off, I reduced my oestrogen from two pumps to one and a half and a week later,  to one. I have felt a little anxious but haven't had any flushes as yet. This now seems to have triggered a bleed, only light, but accompanied by a headache and usual PMS symptoms. Does any change in oestrogen dose potentially trigger breakthrough bleeding/cycle to kick in? I hope to try a sequential regime for 3 months or so on this lower dose of Oestrogel to see if too much oestrogen (for me) has been causing the breakthrough bleeding. If that doesn't work,  I will reduce further and come off HRT. Does this seem wise, or am I barking up the wrong tree? My GP isn't concerned, but just seems to want me to try the Mirena or just put up with the best of a bad job.

At 55, I really am fed up now.

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[LuLu71]

Hi Pricey,

Good luck to you with planning to eventually get off of HRT altogether for a reset. From my own recent personal experience of lowering my continuous estrogel dose by one pump a day for a little over a week, I find that this enough to induce blood. I actually have a full-on period after not having one for almost a year and a half and it was very shocking! However, in my case, I think I had inadvertently created a kind of cyclical HRT which brought on a period, if that makes sense?

Basically, I think when we are fidgeting around with our doses, it kind of messes up an already messed up system so I wouldn't be surprised that you are getting extra bleeding in between regular bleeds. I hope that helps! This whole journey is crazy eh? I hope you feel better soon xo

[Kathleen]

Hello pricey.

I was on the same regime as you, namely two pumps of gel and 100 mg of Utrogestan. This was the last of several attempts at HRT but sadly none of them helped with all my symptoms. When I stopped taking HRT eight months ago I stopped Utrogestan first and after two weeks all my breast tenderness disappeared. I continued reducing Oestrogel and again a few weeks after finishing I experienced vaginal atrophy for the first time. Luckily I am able to manage this with a vaginal moisturiser.

I did not have any bleeding at all on Utrogestan and I tried it orally and vaginally however I was definitely post meno when I started taking it.

I completely understand your frustration with it all. I also stopped HRT to see where I was naturally and although I am no worse without it I was secretly hoping I would be all better. Ho hum, keep on keeping on!

Wishing you well.

K.

[pricey]

Hi ladies. Thanks for listening and for the advice. Stellajane,  I have been using 2 pumps of Oestrogel and 200mg of utrogestan for 12 days as recommended. This worked for a couple of cycles,  but as with Femeston and various patches, my own cycle seems to have kicked in again. My doctor says it is just very persistent and my own hormones are overriding the HRT.   Last month I had more breakthrough bleeding and have wondered if 2 pumps of Oestrogel is too high for me and it's causing me to have a build up of lining I need to shed. I eat  a plantbased diet which includes a lot of soy products so my oestrogen may be higher to begin with?

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[sheila99]

I'm not sure why your gp is surprised your own cycle overrides the hrt one? In my experience this always happens. I have a natural long cycle, usually 6 weeks but anything from 5-7, which just won't fit into a 4 week hrt cycle, it results in bleeding at any time, sometimes twice in a month. I'm now on gel/utro so start the utro when I've ovulated, or after 4.5 weeks if it's a non-ovulating cycle. This has always produced a bleed at the right time except for one non-ovulating cycle when there was no bleed. Can you tell where you are in your own cycle so you can adjust the hrt cycle to fit in with yours?  If you have PMS symptoms it's a period not breakthrough bleeding and IMO the problem is when you take the utro not the level of oestrogen (and if symptoms are returning it's too low).

[Hurdity]

It's difficult to say pricey, what is going on. If you have worryingly heavy bleeding then the doc should order a scan for immediately after your withdrawal bleed, just to check all is OK? Also maybe you have fibroids or something causing the heavy bleeds - especially at your age when the worst of peri-menopause should be over (though some women do have a late menopause)?

Yes there are other sorts of bleeding than progesterone withdrawal bleeding ( which is the normal menstural cycle bleeding or the HRT equivalent). Oestrogen breakthrough bleeding can happen if the lining gets too thick but this would be sporadic and not accompanied by other pms symptoms eg breat tenderness, headaches. Oestrogen withdrawal beleding is also a phenomenon - bleeding that heppens when you reduce oestrogen. Some women get this just after ovulation and I think Cassie used to get it when she reduced her oestrogen.

If you think your cycle is kicking in I would try to sync both bleeds - and depends if the heavier bleed is the prog withdrawal from the hRT or the one that you think is your own cycle coming into play?

Have you tried oestrogen patches?

Hope you manage to get it sorted.

Hurdity x

[LuLu71]

Yes there are other sorts of bleeding than progesterone withdrawal bleeding ( which is the normal menstural cycle bleeding or the HRT equivalent). Oestrogen breakthrough bleeding can happen if the lining gets too thick but this would be sporadic and not accompanied by other pms symptoms eg breat tenderness, headaches. Oestrogen withdrawal beleding is also a phenomenon - bleeding that heppens when you reduce oestrogen. Some women get this just after ovulation and I think Cassie used to get it when she reduced her oestrogen.

Hi Hurdity, is having menstrual cramping along with bleeding an actual period? Mine feels like a period rather than bleeding but not sure because I haven't had a period in almost a year and a half...

[LuLu71]

Don't really understand what happened there Lulu71. How had you been taking your progesterone?

If you hadn't changed your dose or pattern of taking progesterone, you wouldn't expect a bleed until the appropriate time.

I don't see why reducing your dose of oestrogen alone would have triggered a bleed - puzzling!

Hi Stellajane, I have been on continuous estrogel and progesterone (100 mg a day) for ten months. Even though it hadn't been a full 12 months since my last period, my gyno thought I was already post meno, based on my blood work and how long it had been since having a period at that time (7 months). Anyway, after about 5 months of using the HRT, I found that two gel pumps wasn't working for me because of my poor sleep and hot flashes persisting. Therefore, I went up to three pumps a day while still taking the same amount of progesterone every day. I felt so much better but my hair was falling out more than the usual shedding. I decided to go back to two pumps and after a week plus a day or two, I got a period! I also joined a gym that week and both times I went that week it was grueling and rigorous exercising. My body was so sore an I am wondering if that brought on the period too?

I am scared to tell my gyno at my next routine appointment coming up because she is very strict and freaked out about me using more than two pumps. She had made me promise not to use more than two pumps and I agreed because I was scared she would take it away! Anyway, I am hoping all is normal...sorry to hijack your post Pricey!

[pricey]

Thanks everyone for your replies and support.
Hurdity, the withdrawal bleed tends to be heavier. That's why I wondered if my oestrogen dose was too high. I have tried patches.  I was on Evorel prior to starting Oestrogel in August last year.  I just didn't seem to absorb the hormones well. I realise too that even chopping and changing from Evorel to my current regime within the last 6 months could mean more likelihood of erratic bleeding. I think I will try 3 or 4 cycles of Oestrogel 1 pump with utrogestan for 12 days and see if it settles.  If not, I will try weaning off and seeing where i am naturally. At least then if I do restart I can try and synchronise my bleed with the withdrawal bleed by starting Oestrogel on the first day of my natural period. Does this seem sensible?

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