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[wherearemyslippers]

Hi all, I've been on Dr Studd's regime for three years (2 pumps of gel a day, low dose of prog) and six months ago we upped the prog to two tablets a day/14 days in the month because my bleeds were quite heavy and my cycle kept breaking through (I had a uterine scan same day, all fine). For six months it's been bliss, little or no bleeding and all good, but last month my cycle broke through again - just like a proper period, sore heavy boobs, water retention, and a more normal, heavy period which lasted 10 days. I guess my question is, is this normal? Is anyone else having their cycle break through, even on quite a strong dose of prog? Thanks for your help x

[Hurdity]

Hi wherearemyslippers

Your post got missed

I don't know where you are in menopause? What your cycle was doing before you started HRT? If you re still in peri-menopause then your cycle can breakthrough at any time as HRT as such does not suppress ovulation although some preparations and doses can do so. Thats why it can't be counted as contraception ( unless you have the Mirena coil).

When you say breaking through do you mean that the bleed happened at the "wrong" time ie not towards the end of the progesterone phase or just after swapping back to the oestrogen only phase of the HRT which is when you should expect it?

Sometimes the bleed might occur because the womb lining has thickened too much - but if you;ve had scans and all is well then that's good .

It is annoying I agree.

Hopefully the bleeds will settle to being more predictable as you reach menopause....

Hurdity x

[wherearemyslippers]

Thanks for your reply Hurdity! So yes, that's what I wanted to know, if HRT suppresses ovulation. It's hard to get a clear answer from doctors. Before HRT I was still having regular periods so I guess its possible I'm still peri.

The bleed happened at completely the wrong time, right on the first day of the prog phase, and I had other symptoms of my natural cycle like sore boobs. So I guess my cycle broke through....

But what's confusing is that prog is supposed to keep the lining thin: so on this regime I can have a month or two without bleeding or with very little. So then to have a big bleed you think "Oh is the prog not working then?"  And you can't go for a scan every other month....

[sheila99]

A sequi regime is supposed to work with your body and you should have a bleed. It can get difficult when your periods are irregular but it's better if you can keep it in step. I can tell when I ovulate so start utro a day or two later and bleed at the 'right' time a couple of days after the end of 200mg x 12 days utro. My own cycle is always stronger than the hrt one so I bleed when my body decides and I try to keep the hrt cycle in step with it. I'm late peri now and the cycles where I don't ovulate the utro induces a bleed  in approx 50% of cycles.
If you use utro continously and still have a cycle of your own you're very likely to get breakthrough bleeding.

[Hurdity]

Progesterone does not keep the lining thin as such, on cyclical regimes, only on continuoius combined ones where it interferes with the ability of oestrogen to make the lining grow.

With cyclical regimes oestrogen makes the lining grow, and the addition of progesterone changes the structure of the lining for pregnancy. Under natural cycles, after ovulation, if fertilisation ( conception) does not take place the ruptured egg follicle disintegrates and progesterone falls which triggers the (thickened and changed) lining to shed as a bleed.

With HRT this happens artificially. You stop the progesterone, levels fall, and this signals to the body that the lining needs to be shed.

Then the natural cycle can interfere with this so all sorts of things can happen re bleeding depending on when you ovulate. Most people won't know when they're ovulating when taking HRT.

Hurdit x