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[Sfifties]

After 6 months on conti and lots of bleeding followed by a clear scan and Gynaecologist referral, i today spoke to my Gp.
The Gynaecologist advised that to settle the bleeding i should :
Increase utrogestan to 200 mg
Or
Increase my oestrogen i am on 4 pumps or switch to a different progesterone a synthetic one to control bleeding .
In the meantime my Gp herself asked for advice from a collegue Gynaecologist and she was advised that increase progesterone will be making my lining too thin and  i could  maybe increase oestrogen .
 she’s not keen on non body identical progesterone options.
Lastly i could try a sequential regime .
As i am now in my 7 months and hopefully over the worse in terms of possible bleeding i would like to give the continuos regime a fee more months but unsure on how to continue.
Basically my Gp asked me what i wanted to do , wether i want to increase utrogestan or increase oestrogen, it’s my decision!
Does  any of you have any advice on what to do please ?
As soon as i hung up i realised that maybe the sensible thing would be to have a blood test first to see my levels of both oestrogen and progesterone and then decide.. too late now .

[Nas]

I would be looking at switching progesterone, from utrogestan to a synthetic type. Utrogestan doesn’t always control bleeding well.
Maybe try 200 nightly to see if that sorts it? If not, a cyclical regime might be better?

I have the same issue, but have opted for a Mirena.
Slightly apprehensive but willing to give it a go.
I would like to trial provera but not getting anywhere with it being prescribed!

Good luck.

[Dotty]

Hi I think you would need to decrease oestrogen to lessen the bleeding. I have dropped from 4 to 3 pumps but still bleeding unfortunately.

Blood tests won’t help you . xx

[Sfifties]

Hi Nas ,
I would have tried Provera too but Gp will not prescribe either.
Dotty , not sure why A Gynaecologist Consultant would give the option to increase Oestrogen to help with bleeding and the  Gynaecologist that my Gp consulted suggested the same as an option to settle bleeding, not sure i understand how that works that’s why i do not know what to do and what will work  best in controlling bleeding .
As mentioned my Gp just gave me the option of final decision.
I was thinking that blood test would give me my oestrogen level which on 3 pumps was 316 so according to what it is now i  could  have maybe started with increasing the oestrogel since two Consultant have suggested but that will not be possible as could not even pick up my standard oestrogel prescription as no stock and could not substitute with  Sandrena as no stock too …

[Dotty]

Hi how long have you been on four pumps ? x

[Sfifties]

I have been on 4 pumps for 6 weeks.
May i ask who gave u the advise of less oestrogen for bleeding, i am just getting more and  more confused as i have been advised the opposite , thanks

[Dandelion]

Decreasing oestrogen helped me.
I take utro.
However I wear a pad.
I noticed light brown, possibly slightly pinky on my pad, is this ok?
Sorry to hijack thread.

[Dotty]

Hi very time you change a dosage of hrt you can get bleeding for 3-6 months. Oestrogen will build the womb lining, so decreasing the oestrogen should hopefully stop the lining building as much.

The advice given by the BMS is to double the Utrogestan to 200mg or change to a synthetic progesterone.

[Nas]

I think bleeding is one of the most annoyingly common side effects of Hrt and probably a key reason why women come off it.

If GPs aren’t prepared to let us trial ALL the progesterone options, it makes the journey so much harder!

I would push for the provera. I am at their mercy, due to a breast cancer diagnosis years ago and has been a thorn in my side ever since menopause hit me, 3.5 years ago. You might be luckier though ?

The general consensus is that oestrogen should be decreased rather than increased, to try and stop bleeding. This is because oestrogen can stimulate  the womb lining, causing it to shed in the form of a bleed.

The other option is to double utrogestan to 200.

[Sfifties]

Hi Dotty, unfortunately i have been bleeding for most of the 7 months regardless on how much oestrogel i was on .
It is still a mistery why two Gynaecologists would suggest the increase in oestrogen to settle bleeding though , i hate not understanding why , even my Gp didn’t know although she had been told the same.
No chances for provera she will not prescribe it.
Nas please update on how u get on with Mirena .

[Dotty]

Hi I can sympathise as I’ve been bleeding like you.

Is it possible that you’re not post menopause ? Had you gone 12 months without a period when you started on hrt ? x

[Sfifties]

Hi Dotty, my period had stopped for around10-11 months before hrt and before that had become very light and irregular. My gp looked at my fhs level before starting hrt and concluded  that her words” i had gone through the menopause “ and advised continuos regime .
Thinking of try sequi but apprehensive that given bleeds very irregular i will mess up even more things as will have to start progesterone not really knowing when is  day12-26 …
On another note i have been unable to get oestrogel or sandrena and might need to swap to estradot patches , have any of you experienced that and will the swap cause possibly more issues?
Will open a new topic for that but wondering if u had to do that and how it worked out.

[Dotty]

It’s possible that you’re not post menopause and would be better on a Sequi regime.  Lots of ladies go nearly 12 months without a period and then have another one. Going 12 months without a period is the best way of telling if you’re post menopause as FSH fluctuates. You don’t need to know an exact date to start the Utrogestan on a sequential basis. Your body should tune itself into a cycle.

I’ve never used patches but you may be better or worse on patches.  You’d have to try them to see. If you’re on 4 pumps of gel then the equivalent patch would be 100. But you may be ok on 75.