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[Curly_049]

Hello fellow menopausers (is that a thing!?) I have a question. I have been on hrt for around six months and was put on the mini pill about six weeks ago. The HRT was keeping the surging rages and mood swings at bay, but this month I had raging PMT which I thought the HRT would control - followed by a period which I haven't had for three months, and didnt expect seeing as I am now on the mini pill.

My question is... does this sound like I need to speak to a doctor about the hrt ? does it sound like the levels need to be evaluated? and should I wait a month or two more before I speak to someone to see if this is a one-off, as I have read that bleeding in the first few months can happen with the mini pill.

Thanks in advance for any help!

[CLKD]

Morning : 'it' can certainly be a thing  . 

I am sure that someone will be along with advice.  I remember rages  - I would kick doors, throw items though never anything of value ;-)

You'll fit right in.

[Curly_049]

That is exactly what my rages have been like! I never had anything like that with PMT before perimenopause kicked in.. I go out in the car and scream too which really helps!

Thanks for your kind reply

[Hurdity]

Hi Curly

Might it be better for you to take one of the contraceptive pills with oestrogen in (estradiol the same as in HRT) but will control the cycle, rather than HRT and the mini pill?

Depends on your age but there are two called Zoely and Qlaira which some gynaes/docs prescribe to peri-menopausal women because they provide a stable oestrogen dose as well as contraception.

Hurdity x

[joziel]

I am also on HRT and the mini pill (desogestrel). I'm 44yo.

But I think before anything else, what HRT are you on and which mini pill??

[CLKD]

Are your rages cyclical?  Mine certainly were  at least they were a warning for DH to duck 

keeping a mood/food/symptom diary may be useful

[joziel]

By the way, going off on a tangent here after what Hurdity said...

In decades past, there was this trend for GPs to get women off combined pills as they got older and get them onto POPs. I think due to the clot risk. (Which wasn't much of a risk but anyway...).

However, this leaves women with no estrogen coming in during peri-menopause and I reckon really isn't good at this stage of life for most women. I was on the POP...

Whereas a friend of mine has a GP who's very knowledgeable about menopause (doing a BMS training) and she has kept my friend on her combined pill right through. Says no need to change, except they did switch to one with more estrogen I think. My friend is also 44yo.

Which is all to say, surely this whole transition and time of life would be a lot easier if women were even encouraged to stay on combined pills later, until 50 or whenever they have to come off them. It would help them through peri-menopause and then they can transition onto HRT.

Thoughts??

[Curly_049]

Hi all - thanks for the replies! I am 50 and so it's an age thing as to why I am on mini pill. I am on estradot patches, noriday mini pill and Utrogestan (progesterone) tablets half a month too.....

[joziel]

If you were okay on the HRT and this happened when you added in the Noriday, then it is probably that causing it. Because it sounds like a progesterone side effect, so would be either your utrogestan or Noriday. And as you were okay on just the utrogestan it's probably the Noriday....

If you need contraception as well as HRT, one possible alternative is the Mirena coil. This can also be the progesterone for your HRT at the same time, so you would then only need the Mirena coil and your estrogen. No Noriday or utrogestan. The Mirena lasts 5 years and then you can have another fitted when that one is removed.

The Mirena does have a small amount of levonorgestrel in it (a different progesterone to Noriday, which is norethisterone) - but it is a tiny amount compared to taking the oral mini pill and it is delivered locally to the uterus so less of it gets into the blood stream. (There is more of it delivered in the first 6 months after fitting but after that it reduces, so if you do get some PMS immediately, try to persevere beyond 6 months.)