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[merlingo68]

Hi All

So I'm progesterone intolerant and am currently trying cyclical cyclogest AGAIN. After about 2 or 3 days on the cyclogest I have a huge bleed which is good. I then have to carry on taking cyclogest for another week and I'm not sure why. Surely the point of the progesterone is to make me lose my lining which I clearly do within days of starting cyclogest so why do I need to carry on taking it while feeling more and more tired/depressed/migraine-y? Could I not stop after about 5 days once I"ve had my bleed? Or is there some other protective mechanism going on which says I have to take it for longer even though I've lost my lining? Just seems a bit pointless esp as it makes me feel so bad.

[VanillaLover]

Interesting....I thought it was the withdrawal of the progesterone that should bring about the bleed, not the taking it in itself. How many months has this happened? Do you still have your own periods? I am interested because I get my own bleeds regard of whether/not/when I am taking progesterone (utrogestan). However my consultant said that it didn’t matter as long as I WAS bleeding every month or so, whether due to progesterone withdrawal or my own cycle. For continuous use the progesterone will prevent the uterine lining from building up too much in the presence of extra oestrogen from HRT.

[merlingo68]

I stopped having my own bleeds about 5 years ago. I've tried a mix of continuous and sequential. Continuous isn't too bad apart from the craven hunger and subsequent weight gain plus horrific stress incontinence. Sequential makes me unable to function after about 10 days or so.

This has happened a couple of times now. It used to be that I started the bleed at the end of the progesterone phase, the last 2 months I've had a bleed after about 3 days. Although actually this month I forgot to take it on day 3 and then had a huge bleed which continued. At which point I started wondering why I'm supposed to take it for 14 days at the risk to my mental health/job/family when I can get a decent bleed after 3.

[joziel]

At some point you are going to get moved to continuous - if you haven't had bleeds yourself for 5 years, you should have been prescribed continuous anyway. Continuous is where everyone is heading, when they are ready for it... and it also provides better protection of the uterus than sequential due to the ongoing steady progesterone.

It is the withdrawal of the progesterone which causes the bleed.

[VanillaLover]

OK, I wonder if it’s possible that you are not absorbing the cyclogest as you are supposed to? So perhaps your lining is building up a lot due to unoppposed oestrogen and the bleeding you are getting is coincidental breakthrough bleeding and not related to when you take the cyclogest at all. How long have you been using cyclogest and did this happen on other progesterones?

I may be seriously barking up the wrong tree here though!

[merlingo68]

I'm not sure who is going to move me to continuous. I'm not seen by anyone. Not been seen by anyone for about 3-4 years at least. I was on continuous for a year or so at my own instigation but the incontinence is really awful. So I changed to a longer cycle sequential. But yeah I don't want to keep having bleeds forever, it's a right pain.

It's not an excess oestrogen bleed, I'e had those, it's a full on and def related to the progesterone.

Really I want to know whether there is any protective benefit to taking progesterone for 14 days if I get a bleed after 3?

[VanillaLover]

No, I would say there is no benefit to carrying on taking it, as long as you are having the bleeds regularly.

[joziel]

I think the progesterone dosage is one thing you don’t want to mess with unless you are having frequent ultrasounds to check your uterine lining isn’t getting too thick.

I don’t know why continuous would cause incontinence…? Have you tried using local estrogen (Vagifem and Ovestin) as that would likely help the incontinence and 20% of women on systemic HRT need local estrogen too?

[merlingo68]

I have a prolapsed bladder and womb and have incontinence generally. Progesterone increases it significantly because of its effect on connective tissue and because it's working locally.

Yeah I feel like messing about with the dose is dangerous re lining but I really struggle with the progesterone. I was on the waiting list for a hysterectomy at one point. I think I'm hoping that someone who knows comes long and goes oh yeah just take for three days but they won't as no-one can do that and also no-one knows!

[joziel]

Are you using local estrogen though? Because that would really help to counter the effects of the progesterone down there. You can use Vagifem daily if needed and if that enables you to take your progesterone, and not to have issues, that would work out well...

There was a conversation I came across between women using utrogestan vaginally who seemed to think it was 'relaxing' things too much down there, leading to slack pelvic floor, urinary issues etc being applied locally. So that does make sense for progesterone to be contributing, but you could counter it with local estrogen?

[merlingo68]

I also use cyclogest vaginally. I haven't been using vagifem but I could start, just not sure there's room for all that up there.

I mean my incontinence isn't going anywhere but on progesterone it gets to the point of soaking though my Tena and I feel like I smell whereas the rest of the time I can cope with pads.

So yes I will try that. Cyclogest can go up the back on the vagifem days I guess. 

What about the gnawing hunger? Anyone got any suggestions for that? I mean I know that sounds like not much of a problem but I get so hungry I feel ill and I'm constantly thinking about what I can eat. No matter how much I eat I'm still hungry. If I go without food for more than 2 hours I get migraines and faint and also can't think about anything else.

[Joaniepat]

I also use cyclogest vaginally. I haven't been using vagifem but I could start, just not sure there's room for all that up there.

I mean my incontinence isn't going anywhere but on progesterone it gets to the point of soaking though my Tena and I feel like I smell whereas the rest of the time I can cope with pads.

So yes I will try that. Cyclogest can go up the back on the vagifem days I guess. 

Could you not use the cyclogest at night and Vagifem in the morning? I don't know how much residue there is from cyclogest, but you could wait for that to emerge and then insert the Vagifem.

JP x

[joziel]

I think you could do both the same place if you can separate by a few hours.

Ie - if you watch TV in the evenings, or don't move around too much, put the Vagifem in early evening - say 7-8pm and then the progesterone just before bed? After a couple of hours, you should have absorbed the estrogen from the Vagifem... Or if there is another time of day when you are not busy or just sitting around, use the Vagifem then.

[merlingo68]

Thanks. I don't really have any issue with using the progesterone at the same time as the vagifem it's more that I'm progesterone intolerant so wondering if I can get away with not using it. Same thing has happened again - started progesterone and within 2 days began a heavy bleed. If this happens everytime then not sure why I need to take ti continuously or for 14 days as Im so sensitive I get a bleed immediately.

[joziel]

It may be that the bleed continues for longer if you are off progesterone for longer?