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[Nanookster]

Hi everyone, I’m pretty new to posting on this forum but have learned so much from reading through the posts as a longtime lurker!

I am 42 and in perimenopause. My gynaecologist put me on a continuous HRT in March 2022 due to my struggle with various symptoms relating to peri. I was still having periods when I started the continuous HRT but they were becoming inconsistent and light. Since starting the HRT 9 months ago, I have had 2 or 3 “periods”. Were these actual periods or were they breakthrough bleeds? I have read through various posts on this forum that state that periods often stop on continuous HRT, but was also informed by the wonderful @Dotty on here that that’s not always the case. If I am still having periods/breakthrough bleeding, would it be better for me to switch to a sequential HRT protocol?

Thanks for reading!

[Dotty]

Hi there is no harm to being on a continual hrt, but you may experience lots of irregular bleeding.

A sequential regime should regulate the bleeding to once a month.

[Nanookster]

Thanks, Dotty! Other than the random bleeding, I think I am fairing quite well on the combined regime. Does the random bleeding occur because my natural menstrual cycle is still whirring away underneath the HRT?

[Dotty]

Yes .. your natural cycle is breaking through .

[sheila99]

Many people prefer sequi because they know when the bleed is coming. If you're on utrogeston it can be useful in late peri to take it 25 days out of 28 as this allows a bleed if there's been a build up. You will usually not be prescribed a conti routine unless you have been a year without a bleed (the nhs's definition of menopausal) because of the problem with breakthrough bleeding. If you want to be bleed free in peri a mirena is your best option.

I'm not altogether sure that there's no harm using a conti regime in peri. I thinks it's true for most people but a few seem to go for months without a bleed and then have a massive one which to me would indicate the lining has been building up. Interested in other opinions on this.

[Nanookster]

Thanks Sheila. This is what seems to happen with me. I go for months without bleeding and then have a breakthrough bleed/period. I’m curious if this is healthy for my body?

[Nanookster]

Before I went on Evorel Conti I hadn't had a period in about 13 months, they'd been fairly regular before that and just stopped, the cessation possibly helped along by other medication, after two months on conti I had a period, heavy, but mine always are, my understanding was that they would happen for a few times then none after that.

I'm on tibolone instead now which is continuous and my own cycle restarted immediately with heavy normal periods, regular within two days each month, always five or six days in duration. After six full cycles it shows no sign of changing except as always before occassionally I'll get a lighter one.

The mirena coil is another option if you wanted to avoid bleeding, a similar one called mireva coil, worked to completely stop my periods about fifteen years ago which impressed me even though I removed it to save my mood from dropping through the floor, for stopping bleeding it was unrivalled.

Yeah, I’ve considered the coil but not too keen on the idea due to a history of depression and anxiety as I’ve heard it affects mood. My periods on HRT are definitely not as regular as yours, but maybe that’s how they’ll become. I’m finding navigating peri a complete mystery! My body just does what it wants at random!