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[Clovie]

Just to comment on the question about age and HRT, I recently looked at the BMS guidelines and they say there should be no arbitrary limit placed on the age of someone being prescribed HRT it might be worth looking at their info, also it is worth looking at the NICE shared decision making guidelines. I have had experience of this lately with menopause clinic/gp surgery so I understand how it feels (not the same just struggles over HRT, not listening). This is your medical care and you have a say in it, particularly as there are no concerns regarding the lining of the womb. How has the bleeding been since going continuous? You can also point out to him that intermittant bleeding is common on a continuous regime for 6-9 months anyway. I hope you are on a good iron supplement and I'm sorry you are dealing with this. It's so important for medical people to listen to women and respect that it is their body xx

Hi Claire

Thank you for your reply x

My bleeding has continued since I've been on continuous. By that I mean, continued at a reasonably predictable timeframe and for a set length, starting gradually getting heavier then tailing off. As a period would do.
I feel they are def still my own periods. I have all the symptoms beforehand, physical and emotional.
I do feel it is getting a little lighter though.

I read that continuous utrogestan can take 6 months to slow any build up?
And my lining is thin, anyway.

I'm still upset today.
 

[Clovie]

I've been left feeling like a total and utter freak.

Unique possibly  , freak definitely not. The problem is his ignorance, it isn't you. I look on it as a positive, we've had our own protection for heart and bones longer than most.

Thank you Sheila. xx
That is how I myself was seeing it after the good news at the scan - well, until I saw the consultant yesterday anyway...

[Clovie]

Hi clovie

So sorry to hear about your difficult experiences with medics over HRT and your situation.

Before commenting further just to say regarding periods - whether they are or they are not, without certain types of investigation which are not usually carried out, once you are on HRT it is impossible to say definitively whether your periods are natural or not. The only way to find out whether a woman is truly menopausal is to be off HRT for at least 12 months and see if a period occurs. The other way I gather is to take a scan of the ovaries and look at the eggs etc - I'm not familiar with the details. However that is not to say that you are not having natural periods ie you could well be - though this is very much on the minority end of the scale...but someone has to be!! Also some docs are wrong if they think everyone is post-meno at 54, I think the stats (which probably will be based on studies of Western women not on HRT) say approx 80%? That is a big number who won't be!!!

However, that being said - the consultant was doing the right thing in investigating whether or not the bleeding was abnormal or normal but having looked into it and the health of your womb, and pronounced it healthy - then that should be an indication that all is well and no reason to stop!! As others have said - it is your body and your decision, provided everything has been looked into and there is no arbitrary age limit on HRT.

Have you thought of taking the utrogestan cyclically again - maybe a higher dose (sorry don't know what dose of oestrogen and prog you are using) but if the lining is being shed, and there are no abnormalities - then there should be no worries. The only thing is they should keep an eye on it, because it is more worrying the older one gets, just in case.....and your body's response to HRT may change as mine has ( ie lining thickened when it didn't do so in the past...).

I hope you manage to resolve this soon so that you can continue taking the HRT you need without hassle

Hurdity x

Hi there Hurdity!
Thanks for your reply!

I had my ovaries checked and all was OK, not counted eggs or anything though.
My womb is "that of a menstruating woman" the sonographer told me. She could tell by the size and shape, she said it was clearly obvious.

The consultant still seems to think it might be 'irregular bleeding'.

Do you know anything about sinister irregular bleeding? Only mine is reasonably predicatable (between 21 and say, 26 days between bleeds) and for a predictable length of time (around 5/6 days) Starts light gets heavier and tails off.
With 'irregular bleeding' would you get all the PMT symptoms beforehand?

He has me worried sick.

He told me towards the end of the appt that he thinks I'm 'peri-menopausal' !!!!  Like it was news to me!!
No sh*t Sherlock!
I know!
I have been on HRT for nearly 10 years due to hot flushes mood swings etc!!!

Thanks for any further insight, and hope you are doing Ok!
 

[Clovie]

Gynaecologists often have little idea about menopause etc..  Could you see a specific menopause specliast ? 

If everything is 'within normal limits' for you, then there isn't any reason to stop a regime that is working.

Thanks, CKLD. Yes, I'm going to see what his follow up letter says and the results of my blood test, then I will prob go private to see someone.

[Clovie]

There is such a thing as late onset menopause. This can happen in your 60s. It's a common and simple phenomenon. Your doctor needs to read a book or two. There are, however, significant supply chain problems relating to HRT, and there is a growing reluctance to prescribe where another explanation or drug route is possible. I can't prove that the two are linked but it is coincidental.

Menopause is under researched and women's problems are often low down the priority.

Many doctors are behind the researchers too. I know that the health crisis that is dementia has led to research and proposals to give women HRT for life due to the protective benefits.

Thanks for reply!
I know, I was like, how much do you actually know about menopause

I totally agree about the benefits of HRT - I said to him when he was talking about me coming off it that I would just go get it privately, that I WANTED to carry on taking it for ALL the benefits it provides.
Yes, I've heard of the link with dementia, very encouraging! 

[Clovie]

Still confused a little...

Following my consultant appt I finally got his letter through which he promised me.
I'd had another blood test whilst at that appointment to see if the intensive iron therapy I was having was working. (Was anaemic following having my own periods and the withdrawal bleeds from sequential HRT as well)

The letter said my blood count was now fine, and to just follow up as necessary with my GP.
No mention of what he thought my bleeds could be - or any agreement that they were indeed periods (regular period-long bleeds at predictable intervals with all the associated PMS symptoms preceding them, which haven't changed DESpite changing to taking continuous HRT for several months now)

Still concerned he had spoken about being taken off HRT as I'd been on it a long time
HRT surely is for women coming up to and following menopause?
Despite my age I clearly still have not even got there yet, so to talk about stopping it just causes excess anxiety, something I've suffered with immensely throughout this whole peri period

[CLKD]

No wonder you are confused.  U don't have to stop unless there is continual heavy bleeding when a hysterectomy may be suggested.  After which a lady may require oestrogen replacement.

If there is no mention of stopping HRT I wouldn't be too worried.  Your GP can contact the consultant if he/she thinks it's necessary.

[Claire MM]

Hi Clovie, Sorry I didn't see your response until now, yes it can definately take time for bleeding to settle on continuous progesterone. I'm glad he didn't mention taking you off HRT in his letter. I had my bloods taken by a nurse at the surgery once and she said she had been on HRT for many years and they tried to take her off it but she refused as she felt much better on it, she seemed very well and older than yourself. Glad the iron has come up I would supplement if I were you to keep your energy etc up, take good care xx

[CLKD]

How can bleeding be 'irregular' if it's cyclical    ..... we know our bodies.  If the bleeding is 'within normal limits' for your body .......

[Clovie]

Hi Clovie, Sorry I didn't see your response until now, yes it can definately take time for bleeding to settle on continuous progesterone. I'm glad he didn't mention taking you off HRT in his letter. I had my bloods taken by a nurse at the surgery once and she said she had been on HRT for many years and they tried to take her off it but she refused as she felt much better on it, she seemed very well and older than yourself. Glad the iron has come up I would supplement if I were you to keep your energy etc up, take good care xx

Thanks for reply   And that's interesting about your blood nurse, thank you .

[Clovie]

How can bleeding be 'irregular' if it's cyclical    ..... we know our bodies.  If the bleeding is 'within normal limits' for your body .......

Exactly CKLD, this is what I said to him at the appointment.

He said to me "I understand you've been sent to see me because you've had a bit of bleeding?"

(What my GP had written to him I have NO idea but she definitely did not believe my periods are my periods and something MUST be amiss at my age)

I said to him
Yes, but my periods have never stopped, it's not post-menstrual bleeding
I told him my bleeds were predictive in length
Lasted as long as a 'period'
Started gradually got heavier and tailed off, like a period does
I get all the PMS symptoms before hand.
My scan was one of a still menstruating woman
no abnormalities at all to note
And since changing from sequential to continuous HRT my bleeds have carried on as normal.


He would STILL not commit to these being periods.

Nor would he say what ELSE they could be!?!

[CLKD]

He's a man, out of his depth ?

What's your GP's take on him?

Let us know how you get on.

[SarahT]

Clovie, I have no words of wisdom but I am 100% certain you know your own body.
As you have said before some of us do not fit into the happy age bracket of menopause that some in the medical profession would like.

I am truly furious and pis*ed off on your behalf. I really feel for you and the lack of belief you have been shown, I am certain you know you are having natural periods.

Xx

[HellsBells]

We didn't dwell on the subject but I wonder if some hospitals and doctors are trying to reduce the number of women on HRT?

The Consultant also said that the private clinics were adding to the problem by prescribing very high doses of Oestrogen.

I wonder if change is in the air and if so women need to be alert to it and prepared to argue their case.

This is exactly what I have picked up from a few different sources. I have an endocrinologist who has looked after me through thyroid, coeliac and osteoporosis issues and in not so many words said that doctors were starting to restrict the prescription of HRT. This is probably in response to proposals (correct me if I'm wrong here) to make it much cheaper for women to get HRT as in one prescription charge for the whole year.

I am getting BHRT privately so I think he was more inclined to tell me - but he basically said that it would be advisable for me to have 'other symptoms' in addition to the osteoporosis or they would force me onto bone drugs.

I have also heard from a senior medical research source that there is a proposal to put all women on HRT for life (low dose) to protect against dementia as that is a public health crisis and HRT can prevent it by up to 50%.

Either way there are policy/product/cost changes afoot which will be driving decisions.

[sheila99]

I have also heard from a senior medical research source that there is a proposal to put all women on HRT for life (low dose) to protect against dementia as that is a public health crisis and HRT can prevent it by up to 50%.

Has the link been proven now? I thought it was still open to debate.