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[Dazedandconfused]

Hi all,
Last period was 7 years ago. I started HRT six months and 10 days ago to relieve night sweats and aching joints amongst other symptoms.   Been spotting for the last 5 days and am now worried as it’s 'bleeding after six months'.  I started on 1 pump of Oestrogel and Utrogestan 100mg every day.  After 4 months upped this to 2 pumps as night sweats returned - had quite heavy spotting for 4 days the following week so went back to 1 pump.  All good until last week when I began spotting slightly again.  Not as much as before but this has gone on for 6 days, also still have slightly painful breasts.  I have a phone appointment with the menopause nurse next week but in the meantime have reduced my Oestrogel to half a pump a day to try and stop the spotting.  Any advice/reassurance or help that anyone can give me in the meantime would be appreciated.  Many thanks. 

[Dotty]

Every time you change a dose it’s classed as a new dose and do the six month resets.

[Hurdity]

Hi dazed and confused

 

It could be that 100 mg Utrogestan is not sufficient to keep your lining thin and the increased oestrogen has meant the lining has thickened so is coming away sporadically hence the spotting. Yes it could settle but may not. The idea is to achieve the right dose of oestrogen that alleviates your symptoms so if your sweats returned on one pump then a solution needs to be found. You haven't said how old you are, but one way to control this is to return to a cyclical regime - like in our natural menstrual days of fertility. Obviously this means a withdrawal bleed monthly which is often unwelcome - but is a way to make it predictable. There are drawbacks with everything and with HRT it is a balance between feeling good and maybe enduring some of the negatives? If you get on OK with the progesterone another alternative is to take 200 mg daily instead of 100 mg but this may be too mich for some women re side effects. Another alternative could be the Mirena coil - but the progestogen is synthetic.

Hurdity x

[Dazedandconfused]

Thanks for the info. I'm 59. As  I'm on only 1
pump of Oestrogel I thought the 100mg Utrogestan couldn't be the problem and would be plenty to compensate.

The fact the spotting (it's still going after 7 days)  started after six months - just - from the day I started hrt is what freaked me out. As I'd done nothing immediately beforehand I decided it must be something serious.

I realise now I may have unsettled things by upping the dose briefly a couple of months ago and going back down.  I daren't up it again, even though I have night sweats.

The doctor has requested an ultrasound for me, which has worried me even more. I'm such a worrier. 

[Kathleen]

Hello dazedandconfused and welcome to the forum.

I agree with poppytoast that bleeding due to HRT is more common than you think.
I have  experienced this often when changing HRT and I have twice had investigations and both times my lining was thin with no sign of problems so definitely the HRT was the cause.

I hope your scan goes well and that everything settles down.

Take care.

K.

[sheila99]

Your gp is erring on the side of caution and that's a good thing. If the scan doesn't show anything, as above, you may have to increase progesterone. Are taking utro orally or vaginally? More gets to where it's needed vaginally so you could try that. It could be that you have a fibroid or polyp that would explain the bleeding. Only a very few scans show something sinister but worst case scenario it will have been found early so do try not to worry.

[Dazedandconfused]

Thanks for the reassurance 😊. I always get in a worry with medical stuff. I'm taking utro orally. Sorry to be thick but is it the same tablets you take vaginally, if so how?  Also I've read it's a bit messy this way, which put me off.  Sorry, it's all a bit new and I'm seriously considering jacking hrt in today, feeling very down right now. This group is great though, much appreciate everyone's help and support 😘

[Kathleen]

Hello again Dazedandconfused.

Regarding your question about the Utrogestan tablet yes,  it is the same small round capsule that you either swallow or insert vaginally.

You are not being thick to ask by the way because it does seem a bit strange to use the same medication in two very different ways.

Apparently the vaginal route is used in Europe but this method is not licenced in the UK, and
consequently GPs advise the oral route only. However the private meno clinics and possibly the NHS ones often suggest that ladies try using Utrogestan vaginally.

I have used Utrogestan both ways in the past but now have Cyclogest pessaries as my progesterone. This was prescribed by a private clinic and it is usually used in fertility treatment but your GP may be able to supply it.

I hope you have found this helpful.

Wishing you well and take care.

K.