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[SwimyAlice]

Hi all,
Due to consistent bleeding problems (driving me crazY!) I'm wanting to ween myself off combined continuous HRT (2xgel and 1xurtogestan daily) - is there a best practice or expereince/advice from others who's done this on here? I thought about halving the dose it every 2-4 weeks but I'm totally guessing - I can't find anything anywhere on here or the internet other than gradually might be better than cold turkey but no protocol.
I have a first phone gyny appt that keeps moving - was supposed to be Feb but now mid-May - they keep cancelling!!! I thought if I came off to see if the bleeding continues that might help with the gyny appt.
Thank you ax

[sheila99]

People seem to have tried both and there doesn't seem to be much picking. If your symptoms are going to return they'll do so whichever way you stop. If you need the oestrogen to control symptoms might it not be better to sort out the progesterone though? Double dose utro is a known strategy and a mirena is usually successful at stopping bleeding. If you're not definitely meno the other option might be a sequi regime, at least then you'll know when it's coming. If you're peri you can expect some bleeding on a conti regime.

[Hollyboll]

Hi - sorry you're having bleeding probs. 
As sheila99 has said there may be another way, aso might be worth getting a referral to a meno clinic while you're waiting for gyne appt?
If you do want to come off ... I've not weaned off completely but have definitely learned the hard way that the fluctuations in levels (including from any change of dose, down as well as up) can cause symptoms incl bleeding at least as much as the levels themselves. 
So fwiw I think ideally best practice is more than every 2-4 weeks on any level to see what's going on (a specialist once told me 6-8 weeks for levels to 'get through'), and in small reductions - I've not used gel so don't know how feasible it is to do that like cutting up patches, although I've seen some people on here talk about half-pumps?
hth x

[Northerngirl]

I've tried both ways...stopping gradually...every other day, then every 3, every 4 etc. This last time I stopped cold turkey in December due to thickening of the womb lining and bleeding etc. I stopped because I thought it would be the right thing to do. 
I still haven't taken any and I'm doing ok really.  A few hot flushes but nothing major thankfully.  The VA is probably an issue more than other things but systemic HRT never helped anyway.  I am currently trying to find natural alternatives rather than oestrogen creams etc.
I know we are all different and this is my choice which may not suit others . Hope you find something that works for you 

[Hollyboll]

fwiw I wouldn't try every few days - that will give you fluctuations, which can cause bleeding ...

but as northerngirl says unfortunately we are all different and there is no set protocol because it's so individualised.  I've had to do a LOT of reductions over the last few months and there's little rhyme or reason with which cause bleeding when and which don't, and that's just me!

So hope you find something that works for you
xx

[Penguin]

To reduce to half a pump of gel, I pressed the pump down fully, drew around it with a sharpie, then used that to work out how to just dispense a half pump.

My symptoms came back really quickly both when reducing to half a pump and stopping entirely but then I am very sensitive to any fluctuations.

I have also tried just increasing the dose during luteal phase when I felt the need and the increase was fine and worked well, but the subsequent drop when I reduced again was horrendous so I do think that whatever you do you should be consistent for awhile. Personally I'd reduce slowly and by less than 50% each time but everyone is different and some people manage months without symptoms returning even when they go cold turkey.

[SwimyAlice]

Brill thanks everyone - I'm on such a low does now I'm stopping cold now as advised by my private GP.
Hopefully it'll help with the bleeding and I'll see how I go on symptoms - poss using an adaptogen approach if needed.
I'll let you all know how I get on in due course!
Alice x