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[ACS2010]

Hi ladies, I’m just wondering if anyone is willing to share what their first period on HRT was like. I’m on 2x pumps Oestrogel every day and Gepretix x 2 for 14 days then a 14 day break. I started the first break 3 days ago and now have had a period since yesterday (though I did have some spotting for a couple of days before that). At the moment I’m bleeding a little bit heavier than I normally would at this stage but I’ve not had a period for 3 months so think that might be related.
Does that sound like anyone else’s experience?  Not overly concerned right now, but just wondering if that’s sort of normal.  Does the flow normally taper off like a normal period would?   Thanks in advance.

[sheila99]

Heavier wouldn't be unexpected as it's a while since the last one. Individual experiences vary though. When my own hormones don't contribute mine are very short and light but others can't tell the difference. With added oestrogen yours may be heavier.

[ACS2010]

Thanks sheila99, that’s reassuring to hear.  If anyone else is willing to share their experiences I’d be interested to hear. Thanks ladies

[GraceM]

My first period on HRT was hell - extremely heavy/clots/cramps.  Unfortunately from then on they were heavy and I ended up having to get the coil a year later.  I also reduced my oestrogen.  Even on the coil I still get periods but they are much lighter.

[ACS2010]

Thanks Grace M. I’m so sorry to hear you had that experience, that sort of thing is horrid. Thankfully for me it was only heavy for a day or so and now it’s tailing off like my normal period would. Don’t want to speak too soon as I’m so early into my HRT journey, but today is a good day with regards to the period so I’m taking it as a win. So many changes are going on with me right now and each day seems to bring a new challenge. To stay sane I’m taking it one day at a time and being happy when it’s been a good one.   

[CLKD]

  .   My periods were like that every month 

[Hurdity]

Everyone is different! Mine was such a long time ago I've forgotten! Started HRT in 2008 I think ( or maybe 2007....). I was very late peri so hadn't had a period for about 5 months and previously something like 9 months. I started on sequi HRT and periods just returned but never very heavy and eventually they tailed off completely by the time I was 57 or 58 even though I was on sequi HRT - though I was taking a high dose of Cyclogest. They were never as heavy as they were when I was fertile. However I was only on a medium dose oestrogen patch of 50 mcg so a lot will depend on your oestrogen dose and how well you absorb it. Some women absorb very well on 2 pumps of gel and then may well have heavier bleeds as a result. Also as you are taking the Utro for 14 days then this is higher than the minimum licensed amount so again will help with protecting the uterus.

Hurdity x

[seemster]

I had gone 8 months without a bleed (between stopping the pill and starting HRT) so wasn’t sure what to expect. For the last few years while on pill I was really just having a withdrawal bleed, very light (I always measure heaviness in terms of colourof lillet tampons - so I would use blue mini and very occasionally yellow regular)

First three HRT cycles I had bleeds which were heavier and I needed to use pink(super) 4-5 days long.

Fourth fifth and sixth were awful!! I didn’t even know you can buy green purple orange - and I was using those and changing every 3 hours, horrid and quite distressing especially as the first really heavy day was Christmas Day and I was so unprepared 🤪 They were also 4-5 days

Seventh used mostly green so felt manageable, and most recent has been v different, pink and green but only lasted 2 days with 5 days spotting.

Hope that’s not TMI…

[seemster]

Some women absorb very well on 2 pumps of gel and then may well have heavier bleeds as a result. Also as you are taking the Utro for 14 days then this is higher than the minimum licensed amount so again will help with protecting the uterus.

Hurdity, not sure if I’ve quoted correctly - but question in your last 2 points…. If increase from 2 to 3 pumps will that lead to heavier bleeds? And does 12 days utro mean lighter bleed and 14 days means heavier? Thanks x

[Hurdity]

Hi seemster

Apologies if I wasn't clear.

Oestrogen (alone) stimuates the growth of the endometrium ( womb lining) in a dose dependent manner - more oestrogen = thicker lining. In a sequi HRT regime, progesterone changes the structure of that lining and withdrawal of the progesterone causes it to shed. The degree to which it does this is also dose and duration dependent ie thicker linings need more progesterone and for longer duration to achieve the full effect (ie changing the structure - as I understand).

Therefore, other things being equal, there is likely to be a bigger bleed as a result of higher doses of oestrogen, provided the progesterone dose is sufficient. On higher doses of oestrogen therefore - that extra two days of Utrogestan will help to protect the womb.

Not sure what the difference in bleeds would be with the increase in progesterone by two days, if the oestrogen dose remained the same - but for example increasing the number of days of progesterone per cycle, from say 14 to 21 should eventually result in lighter bleeds, because continuous progesterone (at the right dose to balance the oestrogen)  also eventually alters the womb lining in such a way that the oestrogen receptors do not respond to oestrogen and it does not thicken - as in continuous combined HRT, and this will start to happen on a regime of 21/28. The exact biological mechanism is somewhat complex and I dont fully understand it!

Hope this clarifies?

Hurdity x