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[Tulip256]

I have been taking 200mg utrogestan orally for 12 days a month for the past 2 years. I always got a bleed on day 9 of taking the utrogestan which was annoying as it was very on off and didn't start properly until I stopped taking it. I also got acid reflux symptoms.

This month I decided to use the same dose but vaginally. This has helped the acid reflux symptoms but I have not had a bleed at all. I am wondering if I am absorbing too much vaginally. I feel OK but my resting heart rate has increased 10 points and my hrv has gone right down. Could I take less vaginally? Is it a problem if I don't bleed?

 I am wondering if I need more oestrogen to balance it? I am on everol 75, mainly for low bone density. When my oestrogen has been tested it has been between 300 and 400 but I have energy and my only symptom is feeling a bit hot at night. I am also taking testosterone.

Any advice would be appreciated.

[Penguin]

It's not a problem if you don't bleed. Maybe you are absorbing more vaginally, but it is a bit risky lowering your utrogestan dose. I'd give it another couple of months and see if you bleed, as it may be that your own cycle has changed underneath the hrt one. If you are going to lower the utrogestan dose you'll need regular lining scans to make sure it isn't getting too thick, which you would need to pay for as NHS wont do routine scans like that.
Re the resting hr, mine always increases in the luteal phase, even before i started hrt, I think that is just the progesterone. Is it making it hard to exercise? And does it go down again when you stop taking the progesterone?

[Tulip256]

Thanks penguin. I am a bit confused on the uterine lining. If I don't bleed doesn't it mean the lining is more likely to build up and get thick?

[Penguin]

Not necessarily. If your own estrogen has dropped it won't build up, and if the utrogestan is doing a good job of keeping it thin (maybe due to better absorption), you may not bleed. A number women om here have said they stopped getting the withdrawal bleed as they move into menopause. It could also just be due to the sudden change in delivery method. Any change in hrt can either trigger or delay a bleed.