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[Queensland22]

Hi all,
I currently have regular periods and am perimenopausal. I've recently started oestrogel and utrogestan (days 12-25) and had my first period, horrendous! It stopped after 3 days the a day later boom mega heavy again. Feel like shit too. If I take continuous utrogestan days 1-25 would this help with heavy periods? Can't have the coil but I'm really down about it. The utrogestan days I actually felt better😥

[joziel]

How much utrogestan are you currently on? You likely need a higher dose, not just taking the same dose but through the entire month.

[Queensland22]

Hi Joziel,

I'm taking 200mg for 12 days each month, although I've only started one month. Just wondering if days 1-25 would be better for me. My GP did initially prescribe my utrogestan days 1-25 but with being peri and having regular periods, I went with utrogestan for 12 days like advised on the NHS site

[joziel]

You can do either really. If you/your body likes more constant levels of utrogestan, you can take it continuously during peri - but with a break to allow a bleed. Usually 5 days, more than just 3. That allows enough time for you to shed what needs to be shed. As for when that bleed happens though, I find it's best to listen to my body. My cycles have got a lot shorter recently and if I start to bleed around day 21, I will stop the utrogestan there and allow a bleed for 5 days. That way you are not 'fighting' your body's own bleeding cycle. If I get to day 26 and there's no bleed, then I stop to allow one.

I take no P days 1-5, then I take 300mg days 5-16 and 400mg days 16 onwards (either till I bleed or till day 26, whatever happens sooner). I am on a high E dose though. If I were on 'normal' levels of E I don't know if I'd take this much P.

[GraceM]

It's very early days yet.  For me, taking it for 2 weeks or for 25 days or even continuously never made a difference to how heavy the bleeding was.  My bleeding just got a lot worse after I started HRT.  The timing of taking progesterone didn't necessarily tie in with bleeds, so I ended up getting the mirena.  I still get periods but they are much lighter.  I ended up stopping the oestrogen patch altogether as I had started to get breakthrough bleeding and daily spotting.  For some women, hrt makes bleeding issues worse as you are adding more oestrogen (the bleeding hormone) to your own levels and utrogestan may not be strong enough to balance it.  As you are only 1 month in however, I wouldn't be changing anything yet - give it another couple of cycles to see if things settle. 

[bombsh3ll]

Periods have been optional since about 1965.

There are multiple medical options that can achieve amenorrhea, or close to it, in virtually everyone.

My preferred treatment is the combined pill taken continuously without any breaks or dummy pills.

I've been on it and completely bleed free since I was 29 and am now 45, with the exception of being unable to access it for a year or two during the pandemic, when my periods returned.

If this isn't an option for you there are multiple other bleed free options aside from the mirena, most of which can be used alongside your estrogen of choice.

Conventional hormone therapy has a whole host of benefits but unfortunately menstrual suppression isn't one of them.

[joziel]

I do think a lot of the 'bleeding issues' on HRT and unscheduled bleeding, spotting etc etc etc - is caused by women not syncing their P use up with their own cycles.

Doctors have no idea how to explain this and don't even realise it. We have been ignoring and overriding periods for so long even the medical profession doesn't get how to work with them.