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[TM73!]

I am 52 and take 2 pumps of estrogel, 200mg utrogestan vaginally 12 days per month and testogel (pea sized amount) 3 times a week. All has been working well for more than 2 years. suddenly, I have started to have spotting prior to the 12 day Utrogestan taking phase occurring (maybe 3 days before I start taking the utrogestan) and some mild cramping/PMS type symptoms.

What could be the cause of this ? The gyno mentioned at our last telephone appointment that I would need to think about having Utrogestan continuously as I am now at an age where I wouldnt have periods anymore. He said we could talk about this next year at my annual review. I bleed for approximately 3 days at the end of the utrogestan phase without any issues.  Could this be the reason for the sudden spotting?

[bombsh3ll]

It is likely to simply be your own hormones changing in the background and not a cause for concern, assuming your cervical screening is up to date.

Vaginal atrophy can also result in spotting, and as you are on quite a low dose of estrogen it is worth considering if this is present.

However just because it is not worrying medically doesn't mean you have to put up with it, there are multiple ways in which your treatment could be tweaked to avoid bleeding altogether if you prefer, which your prescriber should be able to advise on.

[joziel]

You can spot because you don't have enough E, by the way. This happens as well - people assume it means too much, but it can also happen when you have too little.

I would get bloods run to check E. If you take P vaginally, you can also test P with an accurate result. (Oral P can't be accurately tested because it creates metabolites which mess up results with false highs.)

Your E should really be 300+, most women do best 400-650.

Not all women are menopausal suddenly at age 52 and it's very likely you are still in peri.

[TM73!]

Thank you both for your responses.  I am due to have a blood test for my testosterone levels soon, so I could ask if they will do a few others while they are at it.

Yes, I was a bit surprised that the gyne consultant was so matter of fact about me being in menopause, just because of my age. Mind you this is the same person who prescribed Pregablin for my insomnia and it clashed massively with my citolopram medication (I was hallucinating after the first couple of doses) my own GP said he should have checked what other medication I was on before prescribing this and seemed baffled that the consultant had even suggested it.

[Minnie Mouse]

Hi,
Yes I'd also challenge that comment about being in meno because you're 52.
I was moved to continuous too early (at 54) for similar arbitrary reasons.
It caused a whole host of problems (and unnecessary health scares) because I'm still very Peri, even now at nearly 56.