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[Cleocat]

I am 61 years old, been on hrt for 8 years.
Since a blood clot I have been on gel and continuous utrogestan for 6 months, apart from everol conti for 6 months before that where I felt awful and wasn’t absorbing.
I have started to bleed one week on, one week off instead of every 3 weeks. I can’t cope with this, it affects my work, leaking through my uniform no matter what pads I use. I will have to make an appointment again about the bleeding as it has been 6 months and I still bleed.
I have had 2 hysteroscopies, polyps removed.
I asked for a hysterectomy, (not to be taken lightly I know) and the gynae refused, I said ‘ok I’ll see you again in about 6 months’.
The gynae said if bleeding continues to up my utrogestan to 200 mg a night, I don’t want to do this as it makes me groggy anyway.
Also I have read that utrogestan can weaken the bladder and cause urinary issues.
**I have uti’s one after the other, all sent to lab and confirmed.
I had been using vagifem but 3 weeks ago swapped to ovestin, as the vagifem didn’t seem to be doing anything.
Prior to the blood clot I was on tablet hrt and despite a few changes I still bled but not as much as this.
Can hrt start periods again? My doctor says no but reading on here it does to some women.
I am thinking of stopping the utrogestan and gel and just using ovestin for my atrophy. Has anyone done this?
Am I one of those who just do not do well on hrt, no matter which it is?

**Edited to add- 6 lab confirmed uti’s in 6 months.

[bombsh3ll]

Have you considered a mirena IUS?

You could also consider tibolone (doesn't increase clot risk) or saving for a private hysterectomy.

[Northerngirl]

Morning cleocat,  no you're definitely  not alone in not being able to find the right hrt....I tried different types for 12 years and never found the right  one,  I gave up 20 months ago when my womb lining needed investigations for being too thick....I really believe that was down to the utrogestan but I felt at the point I just can't do this anymore and stopped hrt. I know many ladies find it massively helps but I wasn't that lucky...it seemed to cause more issues than it solved.
I only started vagifem earlier this year and  it doesn't seem to be helping much yet  either but I found ovestin didn't suit me either...
It really is a learning curve isn't it....good luck with it all 😊

[Cleocat]

 

Thankyou for your replies.
I had a coil years ago and it moved inside me and they just pulled it out, I’m scared to have another.
I’m not good with anaesthetic, and my last hysteroscopy I took a long time to come round and I said to myself I can’t keep going through this. I had stitches in my cervix then a few days later an infection was discovered by having a swab. I really think hrt doesn’t suit me, I’ve never felt good on it in 8 years.

[sheila99]

There are many people not taking systemic hrt who keep their va under control with local oestrogen. If you stop hrt you may find you need to increase the frequency you use it though. You may want estriol gel for the outside if you go dry there.

[Cleocat]

sheila99 Thankyou for your reply. The va is mainly the reason I am still on hrt, although I don’t think my 8 years on systemic hrt have done much if anything for my va.

[CLKD]

If U R having bleeds that you no longer want: and I believe that HRT can trigger these in ladies who haven't had it for a few years: then stop. 

Do get the VA under control, regular use of treatment and it can depend on which suits us: a bit Trial and Error sadly : then stick with your choice.

Some find vagifem inserted every night with estriol/ovestin on the outer labia areas really helps.  Others use yes or sylc moisturiser successfully.  I use estriol every few nights with a smear on the outer labia when necessary or KY Jelly.

When symptoms niggle: a feeling of fullness below the belly button : I up the estriol and swallow 2 Nurofen to help symptoms.

I agree with Sheila99 .  Let us know how you get on.

[Dandelion]

What doe HRT were you on?
I bled heavier than my heaviest period and the pain, OMG.
I also had a hysteroscopy and put on 200mcg utrogestan.
We reduced the oestrogen from 100mcg to 25mcg in 3 steps, every time I bled.
I would still get spotting on this from time to time, and I was about to give up on HRT, as I was 58 by this time, and thought I was through the menopause until a friend told me that once your hormones stop fluctuating and flat-line, you're in it forever.
By this time, I was seeing menopause as a total vandal on the body because I never had many medical problems before, but now, it was like one after the other.
I needed more education, I started watching vids from evidence based Drs and following them, as there is so much rubbish fluff online around menopause.
I went back and found that my oestrogen was low, and am still increasing it in steps and giving it time in between increases with a different doctor, who added in testosterone.
I found out recently that low oestrogen can cause bleeds.
I think I'd gone fishing around the web about it. It made sense as I still had symptoms on a massive dose, and blood tests confirmed low oestrogen, still.
I am confident I will get no spotting once the oestrogen is a higher dose.
I don't know how many of us need much higher than licensed dose, but I get this feeling that there is a "HRT does not work if symptoms happen still at 100mcg" kinda vibe going on, there was with me.
In reality there are women who need more and they are being over looked or seen as non responders to HRT, when it just needs increasing.

[KittyKats]

My gynaecologist, whom is an expert in fibroids and HRT, told me some women just bleed on HRT (just like oral contraceptives) but because of the way the NICE guidelines are set up they are forever on two week suspected cancer pathways with any post meno bleeding. He also said Utrogestan is a gentle progesterone but after five years may not be strong enough to protect the uterus or stop bleeding. The uterine lining naturally thickens a few years after menopause. Mirena is an alternative. I can't take it unfortunately because I had a bad psychiatric reaction to Levonorgestrel decades ago. But you could look into it. Progestins are more likely to control the bleeding apparently. I do understand how you feel. I have halved my oestrogel dose and I am awaiting a hysteroscopy for polyp and bleeding. It's all so boring and after I get my results I will decide whether to throw in the towel for HRT after being on it for over 5 years.

[Zara24]

Good to read that others have had bleeding with Utrogestan. Well not good, never good but makes me feel less alone and that maybe I’m right to consider going back to my old regime. I was on Evorel Conti for ten years, no problems but then when I heard about Utrogestan being safer, I thought I’d try it. So in September 2023 changed to Evorel 50 plus 100g Utrogestan. I had vagina bleeding in April 2024, thickened womb lining and polyps. They did a biopsy , which was clear, and got rid of the polyp. Now this May i started bleeding again and again thickened womb lining and possible polyp so I’m having hysterostomy in a couple of weeks under GA. I feel I can’t go in with this , if it’s going to be every year. They offered to put in a Mirena coil whilst I’m under but it would still have to come out and be replaced in a few years and I don’t think I’d cope. I have cervical stenosis , smears were painful but bearable but the pain when he tried to get a cervical biopsy was too much, likewise the first hysterectomy they did last year under local was so severe they stopped rather than dealing with the polyp.
I have a review with the nurse tomorrow and think I’ll ask to go back on Evorel Conti but if I keep getting thickened womb linings then I’ll give up on HRT.
Northerngirl..how are you doing without it? Kitty at..good to know Utrogestan is known to be gentle and not always protect. I’m 67 and wonder if my body just responds better to progestins as I took cerazette for a few years before menopause and again no problems with it.
Cleocat..good luck going forwards

[Cleocat]

Thankyou everyone for your replies.
I am on sandrena 1.5 mg and utrogestan continuously, I was on vagifem for 6 months now on ovestin.

[CLKD]

Hi how often are U applying the 'ovestin/estriol'?  Every night is never too much!

[Cleocat]

Ovestin inside and outside every other night.