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[Rachatkinson]

I am pan hypopituitary, so have produced no oestrogen or progesterone since I was 37 , I’m now 62 . I’ve been on HRT for a long time . I am on continuous at the moment but struggle with breakthrough bleeding ( been checked out twice. ) if I take one pump of Oestrogel and 200 mg utrogestan I’m fine ,but if I increase the Oestrogel ( serum levels low) I bleed. I have had my utrogestan upped to 300mg , but that just feels yuk and I could sleep all day. I don’t want the minera coil. Any thoughts please.

[Dotty]

Hi other options would be Provera, Slynd, Norethisterone or Desogestrel. Some of these are off licence.

Or you could try a Femseven Conti patch or Evorel Conti patch.

There are also oral tablets available.

[Winterangel]

Hi Rachatkinson. I’m in the same boat. Currently been having bleeding for the last 7 weeks! I don’t have the pituitary issue but I do have a fibroid - gynae says bleeding is due to HRT, menopause specialist says it’s due to fibroid! 🤷🏼‍♀️ I’m reaching the end of my tether!
However, the menopause specialist recommended cyclogest instead of Utrogestan but I struggled to get hold of it. Maybe you could give that a try?

[CLKD]

It may be the HRT stimulating the fibroid 

[sheila99]

If your concern about the mirena is the length of time to get it taken out talk to your gp. We have a nurse who can do it at short notice. I spent years wanting to stick to body identical but feeling lousy on utro, now I have a mirena I'm bleed and symptom free and wish I'd done it years ago.
  If you don't mind a bleed you could use sequi utro so you have more 'good'  time (that's what I did). Cyclogest does seem to suit some people better but it isn't licensed for hrt so your gp may refuse it. Or one of the synthetic ones already mentioned.