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[jelolo]

Hi - I am new here.
I'm 48, perimenopausal. Been on HRT about 3 months. I started with half a 2mcg evorel patch and have slowly increased the dose to 50mcg.
I have gone slowly becuase i was concerned about exacerbating hormonal migraines which I've had all my life. I've been unable to tolerate synthetic progesterone in birth control on the couple of times i've tried it. But i'm pleased to say that HRT has not seemed to have any effect on migraine frequency at all.

I have really heavy periods. the first month i had my period before taking utrogestan was really heavy (I use 50ml menstrual cup - I call it the menstrual bucket) and I was filling that up several times a day, and lasted for 8 days. my second period on HRT which came after two weeks of vaginal utrogestan was lighter and shorter.

I've just finished my second cycle of utrogestan. Today I have a really heavy period, terrible sleep. My fitbit kindly told me i got three hours sleep last night
I experimented with taken 100mg utrogestan orally and the 100mg up my fanny and I found I slept really well but I got a bit of breakthrough bleeding. I'm wondering if the that the progesterone was metabolised by my liver and produced some metabolites made my sleep better but lessened the effect on my womb lining.

Anyway. terrible sleep when just on estrogen - is that a thing? My dr said i can't go on continuous progesterone for another couple of years...

(also - I seem to have found myself in a facebook group that is about treating PMDD with progesterone and they are all so anti estrogen it's untrue - I've had a lot of positive effects from estrogen. my joints are far less painful and i feel much more upbeat than I did before. Is estrogen really that bad?!)

[bombsh3ll]

Of course you can go on continuous progesterone if it benefits you!

Often a GP with limited knowledge around menopause will stick rigidly to flowchart based guidelines, providing care that is not individualised, without any real understanding of the physiology.

The ONLY reason sequential progesterone is typically prescribed if you are still menstruating is due to the theoretical belief that continuous MIGHT produce a less regular bleed pattern.

Sometimes this is the case and sometimes it isn't, however you are old enough to know your way around a moon cup and there is nothing dangerous or harmful about this.

Menstrual irregularity is common in untreated perimenopausal women anyway, and when this is secondary to continuous progesterone, which is actually more protective against endometrial hyperplasia than intermittent, this doesn't need to be referred for inappropriate investigation.

In any case, the dose of progesterone for continuous use is typically double that for cyclical, so it is already within your gift to take it continuously if you wish, without needing to get your prescription changed.

[jelolo]

thanks for your reply bombsh3ll!

I may be reading you wrongly, but did you mean that the progesterone dose when given cyclically is usually double that when given continuously? So this means that if I am prescribed 200mg for 14 days a month, i could therefore take 100mg every day throughout the month without needing a change in prescription?

Are there any risks to stopping my periods with progesterone? It seems crazy to ask that because I was once prescribed progesterone only birth control to try to prevent migraines (it didn't work...)
And the mirena coil would stop periods if I had that...