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[Starfish]

Hi there,

I hope everyone is well. I had been on cyclical HRt, various kinds for a number of years due to early menopause. However I don’t get a withdrawal bleed from utrogestan. Then my dr suggested continuous. I trialled for 8 weeks, I had spotting, bleeding with clots continuously. My mood was very low too. I had full on depression and I felt an awful sense of dread every morning. Anyone else have this. My dr seems to think it’s all normal, but I could get a scan if I really wanted but this is probably not necessary. Any advice or suggestions? Anyone else experience very low mood and bleeding triggered by progesterone?

[MrsMitch]

Not sure I can help except to say that I also didn't get a withdrawal bleed when it was suggested I try that to stop the spotting I was getting. What I did find was that stopping the utrogestan to induce a bleed messed my sleep up massively. That was one of my issues I needed HRT to help with & up to that point the utrogestan helped with. So I abandoned that method & take it continuously again, it just didn't seem worth the lack of sleep.
I do know that Bombsh3ll gave me excellent information as to what types of progesterone was available & she did say one particular one would stop an elephant bleeding! I went to my menopause specialist armed with the list but each was dismissed because utrogestan is supposed to be the safest. But it's lousy at controlling bleeding, it seems, that's the downside. I'm still not satisfied because I still get spotting some months, I just ignore it now as what's the point in trying to stop it when no one will let me try something else.
I realise that may not help you but just thought I'd add my experience.

[sheila99]

I have side effects from utro too, I can tolerate it up to day 8 but the insomnia and groggyness increase too much after that. I'd suggest you either continue with sequi or change to a different progestogen that you tolerate better. I have a mirena which is bleed free and gives me no side effects. You don't have to put up with something that makes you feel so bad when there are alternatives.

[Starfish]

Thanks Mrs Mitch and Sheila. I think I might be post meno at this stage so all the bleeding is bit much.  I went into early menopause at age 42, periods 4 months apart. I’m now 47.

[bombsh3ll]

The obvious suggestion is to go back to sequential if that suited you better.

I wouldn't consider a scan necessary because of bleeding clearly triggered by a change in hormone therapy unless abnormal bleeding persists.

However if a scan is offered I would take it, as I personally think it is a good idea for all women to have a pelvic scan now again as part of regular well woman health maintenance, similar to the mammogram or cervical screening.

[Taz2]

It's common to experience bleeding for the first six months of using any continuous HRT. I had continuous bleeding for the whole of the first six months when I changed to a conti regime. I reverted to sequi which gave me a much more predictable and lighter, shorter bleed.

Taz x

[Starfish]

Thanks Taz and bombshell. I also had a strange bleeding pattern while on sequential. After 7 days of progesterone on the sequential regime I bled, this only stopped when I stopped progesterone. No withdrawal bleeding.

[bombsh3ll]

I think it depends what your priorities are but ideally everyone should be able to find a regime that works for them in terms of feeling well, meeting long term health goals eg cardiometabolic and bone health, and having an acceptable bleed pattern, which for some means no bleeding at all.

Sometimes a degree of compromise has to be made for example a strong progestin taken continuously either by mouth or the IUS can achieve amenorrhoea, but cause intolerable low mood or bloating etc.

Others may choose to accept some bleeding, particularly if this can be regular and predictable, in order to minimise the progesterone burden, so long as endometrial protection is maintained.

But clearly if continuous micronised progesterone is both poorly tolerated and resulting in an unacceptable bleed pattern, then I would suggest it is not the best fit for you as an individual.

[Dandelion]

I bled while taking utrogestan.
The first time was heavy and my doctor increased my progesterone.
The rest of the times were due to low oestrogen, unbeknownst to me at the time so I reduced it 😐 to stop them.
No bleeds since the latest increases.