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[rachie]

Hi
I just wanted to get some options before I see my doctor next week.
Ive been on HRT for 4.5 years and its been good for my achy bones and brain fog.
I’m 56 and was put on continuous HRT last Dec. 2 pumps gel and 100 of utrogestan.
I had a lot of bleeding and had a biopsy and a polyp removed at the start of June. I was discharged from the gynaecology 2 weeks later with clear results.
Everything was fine for a month and then I had a really heavy bleed for 7 days.
Since then, I’ve had bleeding for 5 to 7 days, every other week.
I increased my utrogestan to 200 a few weeks ago(as I couldn’t see a doctor within 4 weeks) and it’s changed nothing.
So…do I just stop the HRT now and see how it goes?
Reduce the gel as I don’t think they will increase my utrogestan further?
Ask to be put on a waiting list for a coil (which I hate the thought of)
A bit annoyed that they automatically discharged me as I assumed I’d be able to go back to see a specialist with options as I’ve never found the doctor that helpful.
Any thoughts or suggestions would be welcome

[sheila99]

You can use 300mg utro if you need it but the synthetic progestins such as norethisterone are more effective than utro. A mirena is usually the best option for problem bleeding though. I've had one since Jan and it's been great, no side effects (unlike utro) and no bleeding after the first 6 weeks. If you're worried about getting it removed ask your surgery, we have a nurse who can do it within a couple of days. If you need the dose of oestrogen you're on to control your symptoms personally I wouldn't reduce it,  it would be better to sort out out the progestin. Are you certain you're meno not peri? As utro won't stop the bleeding if you're peri. Has the bleeding only been a problem since you started using it continuously? If so another option would be to go back to sequi.

[rachie]

Thank you.
The doctor assumed that I was meno due to my age but not sure. I know that when I bleed, I have no pains or mood swings etc and it doesn’t feel like a period.
I do wonder if maybe to opt for a coil.
I like the utrogestan, as it helps me sleep but it doesn’t seem to be doing the job as my last scan showed a endo thickening (hence the biopsy)
I feel great with everything else but it’s just this one (annoying) symptom

[sheila99]

There seems to be a textbook somewhere that says that everyone is meno by 54 even though some aren't until their early 60s. I was mostly regular when I started hrt at 57. Did the problems start when you went on a conti regime? If you don't want to back on sequi you may find the 25/28 day routine useful as it allows a bleed if there's been a build up and gives you more days on utro if you want it for sleep.

[rachie]

Thank you. Haven’t heard of that regime, so will take a look

[MrsMitch]

Hello rachie, I don't know if this will help but just thought I'd add my experience. I'm on 4 pumps & 200mg Utrogestan & was fine till 18 months ago when I had a significant bleed. Ended up with a hysteroscopy due to thickened lining but all was OK. When I saw I menopause specialist to get testosterone, I mentioned I was still getting spotting & she suggested I stop Utrogestan for a few days a month so I have a scheduled bleed. I went through a list of progesterones that are meant to be better at preventing bleeding but she didn't want me to have any of them as Utrogestan is the safest - just not good at preventing bleeds/spotting.
So I agreed to try the scheduled bleed (can't remember the term for that) but stopping the utrogestan ruined my sleep (after 3 years of appalling sleep it worked really well for that) & I didn't bleed. Persevered for a few months but never had a bleed & decided I wasn't prepared to forfeit sleep.
So now each month I bleed a bit - sometimes spotting sometimes 2 days of light bleeding. The specialist told me not to be concerned unless I bleed continuously for a month that didn't stop, so I'm not, annoying as it can be.
There is no way I'd have a coil, ever.
So if the HRT works for all your symptoms is it worth stopping? Maybe take a look on the forum & see the different types of progesterone that will prevent bleeding & see the GP armed with the info? If they won't help could you ask to be referred to a menopause specialist?
Just a few thoughts for you.

[rachie]

Thank you.
I’m really fed up now.
I saw the doctor and mentioned a few things as you suggested. 
His response was to stop HRT altogether or a referral back to the gynaecologist.
He could not suggest anything else.
I’ve been told that as they’d discharged me already, I have to go in the waitlist, which is 5 to 6 months.
This sounds like such a cop out and now I really don’t know what to do.
Maybe go back to sequential as I don’t know whether 100 plus 2 pumps plus a few days off will be enough. 

[MrsMitch]

So yet another GP who won't do anything. I'm sure other ladies will make suggestions as well but here's a few things I've learned from others here.
If you don't get the help you need from your GP you can contact your practice manager & let them know the issue you saw the GP hasn't been satisfactorily resolved.
A gynaecologist doesn't necessarily know much about menopause- the one I saw certainly didn't. So it might be better to have a referral to a dedicated menopause specialist. But it could be a long wait.
Y0u definitely don't have to accept being fobbed off.
I'm sure others will give you some good suggestions too.