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[Blackcat11]

Hello
Just wondering if anyone can help or has experience similar to mine.
I am 53 and have been on Evorel Conti patches for 2 years, only using a half patch at a time twice weekly as a full seem to aggravate my IBS.
I have also used desogestrel progesterone contraception pill for well over 15 years until recently when I stopped. This was at the beginning of July. I stopped as I assumed I didn't need the contraceptive any more as was told the patches I was on had the right level of estrogen to progesterone and had had a transvaginal scan last year in April which stated I have atrophic ovaries and therefore post menopausal.
In the last 3 months I have had 3 occasions of bleeding. The first 2 ( middle of May and end of July) were light and only lasted a few days. I checked in with the menopause nurse at my doctors about this and she arranged for me to have the CA125 blood test which has come back normal. I have also recently had an abdominal and pelvic CT scan which was was part of investigations into my IBS. The menopause nurse said if I had still been bleeding when I went for my appointment she would have said to come off my patches for 2 weeks and to wait for the results of the CT scan and blood test. I have not had the results yet of the CT scan which was done on the 17th August. This was requested following a private consultation with a gastroenterologist. I have a phone call with him on the 9th Sept  for an update.
On Sunday I started bleeding again, much heavier this time with very red 'fresh' type blood with period type cramps and back ache. This has lasted until today where I thought it was easing up. The blood was darker and only slight today. However this afternoon I have started with cramps again and have gone back to very red 'fresh' type blood again.  I used a warm wheatbag this afternoon on my lap whist watching television. Could this have restarted the bleeding?
I am not sure what to do now. I don't know whether to try to see the menopause nurse again tomorrow if I can get an appointment or wait for my phone call on 9th Sept to see what the results of my CT scan were. Has anyone else had experience of 'sudden' heavy periods after being on HRT for 18 months?
Is it usual to 'restart' with red blood after a day of hardly anything and dark blood? Could this be because I have stopped the progesterone pill? Though my first bleed was before I stopped it?  Thinking back to what she said at my appointment I took my patch off on Monday and haven't reapplied. I am beginning to fret about what this is. Any help would be much appreciated.

[CLKD]

Without any HRT 1 is in2 menopause after the last bleed.  It may be difficult to decide how far we are if we are using replacement.

A scan won't tell if ovaries may still pump out small amounts of hormone.  Nature can throw in some surprises!  What were your periods doing B4 U began HRT?  Was there a particular reason for using a regime?

IBS is often an excuse for 'we don't know the cause of symptoms'.  R U able to explain more about how your bowels work/not?  10 mins B4 a bleed I would have to dash to the loo 'or else' even if a period wasn't due.  I would also have belatedness and 'constipation' feelings throughout my menstruating years in the week prior to my period.  These symptoms would relieve once the bleed began. In more recent years I've had slow transit which can be a real nuisance on holiday! 

If u stopped the regime bleeding is a possibility. If it's fresh, red blood don't worry too much.  Dark blood means that there isn't enough hormone to clean the womb completely and it gets left behind.  I always had 10 days heavy, excruciatingly painful periods, 2 days with nowt then 2 days of dark blood.  Normal 4 me.

Some find that keeping a mood/food/symptom diary of use to chart progress.  Let us know how you get on.

[Blackcat11]

Thanks for your reply.
I haven't had periods for such a long time as the desogestrel pill stopped them completely for all the years I took it, so it's hard to know what a typical period looks like for me.
I have just been reading posts previously written about post menopausal bleeding whilst on HRT and this has given me some comfort. I suffer with health anxiety which doesn't help. Feels like if it's not one thing it's another.

[bombsh3ll]

It is always a shame when someone is so needlessly frightened of bleeding from an organ that was designed to bleed in the presence of ovarian hormones.

Firstly there is no evidence you even are postmenopausal - you said yourself you had been amenorrhoeic for many years on cerazette.

Ultrasound appearance of ovaries is not a reliable method of "diagnosing" menopause, particularly if someone is on suppressive treatment such as a birth control pill.

I would simply restart the cerazette and ask for a routine pelvic ultrasound for peace of mind.

There is no need to stop your hormone therapy, and it doesn't sound as if this is being particularly well managed by your clinicians.

Rather than being on a murine dose of estrogen due to the combined patch aggravating your IBS, which norethisterone is particularly known for, why not consider separate estrogen at a dose that truly serves you and try a different progestogen such as either micronised progesterone OR a double daily dose of cerazette as your progestin?

The latter is unlicensed but supported by the BMS based on evidence. This would also almost certainly have you bleed free before you know it.

[Blackcat11]

Thank you very much for your reply. I was reassured by some of the your earlier replies to other posts too about post menopausal bleeding.
I agree I don't think my HRT was managed well on the patches. I am hoping to speak to my gps today and will consider suggesting a change of routine.
Much appreciated.