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[rachie]

Ok, so I had controlled HRT for many years on the sequential regime.
Since going continuous last year, I have been bleeding every two weeks.
I’ve had hospital check ups and everything is ok and have upped the utrogestan to 200mg to no effect. I did try vaginally but it was horrible!
I’m on 2 pumps but was advised to up it to 3 as I was feeling so dehydrated and achy in the morning.
Reading posts, I wonder if the utrogestan could cause the thirst etc?
Also, I am 56, so maybe still a period?
I’m thinking of trying the regime where I take a break from the utrogestan for a few days to allow a bleed as at the moment, it’s 7 days heavy bleeding and about 5 days none.
The trouble is, how can I do this as I don’t stop bleeding for long enough?
I’m tempted to just stop HRT for a few months to reset and maybe see if I still have a period. Maybe then restart with sequential if I do…
Just don’t know what to do. Doctor doesn’t want to alter anything else now as I am on the gynae list, but they are looking at next year now.
I feel that the cons are far outweighing the pros at the moment
Any thoughts of how to break this cycle.

[bombsh3ll]

Nobody needs to put up with any vaginal bleeding at all unless they want to, and certainly it should not be a choice between untreated menopause vs uncontrolled bleeding.

Micronised progesterone is the weakest option for controlling bleeding and there are multiple synthetic alternatives including desogestrel 150mcg, slynd, provera and dydrogesterone however the latter is currently only available in combination with oral estradiol.

There's also the mirena IUS.

Have you considered any of these options?

[rachie]

I asked about the coil and that’s when I was referred to the gynae.
The doctor suggested upping everything but as I’ve upped the gel,  the bleeding is now flooding 😩

[Clovie]

Rachie, I too had frequent periods (every 24 days-ish and now down to 20 days-ish) ever since I have been on continuous 100g Utrogestan, I was never postmenopausal before I was changed to conti though, my own periods broke through on sequential so that along with the withdrawal bleeds I was told I HAD to have I got anaemic because of all the flippin' blood loss...
Anyway, I'm now switched to 200mg utrogestan and I'm hoping against hope it stops my bleeding but I doubt it... Because of my age , 61, I'm being sent for a scan as my docs still dont believe that my periods have never stopped (Like I've FOGOTTEN THAT, doh!) even though 2 years ago aged 59 I had a scan that showed I was still having periods. Nothing has changed since... still regular...

Bombshell seems to know a lot about Utrogestan and I find she talks a lot of sense!


Hey, Bombshell, what do you feel might work for me, given that the Utrogestan isn't strong enough to control my errant natural cycle  - I don't want a IUD.
Which do you think I might suggest I might try to my Doctor? (Yes, I do understand that this is just your opinion, and no, I am not using someone 'off the internet' to diagnose or whatever, I just value your opinion )

Also, Bombshell, do you happen to know how long taking 200mg  continuously might take to stop my cycle, IF it WAS going to stop it I mean?

Thank you Bombshell for any words of wisdom , and here's hoping you get sorted soon, Rachie

[rachie]

“Also, Bombshell, do you happen to know how long taking 200mg  continuously might take to stop my cycle, IF it WAS going to stop it I mean?”

Thanks Clovie and that’s a really good question. I was switched to the 200 mg continuous about 6 weeks ago and nothing has improved so far.

[bombsh3ll]

Frankly I don't think 200mg progesterone is likely to stop bleeding, whether that be menstruation or any other cause.

Leaving out the IUS, which requires an appointment for insertion and can take several months to stop bleeding (although it is a good option for many and worth considering long term), the two oral agents that I have most faith in to stop bleeding in the majority are:

Desogestrel 150mcg taken daily (2*cerazette contraceptive pills)

Provera daily dose of 10mg (some are controlled on 5mg, up to 15mg daily may occasionally be required).

Of the two, desogestrel is more favourable in terms of tolerability and many women have previously used it within contraception.

However using it either to control problem bleeding or as your progestin as part of HRT is off label and it doesn't sound as if either of your GPs would have the knowledge or confidence to prescribe it for this.

It is also available to buy from online pharmacies as birth control but only up to age 55.

So unless you have either a supportive prescriber or someone younger who can obtain it on your behalf, accessing desogestrel over 55 may be problematic.

Your other option is provera, which IS licenced for endometrial protection, and whilst old fashioned it is likely still listed on their formulary for this indication, so they may well be happy to prescribe this as an alternative to micronised progesterone.

[sheila99]

Rachie the nhs have the idea that everyone is meno by 54 and this causes so many problems for those who aren't. If you were OK on sequi utro and it suited you the obvious answer is to go back to that. A mirena is the most effective option to be bleed free. There is no need to be coerced into a conti regime before your body is ready for it.

[rachie]

Thanks all.
I may try the sequential then before going back (I was getting headaches and this is why I was swapped)
If that’s doesn’t suit, I think the Mirena could be an option.
I feel like I’m leading my GP, rather that the other way round 🤷‍♀️