Menopause Discussion > Personal Experiences

Not sure of a way forward!

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Samantha54:
Hi everyone,

I am a new poster, but have read lots of your posts yesterday and today.

This is my issue, I will try and keep it short(ish)

Aged 45 I started perimenopause; it took me until I was 51 (18 months ago) to get HRT from my Doctor - at that point I hadn't had a period for 2 year.

Then in March I started to bleed everyday.  Sometimes heavy, sometimes light, but every single day.
I was referred for an internal scan after I badgered the Doctors for 2 months.  Then I went for a womb biopsy in May.

At the end of July, I got the result and the letter said that nothing was wrong and to continue with my HRT - its literally a two liner.

And that is where I am stuck, I have had umpteen telephone appointments with my Doctor (I have never met her) and she is very nice, but doesn't know what to do - her words not mine.

Yesterday, after reading on here I emailed the Menopause Specialist who is local to me and she replied saying I need a Doctors referral.  I had another chat with my Doctor today, and she has gone back to the Gynae to ask what I can do but says she doesn't think I need a referral to the Menopause specialist as well.  Thing is, the Gynae department had my results after a week and the letter took another 10 weeks to get to me! Dated 22nd May.

My question is, do I stop the HRT, is there anything I can do.  I feel like the system is not so much letting me down and just sending me round in circles!

I am on one pump of gel on each arm daily and continuous progesterone (they changed me from 14 days on and 14 days off about 8 weeks ago)

Thank you so much, any ideas would be amazing.

sheila99:
You can increase the progestogen and/or change to something more effective. What are you on now and what dose? A mirena is usually the most effective solution for problem bleeding but the synthetics (norethisterone, provera etc) are more effective than utrogestan. How thick was your lining?

bombsh3ll:
There is never any need for anyone to give up beneficial hormone therapy due to bleeding - this can ALWAYS be managed by a skilled and caring provider.

The main thing is your investigations were negative. That is a great place to start.

It sounds like you were on sequential progesterone until 8 weeks ago, which was historically DESIGNED to cause repeated episodes of vaginal bleeding for paternalistic reasons.

So you have only been on a regime which is intended to maintain amenorrhea for 8 weeks - it can take up to 6 months of this for initial bleeding to settle.

Strategies you can try if you don't want to wait are taking the progesterone vaginally, increase the progesterone to 200mg daily, or switch to a more potent progestin such as the IUS or an oral synthetic progestin.

The above assumes you are happy with your current estrogen dose - low estrogen can also cause an atrophic and unstable endometrium which can result in bleeding.

Vaginal atrophy should also have been excluded as a cause of bleeding, as well as cervical screening being up to date.

CLKD:
 :welcomemm:

Samantha54:
Thank you so much for your replies.

I am so glad I found this website!

I am going to go back to my doctor today and put forward your suggestions.  By the way, the hospital went back to her yesterday and said that I have been discharged into her care. 

Thank you again

S

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