Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Sadiesare]

I starred on Conti about 5 months ago after being on Sequi. When I was on Sequi I would have a period once a month as normal but since I've been on Conti it's been twice a month, although much lighter than before. My Dr sent me for a pelvic scan and results were normal. I asked if I could go on the mini pill, or have extra progesterone, as I'd read that stops bleeding. My Dr  after consulting with Gynaecology at hospital has now referred me to a Primar Care Menopause Clinic, because the hospital told her not to prescribe progesterone without further investigation and she even mentioned I might need a biopsy which I've heard is excruciating, so now I'm panicked.

[bombsh3ll]

This is incorrect.

It sounds as if you have possibly moved to continuous prematurely if avoiding unscheduled bleeding is an important outcome for you.

Irregular bleeding occurring within the first 6 months of new or changed HRT in a low risk patient should not trigger referral for invasive investigations.

You could either go back on sequi until you are fully postmenopausal, stay on the conti patches and add in desogestrel - you can either say it is for contraception or buy it online, or change to either a mirena IUS or a suppressive oral progestin such as 150mcg desogestrel or Slynd, taken daily alongside estrogen only patches.

The latter two are unlicensed however and may not be supported by an inexperienced clinician.

If your endometrium was nice and thin on the scan there is no indication for a biopsy.

[Sadiesare]

Thank you for your reply. From reading about Evorel Conti and possible side effects if not post menopausal I thought the same. I have had bladder frequency for the last 18 months and am currently being treated for chronic cystitis with long term antibiotics, am also on oxybutinin. The urgency does seem to be improving apart from on the day I start bleeding and again when I stop. So they put me on Conti hoping it would stop my periods. I also use estriol cream and replens for dryness as well. I've never heard of a primary care menopause clinic before and I don't really understand how they're different from a GP.

[bombsh3ll]

Using menopause hormone therapy to try to stop periods is missguided, as it was never designed to provide menstrual suppression and seldom contains a strong enough progestin to shut your own cycle down.

The products which can eradicate bleeding that I listed above are all forms of birth control although they can be used alongside estrogen for menopause treatment.

If you are under 50 the combined pill taken continuously can be a good choice - this is what I take for menstrual suppression and to provide me with adequate, stable estrogen levels.

The other problem with the combined patch is the fixed low dose of estradiol (50mcg).

Finally I would really, really caution against oxybutinin due to the anticholinergic burden. This is a class A dementogen, and most people would rather piss themselves all day long if they knew the cognitive impact of this drug class.

This is so sad when the cause of urinary issues in women is often loss of ovarian hormones.

[Sadiesare]

Hi,
Thanks so much. I am 54, I have always thought my urinary issue is caused by hormones. I will ask my urogynaecologist about alternatives to oxybutinin, but I don't see him until January. He's only offered me bladder botox so far but the potential side effects of that are really quite scary. I just got the appointment for the menopause clinic on 2 December. The lady I spoke to was very helpful actually. She said they're experts in menopause issues. So I'm feeling a bit more hopeful now. Fingers crossed...

[bombsh3ll]

That's great news!

Just don't be shy about advocating for yourself because nobody deserves to suffer from treatable symptoms.

I would also ask for testosterone (you may have to say it's for libido to get it on the NHS) but it is also really important for urogenital health in women and often overlooked.

The list of really detrimental and ineffective treatments offered to women instead of replacing natural hormones is seemingly endless and causes large scale harm and suffering as well as being a false economy.

I am not saying that nobody benefits from bladder botox, but really anything that literally has toxin in the name, as well as anticholinergic medications, should be a last resort when someone is well estrogenised and androgen replete, and still has problems.

[Sadiesare]

Thank you so much for all your advice. It's a relief to talk to someone who knows what they're talking about. I didn't know about testosterone being good for bladder health. I'll ask about that at the menopause clinic. Thanks again.