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[rferdi]

Hi, I'm 53, I think still perimenopausal, have been on hrt for 1 year and 8 months now, and on a cyclical regime for more than a year. So far I've tried Oestrogel and Lenzetto, sticking with Lenzetto for convenience, and I last increased my dose 8 months ago.

Over all this time I've found that almost always I get a bleed only about 7 to 9 days after starting Utrogestan, I rarely ever get to do the 12 or 14 days before bleeding occurs. I keep taking the progesterone until I complete the 14 days, which is what I was advised to do by my gynecologist, although it feels to me that I should stop. But then I would've not taken it for long enough as I understand the minimum is 12 days per cycle.

A couple of months ago I decided to switch to a 25 day cycle instead of a 28 day, just because 25 days used to be my natural cycle and I thought maybe that's why the withdrawal bleed happened too soon after starting to take the progesterone.

It hasn't been the case however, I'm getting the bleed after 7 to 9 days anyway. I wonder why this may be, could it be I have too much estrogen and there's been enough build up in the lining of my uterus, so the bleed has to happen earlier once I'm on progesterone a week or so?

All my blood tests have been showing my levels of estradiol are on the lower end, and in fact I still have many symptoms. Hrt has been helpful in that it's diminished most of them but I still have to find an adequate dose, and in fact I was about to increase it but I've been doubting to do so because of this early withdrawal bleed thing going on.

Anyone who knows about this and wants to comment, I'd love to hear your thoughts. Thanks!

[bombsh3ll]

Unfortunately this is common with sequential HRT using micronised progesterone in perimenopause.

Bleeding pattern should not dictate your dose of estrogen, this should be guided by your individual treatment objectives, and then a progestogen type, dose and regimen selected based on what will protect your endometrium and, if important to you, will result in a bleed pattern that is acceptable to you, which for some people means not bleeding at all.

Your options are to either stick with sequential micronised progesterone and accept the resultant bleed pattern, try a hybrid 25/28 regime or continuous progesterone (these would be at half the dose of sequential) to see if this improves things, or switch to a more potent progestin.

Hi, I'm 53, I think still perimenopausal, have been on hrt for 1 year and 8 months now, and on a cyclical regime for more than a year. So far I've tried Oestrogel and Lenzetto, sticking with Lenzetto for convenience, and I last increased my dose 8 months ago.

Over all this time I've found that almost always I get a bleed only about 7 to 9 days after starting Utrogestan, I rarely ever get to do the 12 or 14 days before bleeding occurs. I keep taking the progesterone until I complete the 14 days, which is what I was advised to do by my gynecologist, although it feels to me that I should stop. But then I would've not taken it for long enough as I understand the minimum is 12 days per cycle.

A couple of months ago I decided to switch to a 25 day cycle instead of a 28 day, just because 25 days used to be my natural cycle and I thought maybe that's why the withdrawal bleed happened too soon after starting to take the progesterone.

It hasn't been the case however, I'm getting the bleed after 7 to 9 days anyway. I wonder why this may be, could it be I have too much estrogen and there's been enough build up in the lining of my uterus, so the bleed has to happen earlier once I'm on progesterone a week or so?

All my blood tests have been showing my levels of estradiol are on the lower end, and in fact I still have many symptoms. Hrt has been helpful in that it's diminished most of them but I still have to find an adequate dose, and in fact I was about to increase it but I've been doubting to do so because of this early withdrawal bleed thing going on.

Anyone who knows about this and wants to comment, I'd love to hear your thoughts. Thanks!