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[Goosieloosie]

I'm 64 and been on HRT for 10yrs, I use the evorel 50 patch and utrogestan 100 for 12 days roughly every 5 weeks cyclical vaginal regime and to be honest I'm getting fed up with it, I've lost quite a bit of weight and my bleeding has changed, darker brown and not such a crampy or painful bleed anymore but I have began bleeding on day 11 this month, I was wondering if I could cut a piece off the evorel 50 patch and carry on with the utrogestan regime reducing the patch over quite some month's. See how I am regarding menopause symptoms and hoping the bleed will not start until I have finished the full 12 days of utrogestan due to the lower oestrogen level. My GP isn't much help and I rarely go except for the yearly review which is with the nurse and she's clueless. My aim is to eventually stop HRT altogether.Any advice is welcome thank you

[sheila99]

Have you considered a conti regime? At 64 it's unlikely you still have your own periods so you could be bleed free. If you want to stop you can either reduce slowly or go cold turkey. The results are the same either way, if your meno symptoms are going to return they'll do so whichever way you do it.

[Goosieloosie]

Have you considered a conti regime? At 64 it's unlikely you still have your own periods so you could be bleed free. If you want to stop you can either reduce slowly or go cold turkey. The results are the same either way, if your meno symptoms are going to return they'll do so whichever way you do it.

Yes I did consider a bleed free regime but it would mean taking utrogestan vaginally every night and I'm not prepared to do that, plus I always seem to start the bleed around day 10 or 11. For my age I feel the utrogestan is the safest progesterone. I don't know what else to do. Unfortunately my GP would be no help.

[sheila99]

Mirena? I'm a similar age and I have one now, for me it's great. But I had side effects from utro which was an incentive to try something else.

[Cassie]

Same with me, 12 days of Utro  100mg used Vaginally then the bleed starts before I am finished around the 10th day, I cannot tolerate P every day either makes my boobs so sore and the cramps are not great. I am also deciding how to go forward, I would love to stay on the Oestrogel but its the Progesterone that is the big issue, I cannot see myself still getting withdrawal bleeds when I am 70 something

[bombsh3ll]

Personally I would seriously think about the long term health implications rather than just the bleeding being a nuisance.

Have you considered taking the micronised progesterone alternative nights? This may well achieve complete amenorrhoea on 50mcg of estradiol.

[Goosieloosie]

Personally I would seriously think about the long term health implications rather than just the bleeding being a nuisance.

Have you considered taking the micronised progesterone alternative nights? This may well achieve complete amenorrhoea on 50mcg of estradiol.

Do you mean use the utrogestan every other night permanently? I don't think I would want to do that mainly because it would be vaginally and it causes me a lot of incontinence issues as I have a bladder prolapse when I'm on the course as it is. I also really don't fancy a mirena coil so I'm kinda stuck. Yes I guess the health benefits of HRT are worth it long term but it'll most likely be something I won't realise until after I've stopped. I really don't know what else to do.

[sheila99]

Are you certain there is no va involved? When it started irritating me it was because va was starting, at that time I had no symptoms when not taking it. The other possible option is rectally which I did for a few cycles. I had a better bleed this so I think it's more effective but there is no medical evidence so if you use it this way you should have scans to make sure your lining remains thin. Likewise if you take it every other night. But if the bladder problems haven't always been there I'd suspect va so you might consider topical oestrogen and/or an increase in systemic.

[bombsh3ll]

You still have two other holes to use, the mouth and the anus.

It is perfectly safe to take micronised progesterone rectally if you want.

This route is socially unappealing to most people but it is medically viable.

You don't even need to stick to one route, you can alternate.

[AmandaJR]

Hi Goosieloosie, I took Utrogestan for 3 months vaginally. For the last two months I was up in the night peeing five times, exhausting. No other GSM/VA symptoms and not frequent peeing in the day. My GP said she wanted to treat it as VA as a precaution so prescribed Vagifem and do UTI test. She told me to use Utrogestan rectally this has worked as I don’t get up in night and it’s far less messy.
I’m on a lot of estrogen so don’t think I’ve got oestrogen deficiency, I think it was related to Utrogestan vaginally as it hasn’t happen since I stopped vaginally.
I hope you find a solution as it’s awful having constantly broken night of sleep.
Good luck

[Goosieloosie]

Hi Goosieloosie, I took Utrogestan for 3 months vaginally. For the last two months I was up in the night peeing five times, exhausting. No other GSM/VA symptoms and not frequent peeing in the day. My GP said she wanted to treat it as VA as a precaution so prescribed Vagifem and do UTI test. She told me to use Utrogestan rectally this has worked as I don’t get up in night and it’s far less messy.
I’m on a lot of estrogen so don’t think I’ve got oestrogen deficiency, I think it was related to Utrogestan vaginally as it hasn’t happen since I stopped vaginally.
I hope you find a solution as it’s awful having constantly broken night of sleep.
Good luck

Thank you, I hope I can find a solution too as it is exhausting constantly going to the toilet. Can I ask how often you use the utrogestan rectally, is it every night or for the 12 days so you have a regular bleed? I already use vagifem.

[AmandaJR]

Morning, I take one 100mg around 9am and another around 9pm for 26 days a month but I was told I could take it continuously.

Ayesha posted this GSM doc last month, I found it really useful, you’ve probably seen it but just in case you haven’t it’s here:

https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

Is it worth increasing your oestrogen patch to see if that helps too? I really feel for you and hope you find a solution quickly.

[Goosieloosie]

Morning, I take one 100mg around 9am and another around 9pm for 26 days a month but I was told I could take it continuously.

Ayesha posted this GSM doc last month, I found it really useful, you’ve probably seen it but just in case you haven’t it’s here:

https://bssm.org.uk/wp-content/uploads/2023/02/GSM-BSSM.pdf

Is it worth increasing your oestrogen patch to see if that helps too? I really feel for you and hope you find a solution quickly.

Oh my gosh you use utrogestan twice a day anally? That actually doesn't sound appealing at all but it might be worth giving it a go. And no,
I haven't seen the link you have sent but I'll have a look now. Thank you so much for your help

[AmandaJR]

I didn’t find it appealing! Far from 
I didn’t have much faith in it working but I don’t get up in the night now at all and I’ve had no side effects.

[Goosieloosie]

I didn’t find it appealing! Far from 
I didn’t have much faith in it working but I don’t get up in the night now at all and I’ve had no side effects.

That's actually great to hear you have no side effects but I'm still a bit hesitant