Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: applejack on October 24, 2017, 12:52:35 PM
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Hello, new here. Have found this forum so helpful over the past few weeks but am now struggling to find what to do now I've run into problems on
HRT.
Am 52, and after being period free since April 2016, I was put on Femoston Conti 0.25/0.5 in June. Really helped, but then started spotting more and more, so two weeks ago was put on fem 0.5/1. Well, since Sunday have been bleeding v heavily. Really badly. In a panic I skipped my tablet yesterday but took one this morning in case I made it worse by stopping. Have tried to phone the doctor but no joy. Don't know whether
to stick with it, drop
Back to the low dose or just stop. The relief from symptoms was great, but this onset of bleeding
Is awful 😧. Don't know what to do.
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Hi applejack. Sorry to hear that you are experiencing problems. Conti HRT is known to give women breakthrough and, sometimes, constant bleeding (that happened to me) so try not to worry. It is down as one of the side effects. Some women give up on the conti and opt for a sequi one to give a monthly bleed. Bleeding can also occur when you stop or lower your dose of progesterone. I haven't had personal experience of the HRT you are on but someone else will be along soon with more knowledge.
How heavy is your bleeding and are there clots?
Taz x :welcomemm:
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Hi and welcome to MMapplejack - as Tazz has said, breakthrough bleeding is common on any conti HRT. The increase in dose wouldn't have helped I'm afraid. If you were doing well on the low dose then I would have stuck with this and over the next 3-6 months the bleeding and spotting would usually subside. It can be better to start on a sequential HRT but this would mean you have a regular monthly bleed.
Perhaps try to stick things out for a few weeks and things might settle. If you want an easier, non bleed, regime then having a Mirena fitted and using oestrogen separately as pills, patch or gel can be a good option. DG x
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Thanks for the replies, it's made me feel better.
I did actually get through to the doctor in the end - to be fair, she is great, pro HRt (she takes it herself) and very supportive. i've seen some posters on here have difficulty getting the help they need from their docs so I know I'm lucky in that respect.
She told me to come off it for a few weeks and give my body a break, then she'll sort a full check with a gynae and take it from there. She says nothing really bad will happen if I stop for a few a month and then come back and see her, and if I'm still bleeding in ten days she wants to know about it.
To be honest I'm happy to sit on the 0.25/.5 and put up with the spotting. I didn't realise it could last up to 6 months and I'd only been taking it for 4. it was the full on flooding that started up with the.5/1 increase that I wasn't happy about. It was flippin' painful if nothing else! spotting - well, it's a bit meh but I can live with it if I know it's nothing sinister.
So I'm going to be back to square one now.
I did wonder if I'd started on conti too soon. Sure, I hadn't had a period for 14 months when I started, but that's barely over the required 1 year without. And I had had some spotting 7 months in, so maybe a sequi would have been better. I assumed that spotting within that no period year didn't really count.
One question - with spotting on HRT in the first 6 months. I was getting it at random times - like sometimes I'd have a 2 week break, or 3, or ten days. It didn't seem to have a pattern or cycle. Is that also normal?
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Yep, erratic spotting/bleeding is quite normal with conti HRT. You may not be fully post meno, from the sound of it, so I would go for sequential HRT when you next go back on. DG x
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Another lack of information from a GP though :-\ or not included in the leaflet with the prescription?
Let us know how you get on.
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It's in the leaflet that there may be some bleeding (although it doesn't say for how long), but I saw two doctors before I went on HRT and both of them said there'd be no bleeding.
The thought never crossed my mind that I wasn't far enough post meno. I guess the "one year and then you're fine" yardstick doesn't fit all women.
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I'm afraid GPs are generally pretty ignorant about meno and the treatments.
Many women don't do well on conti HRT so tend to stick with a sequential HRT and put up with monthly bleeds. Sequi HRT means fewer side effects from progesterone and less likely to get problematic bleeding. DG x
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Hi applejack
:welcomemm:
You've been given great advice already from Taz and Dancinggirl but just to add that if your doc is saying wait a few months before going back on HRT - I would suggest that this really is not necessary. By that I mean you do not have to suffer if your symptoms recur sooner than this. When I had some bleeding (at the wrong time) whilst on HRT my GP said I had to stop as with you and then go back if the bleeding recurred, but I had an e-mail consultation with Dr Currie who said I did not need to stop HRT pending investigations so took this to another GP and she agreed - so the investigation carried on while I was still taking HRT.
In your case as already said - this bleeding is quite normal so not quite sure why the investigation is deemed necessary - but I would always go for whatever is recommended as it's always good to get checked out. It's the stopping of HRT that I would want to take issue with ( as you are still within the timescale during which bleeding is normal even if you are post-menopausal) - depending on how you feel of course!
Hurdity x
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Hi
been offline for a bit. Wanted to say thanks for all the help on this thread and wish I'd known you were all here earlier.
The bleeding stopped eventually and I've had nothing since then (not taken HRT as advised by the doc, even though I'm not sure if that was neccessary for the reasons some of you mentioned).
Had the ultrasound today, and slightly perturbed by it. Took nearly ten minutes, which I worried was a bit long, and then she said "ok, I'm going to scan your tummy now" and did a scan of my lower pelvis externally. Which I wasn't expecting so am imagining that she saw something dreadful and was double checking. Do they usually do that?
I also had a tiny bit of spotting today after about three weeks off the HRT. So this, combined with the unexpected tummy scan, has sent me into a tiz.
Must say though - if any of you are likely to need a TVScan, don't worry about it. I hate smears and examinations, but this was so easy and you are pretty much covered up throughout. I was amazed.
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Hi applejack
Did they not tell you what they saw during the scans? They usually give you the results there are then!!!!!
If there was anything of concern, then I'm sure they would have told you.
If you are getting odd bleeds without HRT- then you may still be per meno - your womb lining may well have built up and this would explain the bleeding. How old are you? Over 54?
I would stick with a sequi HRT and put up with a monthly bleed for at least a year before trying conti HRT again. You could have a Mirena fitted with oestrogen alongside as gel, patch or pills. The Mirena can be good in both peri and post meno and will usually result in no bleeding at all after the first few weeks. DG x
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Try not to worry applejack - the two scans are common. Usually you have the external one first though - with a full bladder - then you are allowed to empty your bladder and have the internal scan. It doesn't mean that anything sinister was found. Just to say that I've never been told any results at the actual scans and this is because, I believe, the scans have to be signed off by a senior someone-or-other. Covers themselves just in case a mistake is made and someone sues the health authority.
Good advice from Dancinggirl re sequi HRT.
Taz x
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Thanks for calming me down!
I'm under 54 - 52 in fact.
What counts as a full year period free? Is it just period free, or spotting free as well? Because whilst I didn't have a full period from APril 2016-April 2017, I did have a bit of spotting in November 2016, just a tiny amount, but it was there. Doc told me it didn't count, but I'm beginning to wonder now if I should have counted it, which would mean I'm still not one year clear yet.
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I was under the impression that conti HRT was for women over 54 or, if younger, 2 years without periods. DG x
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All the advice I've read on this thread seems to suggest that conti was completely wrong for me. Ho hum!
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GPs :bang: - so often not up to speed and I'll informed - particularly when it comes to treating menopause problems. The NICE guidelines have been out for over 2 years now and awareness of the impact of meno symptoms are now being highlighted far more. If GPs got their act together the NHS would save a great deal of money.
Print stuff off from this site to show your GP and tell them what you want. Why not try Femoston 1/10 ? DG x
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Thank you DG. Going to mosey around the thread and get more info re 1/10 before I get the results from doc next week.
Meanwhile, despite being off HRT for nearly a month, have started bleeding again. Getting worried now ☹️
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Probably your ovaries having a final few gasps!!! You definitely need a sequi HRT. DG x
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Life in the old girl yet ;)
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I have been on HRT for 4 months using an Estalis Conti Patch 50/140. After being on it for 4 weeks I started to bleed; spotting at first, then it got heavier. I really didn't want this after 12 months of no periods plus also having an iron deficiency. I didn't want to lose blood unnecessarily.
So I decided to cut the patch in half and see if I could wear half a patch, hoping it would stop the bleeding but still keep the HRT benefits.
Well so far it has, the bleeding has stopped and the meno symptoms have not come back so I'll keep going with this for now....
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Kritsty - Some bleeding in the first few weeks or even months, on any conti HRt, is quite normal. The patches are medium dose generally and if your oestrogen levels were low at the start then to hit the body, quite hard, with hormones, it will inevitably react accordingly. The last time I started HRT, after a 15 month break from HRT, the gynaecologist told me to start low and slowly build - I was using Oestrogel with separate progesterone on a sequential basis so expected a monthly bleed as I'd found in the past that conti regimes didn't suit me.
The best non bleed HRT regime for me, post meno, was the Mirena with Oestrogel alongside.
It's all about trial and error with HRT but beware of chopping and changing too quickly and too often, as this can confuse the body and not achieve anything.. DG x