Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: soniad on March 02, 2020, 03:14:44 AM
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Hi everyone,
I started on HRT while I was still having periods, so have no idea if I'm still in perimenopause (I'm 52YO, will turn 53 in July).
At what age is it considered 'safe' to switch to a continuous regime?
Any advice is greatly appreciated
thanks
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I'm 53 and have just started 3 months ago continuous HRT.🌹
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Thanks Penelope:)
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Hi you can try continuous at any time but you may get breakthrough bleeding. it's usually recommended to be on sequential for a year before swapping. X
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Thank you:)
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A woman can take continuous HRT at any age but it may cause erratic bleeding if given too early. Usually women can switch from cyclical to continuous after one year of use or at least by the age of 54.
This is copied from an hrt prescribing guide. X
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I'm nearly 58 and was having regular periods up until going on sequi HRT 18 months ago, age 56. I wanted to change to conti as the fluctuations are not helping my headaches, But the dr at the menopause clinic wasn't sure of the advisability of this as she felt I may still be at the end of peri. However, as Dotty says she said it was ok and did prescribe conti. She said I would know as I would get breakthrough bleeding and if I did should then return to sequi. It's hard to know where you are when you are on HRT.
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I'm nearly 58 and was having regular periods up until going on sequi HRT 18 months ago, age 56. I wanted to change to conti as the fluctuations are not helping my headaches, But the dr at the menopause clinic wasn't sure of the advisability of this as she felt I may still be at the end of peri. However, as Dotty says she said it was ok and did prescribe conti. She said I would know as I would get breakthrough bleeding and if I did should then return to sequi. It's hard to know where you are when you are on HRT.
You might get bleeding with Conti anyway. I didn't start it until 5 years post meno and have still been having bleeding.
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Hi Katejo,
How long have you been on conti for? Are you going to return to sequential?
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Hi Katejo,
How long have you been on conti for? Are you going to return to sequential?
I only started HRT last May so have never used Sequi. I was already 4 years post meno then.
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ok thanks:)
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Conti just doesn't work for some of us at whatever age.
Nuisance spotting for up to 12 months - >:( - depends on your tolerance level I suppose!
I tend to believe from all I've read on here over the years that if its going to work it works pretty much from the get go.
Keeeping fingers crossed that bleeding will stop by 12 months. Half expected it to restart this week but nothing yet. If I get through March without any, I will be more optimistic. I like it apart from the bleeding.
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Thank you everyone for your replies,
this is really helpful.
Conti just doesn't work for some of us at whatever age.
Nuisance spotting for up to 12 months - >:( - depends on your tolerance level I suppose!
I see that some of you have experienced spotting for 12 months - I thought it was only considered 'normal' to experience breakthrough bleeding withing the first 6 months.
My breakthough bleeding started after 7 months. I was peri when I started sequi hrt at 49YO, I'm 52YO now will turn 53 in July. So no idea if I'l still peri or not.
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Hi soniad. There are several different issues here. Like Dotty said if you start sequi HRT when you are peri-menopausal depending on your age and what your cycles were doing when you started, then some docs will suggest a trial of conti HRT after a year on sequi and if you get regular breakthrough bleeding that coudl indicate you are still peri so a return to sequi would be advised. Otherwise at age 54 (again depending what age you started and the stage you were at) a trial of conti HRT would normally be advised.
If you start conti HRT when you are post-menopause then as already said 6 months of bleeding might be expected and sometimes up to 9 months - or worst case scenario 12 months or never!
The medical advice is to get bleeding checked out that persists after 6 months on conti regime ( if not due to peri-menopause - though how you would know is not possible if you start when peri!) or earlier if the amount or nature of it is abnormal or worrying.
I can't speak for others but I imagine those who have experienced bleeding for longer than 6 months eg 12 months will have been checked out, nothing found to be wrong, have gone back to conti HRT and have continued to experience bleeding or spotting. These women would be better off taking sequi HRT - although if taking seperate oestrogen and progesterone a higher dose of progesterone may stop the bleeding.
Hope this hasn't confused you further!
Hurdity x
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The medical advice is to get bleeding checked out that persists after 6 months on conti regime ( if not due to peri-menopause - though how you would know is not possible if you start when peri!) or earlier if the amount or nature of it is abnormal or worrying.
I can't speak for others but I imagine those who have experienced bleeding for longer than 6 months eg 12 months will have been checked out, nothing found to be wrong, have gone back to conti HRT and have continued to experience bleeding or spotting.
Hurdity x
Hi Soniad I am going through this now. The bleeding didn't start until 3 months on full patches. I have already had part of a hysteroscopy to check for fibroids and polyps but have to go back again under GA to have a biopsy as a precaution. I want to continue with patches up to 9-12 months to see if it stops (none for past 2 weeks). I don't want to have regular bleeding so might have to find an alternative.
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Thank you everyone,
You have given me a lot to think about:)
Am wondering if I should stop the progesterone for 5 days and see if I can shed the lining?
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I'm 54 and switched from a sequential to a conti over 14 months ago. I was told, I'd been on the sequential too long, as after 12 months on a you should then switch to a conti.
Was okay for the first few months, then breakthrough spotting/bleeding started. As it went on for longer than 6 months, I was referrred on to get it all checked. Had scans done, to check ovaries, and also checked the thickness of the lining of the womb. All was okay. The breakthrough bleeding settled, but on the odd occasion it does come back only slightly
Sequential was great, but then after a period of time started having troublesome breakthrough bleeding, so thats when it was decided to switch to conti
Ive found conti much better, once the switch was made.
Guess it takes time to try things, to find something that works for you. As people have said conti just doesnt work for some people and they revert back to a sequential
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I'm 48 and have been on conti for about 3 years. I switched because I just couldn't cope with the up and down hormones of a cycle.
Mostly it's been great but sometimes I get a bit of spotting and occasionally a bleed. I know they are coming because my boobs start hurting!
I much prefer it even if it is a bit unpredictable.
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I'm quite happy to go back to sequi.
I don't want the stress of having to get things checked out if there's breakthrough bleeding.
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StellaJane
Thanks for letting me know about the information on switching to a conti. That's very interesting that you don't need to switch :)