Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: Stella2 on June 17, 2023, 06:46:15 AM
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Hello ladies,
I wonder if anyone would be able to offer an advice or comment. I will try to keep it short.
I have been on continuous HRT for year and a half ( Esstradot 50 and Utrogestan) and in the first year I haven't had any issues with bleeding. Then, after a year, I assume due to increasing Estradot to just bellow 75, spotting occurred first time. I had a scan, the lining was 3mm and the gynaecologist suggested to use double dose of Utrogestan what I did for a while. At the same time I lowered my patch from 75 to 50 so I have been OK for a while and couple of months ago I went back to normal 100 mg dose of Utrogestan. I tried to lower my patch from 50 to 25 gradually but 25 was not enough to control my symptoms. I went back to 50 gradually couple of months ago and had a one day spotting only in the morning one day.
In the meantime, due to shortage I had to change to Estraderm - 3 weeks ago. Yesterday again I had spotting in the morning whilst wiping and then again today. I wonder if this is due to change to a different patch although equivalent dose? Otherwise I feel fine, but I do have a slight feeling as if I am going to have a period.
My GP suggested, when I had bleeding at the first instance after a year, that the bleeding will not stop and I will have to consider either Mirena or sequential. Bleeding did stop, but it seems that there is occasional spotting.
I wonder if I can just assume this is due to change from Estradot to Estraderm? Is Estraderm maybe stronger? Or do I need to contact GP? She did not want to refer me to a scan first time so I had to ask the surgery for the second opinion. I am not sure how often you need to have scans in these situations?
I am quite stressed at the moment anyway and it doesn't help that this happened. I also have health anxiety so I started worrying that there is something happening there, I would be grateful for your thoughts.
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I would go back to your gp as the story doesn't quite add up for me. 3mm is a thin lining so not a cause of bleeding. Did they find anything else such as polyps or fibroids that might have caused it? As it was already thin I don't understand why they increased progesterone which would thin it further, possibly by too much. Being too thin can cause bleeding too.
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Hi Sheila,
Thank you for your response. They haven't found any polyps or fibroids. Gynecologist said that she would recommend to double the dose of Utrogestan for at least a month to stop the bleeding. She also recommended to consider taking 200 continuously to keep the lining thin. As you said, it was thin already...I am so confused and feel that I can't rely on advice given. The GP came up with other comments as I mentioned before. I feel very powerless when contacting them.
I didn't know that thin lining can also be the cause of bleeding. thank you.
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200mg of Utrogestan daily has made me bleed more than ever so I have reduced back down too 100mg daily as I am not supposed to bleed at all!
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Sorry to hear that SLUC, didn't know that this can happen. I hope you will be better now.
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Hello ladies,
I thought to ask again if anyone has similar experience or for any advice.
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Hi Stella,
I had exactly the same issues as you when I couldn’t get my estradot patches and was given estraderm. I’m back on Estradot again and everything is back to normal. Hopefully you will find a supply of estradot soon. I’m on the border of Worcestershire and Herefordshire. In Herefordshire there are supply issues. In Worcestershire there is a plentiful supply (including utrogestan). Go figure…..
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Hello Ermin2trude,
Thank you for letting me know, it's been really difficult with Estradot and I have problems every time when I am due a prescription. This time they just swapped it an I couldn't do anything about it.
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Hi Stella,
I’ve also experienced post menopausal bleeding on HRT and my lining was atrophic (no lining at all :o) and I too was told to take 200 mg of utrogestan from a gynaecologist, which didn’t stop my bleeding. I think As others have said, 3 mm is not a thick lining. My bleeding I believe is due to low Estrogen, which is a current ongoing battle. I think Gynaecologists seem to follow a script - but one size doesn’t fit all.
Does your HRT stop all your symptoms? Have you ever had an estradiol blood test to show your Estrogen levels are what they should be?
Teresa
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Hi Teresa,
Thank you for your reply. I am sorry to hear that you have issues with bleeding too. Not all of my symptoms are stopped but my main issue were constant hot flushes that are now gone. I still experience a bit of early morning heat but that's bearable.
Unfortunately I tried to get a hormone test but my surgery do not wish to approve this. I seem to be very sensitive and experience breast tenderness when I attempt to raise estrogen. I feel a bit of it now too so I wondered if Estraderm might be stronger than Estradot.
How are you coping with upping your estrogen?
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Hi Stella,
It’s a shame your surgery won’t do a test. Some surgeries think you should go by how you feel. I’ve never experienced any breast tenderness, but I have read that many do.
It’s actually Estroderm that I’ve got now, its my second patch, it’s huge ::) yours is probably quite big, but I’ve never had one this big :o To be honest, I’ve not noticed much difference to how I felt on the Evorel 75. It shows we are all different…I’m a poor absorber though.
Like you I went quite a while with no bleeding. Then I got some bleeding, which stopped, another test passed and it happened again. I hadn’t changed my dose. I changed from utrogestan and had a Mirena coil fitted two weeks ago. It might be worth you considering that? I was really fed up with the bleeding. it was lasting over two weeks. I was getting through nearly two packs of pads ??? It’s my third Mirena and my first on HRT. It gets a lot of bad press, but I’m hoping it will soon sort out the bleeding, as it stopped my heavy periods in the past.
It’s a difficult decision to make, I know.
Teresa
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Thank you Teresa. Yes, Estraderm are massive comparing to Estradot., I am on 50.
I understand that Utrogestan doesn't control bleeding very well and Mirena seems to be a better choice. I am just reluctant to go for it as I am afraid of not being able to get it out straight away in case it makes me feel unwell. Unfortunately anxiety is also one of the symptoms that are still there.
I hardly bleed it's more like spotting in the morning when wiping, I don't need pads. It must have been awful for you, I hope that the bleeding will stop soon now when you have Mirena :)
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Your surgery may fit them? If you have trouble with it, they should be able to remove it if they put it in?
Unfortunately both the nurse and GP can’t find my cervix ( tilted) so I had to go privately to get mine fitted….I’d have had to wait months for a hospital appointment. You may find your bleeding just stops all on it’s own, you never know.
I wish you luck with whatever you decide.
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That was a long wait for you. Thank you for your advice, I wish you well too :)
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I was told by my gp in Australia that my irregular bleeding on continuous hrt patches is caused by not having enough progesterone. He has not even suggested a scan which I had to but wants me to up my dose from 50/140 to 50/250 Estalis Continous. I'm reluctant to increase dose for possible side affects but I also don't want to continue bleeding. Its been 6 months for me and I've read online Uk Dr Newton that up to 6 months of bleeding is normal.
So if you want to stop the bleeding apparently increasing progesterone should do this.
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Thank you Gogirl,
I have also been prescribed double progesterone in the past and it stopped my bleeding. I had some side effects such as tiredness and due this a bit of low mood, but nothing too awful. I hope it will work well for you.