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[Hurdity]

The end of my road with utrogestan. Which is sad as it made me feel so well in myself but the bleeding was unbelievable. At the weekend it looked like people had been murdered. The clots were huge . I saw my GP after the bleed before this one and an emergency referral was arranged for the gynae dept. Saw the consultant today he did a trans vaginal scan and all I have is one small fibroid and a thin uterine lining ( presumably because the rest of it was all over the bed, bathroom floor etc etc.) He has taken an endometrial biopsy for completeness but said won't be anything bad all looks too healthy. Utrogestan caused my bleeding. I was on 3 pumps of oestrogel and 1 100mg Utrogestan vaginally 25.days out of 28 so correct dosing.  I don't know why some women react like this because I have found other bleeders posts. He put in another Mirena coil which I had had several without problem previously so hopefully thats the end of it because I could not go through another  bleed like the last two and am now anaemic. He did give me the lecture that I should stop HRT altogether because have been on it about 17 years but I have never smoked, don't drink so I guess you choose your risk factors.  I am traumatised by those last two bleeds, it was like starring in your own Quentin Tarantino movie. I hope this Mirena works as well for me as previously and sharing my experience may help someone else at some point.

Sorry to hear about this Peony. Sounds horrendous!  With fibroids everything is going to be different unfortunately, although it's strange that this occurred if the fibroid was small (I have one that actually shrunk on HRT but mine  was 0.8 cm). What point in the 28 days did you have the TVS? It may well be that the lining is building up on the 3 pumps and the utrogestan is being very effective in shedding it? Also how many months had you been on this regime ( the 23 pumps and the 25/28 utrogestan) and were you on HRT before? Maybe the uterus lining had been building previously and only now was coming away although one would expect that to happen just once eg with the first cycle unless it had thickened a lot? The utrogestan does not cause the bleeding as such - it enables whatever has been stimulated by oestrogen (ie lining or fibroids) to change in strutcture and then be shed when the progesterone is stopped.

Here is what it says on this website about fibroids and HRT:

Fibroids are benign smooth muscle tumours of the uterine (womb) wall and are dependant on estrogen. They tend to shrink after the menopause but shrinkage may not occur, or they may even increase in size with HRT use. Increase is thought to occur in 25% of HRT users and mainly occurs in the first six months of therapy. There is some evidence that transdermal (patch or gel) but not tablet HRT nor tibolone may promote fibroid growth. [ref 24] Fibroid size can be monitored by regular examinations and sometimes by ultrasound scans. There is some evidence that the use of the progestogen releasing intra-uterine system, Mirena may cause fibroids to reduce in size. Mirena is often used in the perimenopause by women who have heavy periods and/or require contraception and can provide the progestogen part of their HRT.

https://www.menopausematters.co.uk/atoz.php#GlossF

Hopefully the Mirena will help in future as it did before for you

Hurdity x

[crazywomen]

Hi Hurdity had  my break through bleed on the 2nd day the doctor told me to take it this way even though I said I have not gone 12 mths without a period my last one was in August she has said they will change it to the 200 one if it isn't suiting me I haven't slept well since starting this hrt also she has given me estrogel instead of oestrogel this time which I find to be stickier than oestrogel but will see how it goes x

[Hurdity]

Hi again - what do you mean by bleed on "the 2nd day"? Do you mean Day 2 of utrogestan (in the 28 day cycle) , or the second day off ( ie day 27)?

Hurdity x

[crazywomen]

Sorry Day 27 it hasn't been bad only light x

[robotwars]

Oh crazy woman I do sympathize, I only started on the utrogestan and gels on the 15th feb, and came on on Saturday and been bleeding very heavy ever since, so not sure whats going on, as I was told to take the utrogestan continually all month... I'm already anaemic so I'm sure this isn't helping!!!!!

[crazywomen]

Hi I was lucky only bled for 3 days it's just the lack of sleep that's annoying xx

[Hurdity]

Sorry Day 27 it hasn't been bad only light x

OK if it was day 27 then it was as you say, day 2 off the utrogestan and you start the utro again after Day 28 which then starts the cycle again as Day 1. If you bled then, it is not actually technically a breakthrough bleed - but a normal progesterone withdrawal bleed and nothing to worry about - completely normal! I was concerned that because you are not post-menopausal you could bleed at any time on this regime. If you do continue to have a small bleed during the 3 days off this is fine and indicates you may well be close to menopause. Sorry to hear about the lack of sleep - Utrogestan often has a sedative effect. Is it due to night sweats or nocturnal bladder or nothing you can explain? If necessary cut down on the caffeine and see if that makes a difference and try all the usual sleep techniques.

Hurdity x

[robotwars]

I contacted my consultant last week and I have now been advised to continue with the gels and stop utrogestan while on a period, but I have persevered with the gels but I'm feeling rubbish, The skin on my legs are itching like crazy, , my face is itching too, feels awful, plus my ankles are swollen ,My IBS has also flared up......... beginning to wonder if HRT is for me.... as I feel awful......suppose to restart the utrogestan tonight...... just not sure what to do, I think I'm re-acting to it, as anyone else had this.....

[Tea and Biscuits]

Hello everyone. This is my first post since starting HRT last August (through Dr Studd's clinic). Mainly taking it in an effort to reduce migraines which have increased massively as I am in peri-menopause (I am 49). So - 4 pumps estrogel each day, utrogestan vaginally days 1-10.  Feel awful on the progesterone part by the way - tried, low etc.  My question is this - I did't take it on day 1 as I was supposed to this time as I was having a period.  Still haven't started it - 8 March.  Puzzling over what to do as it's our annual family holiday 25 March to 8 April and I so don't want to feel ill - or be having a bleed, as it will be migraine city for me for days.  Wondering if I could just start the utrogestan on 1 April so having skipped a month?  Any thoughts or experience anyone?  And by the by, I don't really feel the HRT has helped much with the migraines.  I also take 50mg nortitriptyline every night - prescribed by GP as a possible help with the migraines - but am gradually reducing it  - Dr Studd thought I should come off it.  However, the HRT has helped with other meno symptoms - anxiety/panic, weird feeling in legs, flushes etc....Thanks to anyone still reading at the end of these ramblings - the menopause is rubbish, isn't it.....

[Mary G]

Tea and Biscuits, sorry to hear you are a fellow migraine sufferer.  I'm sorry that your HRT regime has not improved your migraines but that could be due to the dreaded Utrogestan.  Firstly, could you ask Professor Studd if you could do the 7 day 100mg Utrogestan phase?  This is what he prescribed for me although I do take less than that and have regular uterine scans.  The problem with taking Utrogestan for 10 days is that by the time you have had a period, it has taken you to about day 18 of the month and after a very short space of time, you have got to start the whole process over again which doesn't leave you with many days of feeling good. 

It sounds like Professor Studd has put you on a high dose of oestrogen to override your cycle which is good and explains why you are feeling better with anxiety etc. 

I would say definitely skip the next Utrogestan phase and start it on 1 April when you get back from your holiday.  If you have just had a period, you are very unlikely to get any breakthrough bleeding.  I would ring Professor Studd's office anyway and ask about the 7 day regime and also tell him you are skipping the next phase due to your holiday.

Regarding migraines, I also started getting silent migraines once I hit the menopause - migraine aura without headache.  I had a Mirena coil for contraception at the time and although I have never got on particularly well with progesterone, I didn't get migraines with it but I really hit the buffers with it once my oestrogen levels tanked.  I feel completely normal when on the oestrogen phase and don't get migraines but if I take too much progesterone for too long, the migraines really kick off. 

You need to find a progesterone level that clears the womb lining but doesn't disable you with constant migraines.

I agree that the menopause is pants but I didn't have an easy time with contraception either so I have just swapped one set of problems for another.  That said, overall I feel far better now on high levels of oestrogen than I did on the pill in my 20s so it's not all bad.  With the benefit of hindsight, I wish I had opted for hysterectomy years ago when it would have be easier to recover from the operation and I was in an office job with paid sick leave.  That would have sorted the contraception/progesterone intolerance once and for all. 

[Hurdity]

Hi Tea and Biscuits

 

I am a bit puzzled by your plans because you are going away on 25th March - 8th April but plan to skip taking the utro in March, and start on 1st April bang in the middle of your holiday when you said you don't want to take it ( and I know the feeling - I'm on a two month cycle approx and always plan my utro and bleed to avoid hols or going away at all if possible!)??

If the treatment is working normally and has suppressed your cycle (ie you normally get a bleed after you stop the progesterone each month, apart from this month), then if I were you I would start taking it asap and then your withdrawal bleed (if any) would be more or less over by the time you go away.

However the fact that you bled before you started the prog does imply that it could be a period and your cycle hasn't fully suppressed. If that is the case and your prog taking is out of cyns with your periods, then another one might come in a month;s time which would be while you're away? However if you take the prog soon, at least your lining may not have built up - but sounds like it could be unpredictable and you might have to go with the flow - literally!

Another reason for bleeding at the "wrong" time - could be your cycle is suppressed but the prog hasn't shed it all so it has shed spontaneously. If this were the scenario then a course of prog would be good because it would help further shedding.

It is impossible to say what is going on and to plan bleeds when you are peri-menopausal and especially on a regime like this one.

Sounds like a good idea to come off the everyday pain meds - but have you been offered an alternative? I presume you have meds if you've had migraines for years? I was recently prescribed sumatriptan for the first time after years of hormone headaches (which started just before peri-menopause)  and unpredictable migraines and they are magic! I haven't had a proper migraine now since early January but I've fended off a couple with these pills!! This is the longest time migraine free for years (fingers crossed....).

Let us know what you decide and how you get on bleed-wise - and if we don't hear from you - enjoy your hols (we have a Holiday thread - in This and That board - the chat part of forum!)

Hurdity x

[Tea and Biscuits]

Dear Mary G and Hurdity, thank you for responding to my post. Mary, I was originally on the 7 day utrogestan regime  and 3 pumps of estrogel but when I saw Dr Studd in February and I reported no improvement in the migraine situation he upped it to 4 estrogel daily and 10 days of utrogestan.  I really think I need to take as little prog as possible and as infrequently as possible - perhaps with scans to check all ok?  And Hurdity, thanks for your comments. I think at the end of the day it is all a bit of a lottery during peri-menopause - how much of various hormones to take, what levels of hormones your own body is producing, etc.  I was planning on going on the Utrogestan on 1 April as it would be 10 days of no bleed - although admittedly 10 days of feeling pretty rotten.  Regarding Sumatriptan for migraines, I was on these but found that a) they took too long to work and b) they made me feel sick.  (before peri-menopause I was not on migraine medication, they were so few and far between, and usually bad headaches prior to menstruation). Eventually my GP put me on Zomig (Zolmatriptan) which has really been a lifesaver.  It is a 5mg nasal spray.  You take it only when a migraine has started and usually relief comes quickly.  I often take it with 3 aspirin as well.  It can work as quickly as 15/20 minutes, or up to 2 hours.  Thanks to everyone on this forum - it really helps to be able to share these problems with people who understand.

[Loubylou]

Hi ladies
I'm new. I'm post-menopausal and I'm 35. Ive been post-meno for about 6 years. No cause for it has been identified. I couldn't tolerate regular pill or hrt as they made me rage and depressed. After 10 I paid to go private and have been given bioidentical hormones.
I am on estrogel - 1 pump daily, utrogestan 100mg for 12 days and testim gel.

I was put on a very low dose to start with for the estrogel given my past reaction to hormones. I have been on it now for just under 2 months and it seems fine. The utrogestan made me sick and dizzy by mouth so I took it vaginally. This caused thrush and so not sure what to do about this. It also makes me have restless nights in that I'm waking up a lot!

Ive started to up my estrogel dose to 1.5 pumps.

[Cassie]

It will make you restless it does to me as well, but I basically just get through the 12 days, treat the thrush, its prob a once off thing and keep using it vaginally, its really good and the gel will make you feel so much better, I also had to start on it at a young age.

[Goosieloosie]

Is it normal to have crampy, moderately painful bleeds after using utrogestan vaginally? I have been on this regime for 2 years now (Estradot patch/Utrogestan vaginally) and my bleeds are always painful like they used to be when I had proper periods. I'm 56 by the way and 3 & half years post menopausal. I had a scan to check the womb lining last August and all was well. The cramps every month are really annoying and painful enough to take painkillers especially this month as I brought the whole cycle a bit closer/shorter as we are going away for the weekend and I wanted to be finished with the bleed, so I figured as this was a shorter cycle there would be less lining to come away, the bleed is not particularly heavy. I was planning on taking the Utrogestan this month 100mg for 12 days but I've only gotten to day 8 when my bleed has began, I have tried 100 x 12 days before about 18 months ago and both times I bled before I got to day 12 so I decided to alternate with 100, 200, 100 etc for the 12 days and for the last 18 months this has worked perfectly but always with crampy bleeds. I decided to try taking the 100 x 12 days again as the 200 feels just that bit much for me with migraines, restless sleep, waking groggy and lately I've began having night sweats while on the Utro.
So what I would like advice on is : is it normal at my age (56) to have painful cramps and moderate bleeds? Does anyone else who's post menopausal have cramps? And why do I bleed before the end of the 12 day Utrogestan course when only taking 100 vaginally? If I wanted to take 100 Utro for 25 days per month on a conti regime I would never get that far as I always begin bleeding after days 7/8  (not that I would want to take it for 25days  ) Oh and I use the Estradot 50 patch. Thank you