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[Kittyjay]

Hoping someone will be able to un-confuse me!
I had my gp review last week after being on estradot patch 50 and utrogestan days 1-25 for 3 months. I said I'd never felt better and that the only time I felt rubbish was for the 3 days I stopped the utrogestan, awful headaches. I had proper bleeds each month but in the week prior to the 3 day break....
I asked him if I could take the progesterone continually to avoid the headaches and he has agreed to that (he interestingly also told me I'm the only patient he has on utrogestan and its only cos I was armed with info from this site that he agreed to it- he hadn't heard of it!!). Anyway... He then went back over my notes from the start of hrt 22 months ago-basically no period prior for 6 months and high fsh blood tests, also diagnosis of premature ovarian failure by consulant during IVF treatment 4/5 years back.
So how will I ever know when I'm post menopausal if I went on hrt after 6 months absence of periods, not 12? Does it matter?
Also at 43 is it ok to take continual progesterone without a break? I think I may still bleed anyway as I have for last 3 months at random times (had lining scan in November all ok but some small fibroids). Thanks xx

[Dancinggirl]

Hi Kittyjay
You have been diagnosed as post menopausal so it should be fine to take HRT continuously. At 43 the HRT is actually essential. Good to hear you have a GP willing to listen and help and the HRT combo you are on is a good one for the long term - you will need this until you are at least 52-55 or even beyond if you wish. Utrogestan is described as 'Breast friendly'!!! Many women don't take this 3 day break especially if they are post menopausal. The bleed you have experienced is no indication of whether you are peri or post meno - it is simply a withdrawal bleed.  If you were to stop HRT you are unlikely to have any bleed at all because your body isn't producing enough eosetogen to build up the womb lining.  The Utrogestan will simply keep the lining thin.  I expect you didn't bleed much anyway over the last 3 months and over the next few months these random bleeds will stop or just be the occasional bit of spotting. When using a continuous HRT there will be some breakthrough bleeding for the first 6 months.
So pleased this regime is suiting you.
BTW - do you get some breast tenderness and if so has it subsided?  I am using Utrogestan but sequentially and would like to know whether using it continuously the breast tenderness settles down?   DG x

[Kittyjay]

Hi DG- I have no breast tenderness whatsoever anymore whereas on femseven and evorel I sometimes cried as they were so sore! The best thing I've found on this hrt is that my anxiety and panic has diminished.
I just don't know if I am post meno as I hadn't been without a period for a year- only 6 months before starting hrt......So how would I know?  Is it ok to take continuously even if not definitely post meno? My gp is great and I'm lucky as he's happy to let me try this as I had researched it (he suggested MM to me in first place) x

[Dancinggirl]

You haven't been having true periods.  When you are on HRT you are simply getting withdrawal bleeds induced by the HRT hormones.  You were diagnosed as post menopause by a gynae because your blood tests showed your ovaries were no longer working - your GP will have seen this in your records.  How great to have a GP who is on the ball.
I had early ovarian failure but was diagnosed as peri menopausal in my mid 30s so was on HRT for many years.  I don't know when I actually went into post meno as I started HRT when I was still getting the odd period but I was probably post meno by about 42-43. Unlike you, I didn't have any blood tests that confirmed this but I did take a break from HRT at 49 and I knew I wouldn't get any bleeds and I didn't.
Your GP is right - so don't worry - just enjoy the fact your have found a good regime that will carry you through the next 10 or more years and will protect you from heart disease bones loss, vaginal atrophy, bladder problems and much more. Just keep you weight under control, eat well, take lots of brisk walks and get on with life.  DG x
PS - Just to go back to the breast tenderness - did you get some breast tenderness on the Utrogestan and it just subsided or didn't you get any tenderness at all?

[Kittyjay]

None at all DG- I do take the utrogestan vaginally though at mo so maybe that makes a difference in keeping the progesterone in the right place so to speak?! X

[Dancinggirl]

Interesting.  I have a very sensitive bladder so don't really want to use Utrogestan vaginally - however I may try this. Thanks for the feedback. DG x

[Hurdity]

Hi Kittyjay - I use it vaginally and usually the only side effect I get is tiredness, sometimes a migraine, and it does affect my bladder at night.

Re being post-menopause. Despite your being diagnosed as having premature menopause 4-5 years ago it sounds like you continued to have periods and had only gone 6 months since last one just under two years ago? If that is the case then you will not know exactly when you are post-menopausal.

There is absoutely no problem in taking progesterone continuously if you are not post-menopausal - it is not usually given though because in many women who still have fairly strong cycle, even if periods are irregular, there can be irregular bleeding which is inconvenient so peri-menopausal women are usually given cyclical HRT.

Unfortunately it is common for all cyclical HRT types to give rise to withdrawal symptoms on coming off the progestogen phase. This is part of normal pms. Of course, once the symptoms clear then everything is usually fine. If you feel fine also on the progesterone phase then I can see why you might want to take it continuously.

Personally I would not want to do this vaginally, while in a relationship for obvious reasons, so that is one of the reasons I keep to a cycle even at 61!!

Hurdity x

[Kittyjay]

Thanks Hurdity. I totally agree that it can be inconvenient to take the utro continuously this way- when I've needed to avoid inserting it for intimacy or during bleed (I'm a bit squeamish) then ive taken the utro orally instead which doesn't seem to have made any difference. Meant to ask gp if that's ok but forgot to be honest!

[Dancinggirl]

Kittyjay
You could probably experiment and try using it orally for a few weeks to see how it is - the only inconvenience with taking it orally is that you have to take it on an empty stomach i.e. 2 hours after food.  You can then decide which is your best option. 
Over the 14 days I took the Utrogestan I didn't get any side effects except the tender breasts  but I did sleep exceptionally well which was lovely. DG x

[Hurdity]

The only potential issue with varying how you take it from day to day ( eg vaginally or orally) is that your progesterone levels may also vary which could lead to some withdrawal bleeding - but if it has worked like this for you then that's great !

Hurdity x