Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Milliepops]

Hi everyone

I am new to this site and looking for some advice.  I was diagnosed with premature menopause (I am 41) 5 months ago.  My doctor prescribed evorel conti patches which I have been using since early November 2014.  Approx 6 weeks after using them I started a bleed, and this lasted 9 days.  And the. 3 weeks later I started another bleed and am now on day 20 

Does anyone know if this is "normal" or experienced this.  My doctor said I would have light bleeds, but this isn't very light either and its wearing me down a little.

Any advice would be much appreciated.

Thankyou.x

[Dancinggirl]

Yes, It is quite normal to get some breakthrough bleeding in the first six months on a continuous HRT.  It is your body getting used to the hormones and you may find you get some random spotting as well. However the bleeds shouldn't be so heavy or last this long really so I would go back to the doctor and check this. I have to say that, though you were probably deemed post menopause, at your age a sequential HRT preparation would probably have been better to start with but I'd see how you go - perhaps ask for the sequential version of this patch if you are finding it suits you generally. If you use a sequential version you will then be able to tell whether you are reacting negatively to the progesterone and then change to a different type if need be.
I had a  premature menopause and kept to a sequential HRT most of the time.  I've always found the progesterone has a negative effect on me when taken continuously so I now use Oestrogel with Utrogestan but on a long cycle - so I have a proper withdrawal bleed every 2 months.
It tends to be a bit of trial and error before many of us find the HRT that really suits us but for you it is important you find the right one as you will need to be on it for some time.
There are a lot of different preparations  - Femoston is very popular as the progesterone is kinder so could be worth trying.
DG x

[sammy]

Dancinggirl, can you comment on your dose of estrogel/utrogestan in your long cycle regime?

I am one who has trouble with progesterone and am interesting in long cycle options. 

Can you explain your regime a bit?  So appreciated.

[Dancinggirl]

Hi sammy
I'm going to PM you as I am on a regime as adviced by a private gynae and it wouldn't normally be offered under the NHS.  Check your personal messages on this site shortly.
DG x

[Hurdity]

Hi Milliepops

 

When you say you were diagnosed with premature menopause - had your periods stopped for 12 months before you were diagnosed with this, or were you just told you were going throiugh the menopause prematurely, perhpas on the basis of blood tests or something? Normally cycles become erratic initially, as hormone levels start to fluctuate more than normally, and in most women they bceom closer together or you miss a period and the gaps between them become longer until they stop altogether.

If you hadn't stopped your periods for 12 months then you were not yet post-menopause and therefore are still likely to have a cycle - and in this case you should be given sequential (cyclical) HRT which is designed to give a bleed every 4 weeks just as with your normal cycle.  You do sometimes get breakthough bleeding but less so than with continuous combined HRT. This is the type you have been given which is why you are getting breakthrough bleeding.

Having said that, even some post-menopausal women get breakthrough bleeding initially on conti HRT as Dancinggirl has said.

If you were not post-menopause I would go back to the doc and ask for cyclical (sequential ) HRT. In your position I would also use separate oestrogen and progesterone so that you can adjust the oestrogen dose to suit - at your age I would want a higher dose of oestrogen. I am on the same dose patches and have been since age 54 approx ie 50 mcg - but you are only 41!

In the meantime do read up as much as you can about menopause using the menu on the left (orange tabs initially, and then green ones) - premature menopause is mentioned here http://www.menopausematters.co.uk/prematuremenopause.php (read all the sub tabs):  and there is an article here which tells you what's going on in your body at peri-menopause http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php

Hope this helps! 

Hurdity x

[Hurdity]

Dancinggirl, can you comment on your dose of estrogel/utrogestan in your long cycle regime?

I am one who has trouble with progesterone and am interesting in long cycle options. 

Can you explain your regime a bit?  So appreciated.

Hi sammy - I know you asked Dancginggirl and not sure if you will see this, but I am also on a long cycle so posting my regime here. Since 2011 I have been using Estradot patches and Utrogestan ( progesterone) on a long cycle - which lasts from 6 -8 weeks. I get my HRT from GP through NHS, not privately and the GP is happy for me to take it on a long cycle. When I first started on the long cycle I did it 2 monthly but was worried about my uterus lining thickening as I am on medium dose patch and I'm now 61 - also I had a bit of bleeding and a small fibroid was found so being a bit cautious here. Because of the possible problem of thickening the uterus lining the GP said I should take norethisterone tabs once a year  "strip the lining" as this is a very strong progestogen and shed any extra lining that had built up.

Hope this helps! 

Hurdity x

[sammy]

Thank youfor that information!  How many days do you take the Utrogestin?  and what dose of patch are you on.  I was always confused why the Utrogestin dose seems the same no matter what estrogen amount the woman is taking. 

I would love to do long cycle cause I don't like the progesterone.    Here we call Utrogestin "Prometrium" - a micronized progesterone derived from plants.  I think it is one and the same drug.

[Hurdity]

It is the same and yes the utrogestan dose seems to be the same whatever the dose of oestrogen which does seem odd since oestrogen thickens the lining in a dose dependent manner, and progesterone thins it in the same way. Makes me think that it is mostly given in a much larger dose than needed!

I use utrogestan 200 mg ( still have some of these left!) which I use vaginally for 12 days - more is absorbed vaginally than taken orally where much of the compound is lost to digestion/liver metabolism so I reckon to use the same amount as someone using a monthly cycle and taking it orally.

I had to have a hysteroscopy last year because of a bit of bleeding and the gynae said my uterus lining was healthy so I carry on with this regime. Sometimes I have  a shorter cycle and depends on what I'm doing when I'm going away - I time it so that I am doing the utrogestan and the bleed when I am not away!

Again vaginal use is off licence in the UK but more and more women are choosing to take it like this and my NHS GP is also happy for me to do this ( although it doesn't say on the prescription - she just puts "use as directed").

Hurdity x

[Lewis]

Hi

Just to say I was using evorel conti patches a year ago - got on fine with them for 6 weeks then started bleeding and didn't really stop.  Had all sorts of investigations to check nothing physically wrong - all fine thankfully.  Following discussion with consultant I went on evorel sequi patches instead.  I'm 50yrs old and have been on hrt for around 5 years now.  I agree that a sequential treatment might be worth looking into with your GP (although, 6  months in to my evorel sequi I've just started bleeding again, so back to the drawing board for me...).
Hope things settle for you.