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[Michelle46]

Hi ladies
How are you all? I've not been on here for about 7 months. A quick question. I use 1 pump of oestrogel and utrogestan for 12 days of the month. I used to be on 2 pumps but I've reduced to 1 in the last 3 months. If the estrogen is reduced will the bleed get really light. Is it the estrogen or progesterone that causes the bleed? Thankyou x

[Dancinggirl]

If you are using less oestrogen, then in theory you should get lighter bleeds because the oestrogen won't be building the womb lining so much. 
Hurdity would be able explain things better but, my basic understanding is:  during our reproductive years, the oestrogen builds the lining ready to receive a fertilised egg, then the role of progesterone is to prepare the womb for pregnancy after ovulation and so if a fertilised egg hasn't taken, the progesterone level drops dramatically thereby triggering the shedding of the lining. The sequential HRT regime mimics this cycle.
I have probably explained this in totally the wrong way but essentially it's oestrogen that builds the lining. DG x

[Michelle46]

Thankyou. I was thinking on those lines too x

[Hurdity]

That's about it Dancinggirl - you don't need me! Just to add that sometimes oestrogen can cause a bleed but only if it overstimulates the uterus and the lining can thicken - so it comes away sporadically as an abnormal bleed even in the absence of progesterone. Sometimes women also bleed when the oestrogen level drops, for some reason too - but in the normal way of things as Dancinggirl has explained, in the menstrual cycle and when using HRT, other things being equal, the lower oestrogen dose will cause less thickening and therefore a smaller bleed.

Do you find that 1 pump is sufficient to control your symptoms and was your bleed heavy when on 2 pumps? Also how do you find the Utrogestan?

Hurdity x

[Michelle46]

Hi Hurdity
Yes I find 1 pump enough at the moment. The utrogestan is ok with me. It didn't use to be. I'm debating whether to go to half a pump if I'm feeling ok. What do you think? Thanks for your reply x

[Hurdity]

I can't really comment as I've never used oestrogen gel and I know that women vary enormously in how much they absorb from different doses - with some women achieving over + 400 pmol/l with only 1 pump and others not feeling  any different with two pumps! Is there any reason why you want to reduce to 1/2 a pump? If you are feeling fine now then I would suggest why rock the boat? if you are under the natural avergae age of menopause which is 51/52 and you are at or near menopause then you will be getting additional bone and cardio-vascular protection the longer you use it and the effect will be dose dependent (for bones at least). If you were in your 60's and wanted to try to come off it then I would say perhaps give it a go, if you are fed up with having to use it, but otherwise why not continue? I'm in my 60's and still use it cyclically and have a withdrawal bleed - not ideal - but I want the oestrogen and I still have my womb so needs must!

Hurdity x

[Michelle46]

Thankyou. I'm 48 and I think I agree with you. I'm going to stay on 1 pump whilst all is ok. This time 2 years ago I was a wreck. A different attitude and realising what I was going through eventually started to help my symptoms along with the hrt. If I remember rightly you live in Devon don't you? I live in Devon too x

[Hurdity]

Great! Sounds like a plan! So pleased that things have improved for you and I hope you continue to feel well on this regime

Hurdity x