Maybe your cycle is still overriding the HRT hence the lack of predicatable withdrawal bleed.
How prog intolerant are you? Although utrogestan is bio-identcial - we have to ingest such large amounts so that it is much more than we normally need and it is the metabolites (after going through liver) which seem to cause the worst side effects. You may well be fine with small doses of syntehtic ones.
Good idea of Optimist perhaps to think about Jaydess if you can find someone to prescribe it, now that it is beginning to be used off licence for HRT?
The only way to tell if you are having enough prog is to have a uterine scan every now and again
Hurdity x
[quote author=Mary G link=topic=38816.msg614884#msg614884 date=1518035843
Thanks Hurdity, Mary G and Optimist - really appreciate your advice. I paid for an ultrasound scan after the second month of 200mg utrogestan as I was worried about not having a bleed. Radiographer said lining of womb was 3mm, no sign of any folicles left in the ovaries and "no cancer". In terms of intolerance I started on the studd regieme on 100mg for 7days and it was ok in terms of emotional symptoms but no bleed and womb lining got up to 5mm which my clinic says is the point at which they would investigate. Initially increased dose to 100mg for 12 days and I seem to be sort of ok on this emotionally - it's not perfect but MUCH preferable to the hell of 200mg per day.
I said to the nurse at the clinic that I thought it might be my own cycle over riding the utrogestan and she said that wasn't possible!!
I am using oestrogel Optimist - I was fine on two pumps per day for about a year but then had to increase it to three pumps a few months ago as my symptoms were returning. Amount of oestrogen and/or utrogestan seems to have no effect on whether or not I have a bleed - I've had three random bleeds in 2 years - two on the lower dose of oestro and one on the higher - none of them in line with the timing of a withdrawal bleed.
I've started on the vaginal route for the utrogestan a few days ago - I know lots of women on here have said there is a lot of discharge with this but I haven't had any so far. Hurdity if I keep on this but still no bleed - how frequently should I pay for a scan? every three months? and is it best to have the scan just after you've finished the utrogestan?
You really don't need a scan if you have had no bleed and are taking the licensed amounty of prog cyclically especially vaginally - rest assured that if your lining gets too thick it will eventually bleed spontaneously - but this is counted as abnormal bleeding.
That comment about the 5 mm needing investigation when you are on cyclical hRT is rubbish and really the professionals should understand what happens to the uterus lining during the course of a cycle. The same thing happened to me - I had some post-sex bleeding so was sent for investigation. My lining was something like 7.4 mm but I was in the middle of the oestrogen part of my cycle - no amount of my telling them that this should be expected and not abnnormal, prevented their sending me for a hysterosocpy (although they did see an abnormality on the U/S scan - which turned out to be small fibroid!).
YOur nurse knows nothing either - of course the prog can override the cycle - otherwise everyone could use HRT as contraception if it always prevented ovulation.
In answer to your question about frequency of scans - I would have thought annually would be sufficient - but if you are peri-menopausal then it is more tricky since the point at which you have a scan is crucial. For regularly menstruating women and post-menopausal women on cyclical HRT - the scan should be done immediately following the bleed because this is when the lining is at its thinnest ie after it has been shed. For post-meno women on conti HRT - scan can be done at any time - but obviously straight away if abnormal bleeding occurs. Also in your case any time you are worried go to the doc - but you shouldn't have to pay for scan if due to abnormal bleeding.
Also to clarify your point re the lining thinning when on utrogestan - this is not the case. During cyclical HRT or natural menstrual cycle, the lining builds all the time on oestrogen only. When you take the prog this changes the lining to become more structural - ready for baby - and it can become thicker over this time. If the prog level drops then if the lining has built up sufficiently and you have taken prog for the right length of time - it will then shed and as I pointed out once shed it will be at its thinnest.
When you take continuous combined HRT during post-menopause the prog actually interferes with the oestrogen receptors to prevent the lining from thickening under the influcence of oestrogen - so this is when it starts to thin if the balance between the two hormones is right - but during the initial few months there can be sporadic bleeding until it gradually settles.
I don't get a discharge - just some white stuff in loo if I go in the night or first wee of the morning - I presume it's just the residue coming out.
Sorry this is a bit of a ramble and hope I've explained clearly enough!
Hurdity x
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Topic: Progesterone intolerant but Mirena coil suggested (Read 7023 times)