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[cazzie29]

Hi all, apologies in advance for this long post but this has been a long journey for the last few years. I'm 57 and started going through the menopause about 5 years ago - first the hot flushes and the night sweats which were bad enough and I tried various herbal remedies as was determined I wasn't going to use HRT. Then came the spells of anxiety and complete lack of energy which really hit me badly as I'd never suffered from anxiety prior to the menopause. Finally gave in and went to the doc 18 months ago for HRT. Have had various problems with finding the right one however, and now on 5th attempt. I've tried Elleste Duet, Elleste Duet Conti, Femoston low dose and higher dose and now on Evorel Conti patch. The first 3 months went fairly well with 1 bleed which didn't last too long then forgot to change the patch on the correct evening, but changed it early the following morning. Bleeding started 3 days later and still continuing 4 weeks on. Not heavy bleeding, just spotting but sometimes bright red, sometimes dark blood and happens every day. This is starting to really worry me and I've made an appointment to see doc but can't get appointment until 6th March. Can anyone please tell me if this is normal after having been on the patch for 6 months? Once again sorry for long post 

[Taz2]

Hi cazzie29 - you have come to the right place and will find lots of help, support and friendship on here. You don't have to apologise for your long post either - it's not long and gives loads of information which is always helpful.

Conti HRT can cause bleeding problems. Sometimes it can happen right from the start but others have found that bleeding can start after a few months. I think that it is a good idea to mention this to your doctor but, in my opinion, it is common for some women to experience spotting and bleeding. Some members on here (me included) changed back to a sequi HRT as at least we knew when to expect a bleed.

Let us know how you get on at the doctors and please ask any other questions you need to. No post is too trivial or too long for us!

Taz x 

[cazzie29]

Hi Taz, thanks for your swift and reassuring reply. Logic tells me it is the patch causing the bleeding. I had the same problem with the Elleste Duet Conti but was changed off that one quite quickly. I've been feeling so well on the Evorel Conti patch and thought I'd give it longer to see if the bleeding would settle down but just worried that I'm doing some harm to my body  .

Guess I may just have to bite the bullet and return to a Sequi  .

I have friends who are on HRT but haven't had any problems with it at all, but heyho, I guess we're all different  !!

[Dancinggirl]

A good non bleed HRT option is to have the Mirena fitted and then use either oestrogen patches or Oestrogel. The Mirena delivers the progesterone more locally to where it is needed and will usually settle any erratic bleeding and protect the womb lining better genereally. Some women don't like the thought of a Mirena and the initial boost of progesterone can bring a few problems (feel a bit sedated or low mood) but these things settle but It's a no hassle HRT combo that usually brings fewer side effects for most women.  DG x

[Hurdity]

Hi cazzie29

  from me too.

You mention that you are 57 now and that you started HRT 18 months ago. How long was it since your last period when you first started HRT, and had you experienced any bleeding problems in the time leading up to last period eg fibroids, and have you had any investigations?

As Taz says a sequi HRT might just do the trick (or the Mirena as Dancinggirl says). I started HRT at almost 54 and have been on sequi HRT more or less ever since - now mid 60's. It is a pain to have a bleed but at least you know when it's coming.  It is good to have a check with the odctor if bleeding persist beyond 6 months as this could indicate that the oestrogen/progesterone balance isn't quite right for you or else you have something else going on eg fibroids.

Hurdity x

[cazzie29]

Thanks DG and Hurdity for your replies.

Not sure if I could go for the Mirena but will give it consideration.

Hurdity, I had my last "natural" period at 52. I had an ultrasound scan done last year after bleeding on Evorel Conti. I dare say I'll be sent for another one after I've been to see my GP in March. It's all very worrying and will let you know how things go.

Thanks all for your support x

[cazzie29]

Well, after starting to relax a bit after my last post regarding continual light bleeding, woke up this morning to a cramping stomach and much heavier bleeding. I have the doc on Tuesday but anxiety now through the roof.

Any words of reassurance more than welcome  x

[Juliet]

I am new to all of this - but I can send hugs and I am sure it is all related to the HRT and you have a doc appt in 3 days, so everything is under control - hopefully others can provide more experienced support 

[cazzie29]

Thanks Juliet. Hope you're not suffering too much from meno symptoms. Guess we just have to try and stay positive  x

[Hurdity]

Hi there - it's good you are seeing the doctor but probably the bleeding is to do with the balance of oestrogen and progesterone in the combi patch which as has been explained is not right for everyone hence the need to go back to a cyclical HRT, as well as to check for anything else which could be causing it eg over-thickening of the womb lining, fibroids etc.

Good luck and let us know how you get on at the doctors.

Hurdity x

[CLKD]

 

[cazzie29]

So went to see doc yesterday and she didn't seem overly concerned about the bleeding. She has arranged an appointment for me to have a biopsy done even though my previous ultrasound scan had been quite normal. Better safe than sorry, I guess, although a little anxious about having the biopsy done.

She has also referred me to the menopause clinic as she's not sure where to go from here. The appointment may take a while to come through though.

Feeling much more reassured now x

[cazzie29]

Hi all, re my biopsy, glad to say all done and dusted and just had results back. All clear thank goodness.

Now waiting for a meno clinic appointment as still bleeding on the Evorel Conti (into 7th month now and bleeding getting worse). I feel like the Dr. has just left me to get on with it.

For 2 weeks I slept beautifully and felt like a different person, happier and with more energy. However for the last 3 nights not slept well at all and feel like I'm going downhill. Can't understand why the Conti would affect my sleep like this as I know it's a continuous dose of HRT.

Not sure whether to just take the patch off or ask the doc to put me onto Evorel Sequi. Don't know which way to turn.

Any advice more than welcome  x

[Taz2]

I had constant bleeding on conti and gave up at the 6 month mark and switched back to sequi. It was so good to return to a predictable bleed.

Sorry about your recent sleep problems. It's easy to blame everything on menopause but there are many things which can disrupt sleep. Have you looked for other reasons which might have affected your sleepability?

Great news about your biopsy results 

Taz 

[Dancinggirl]

cazzie - some women do get real problems with bleeding on conti HRTs.  Moving to a sequi would at least give you the regular bleeds.  However, I think there can be absorption issues with the combined patches so you may not be getting enough progesterone to control the bleeds -  this is why I suggested the Mirena as this delivers the progesterone in a targeted way(at a lower dose, so fewer side effects generally) where it is needed, so erratic bleeding is less likely.
Another alternative would be to have oestrogen as patch but take progesterone in pill form as either Utrogestan or Provera. If you do a sequi regime then women do use Utrogestan vaginally - this isn't practical on a conti regime and I had problems with Utrogestan on a conti regime as it does make one feel very sedated taken every day. 
If I were you I'd be tempted to try Provera on a continuous basis with either oestrogen patch or Oestrogel.  Look under TREATMENTS to find out more and possibly print the info off to show the GP. DG x