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Author Topic: Postmenopausal bleeding - worried!  (Read 2493 times)

MichiHope

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Postmenopausal bleeding - worried!
« on: September 07, 2018, 08:18:12 PM »

Hello,  I am new here so not quite sure yet how to post and where to post etc.   I am about 3- 4 years postmenopausal (54 now) can't even remember how long now as my brain feels so scrambled up :o .  I feel that the menopause has hit me really hard.   I have been familiar with depression on and off in my life since my teenage years but always had respite periods where antidepressants etc.  have helped me have a better quality of life.    Unfortunately I have had a more or less "chronic depression" episode lasting 5 years plus...(since I have hit peri and now post menopause..)    But that's another long story. 

My main concern at the moment is that I started "a period" yesterday after not having had a bleed for approx 3 - 4 years now.   I am currently on 1 mg of Sandrena gel and I have experimented (on my own accord) with 100 mg of Utrogestan vaginally for 10 days (from day 20 -30).   Stopped taking the Utrogestan on the 1st of Sept and yesterday (6th of Sept) started to spot and today dark red blood.   I just wanted to see how much the Utrogestan is affecting me mentally as I am sick and tired of the depression and worried that I am progesterone intolerant and that it is making the depression even worse?!    I just don't know what's what anymore and I feel very confused.   I feel even worried about going back to the menopause nurse as I don't think she'll approve of me experimenting with the Utrogestan vaginally.  I even tried to go without HRT a few months ago but the hot flushes came back with a vengeance and  I don't feel I can cope with all of that as well as deal with the depression/anxiety.   I am so confused re progesterone intolerance as I always suffered really bad PMS,  but was also depressed during pregnancy,  and thankfully no postnatal depression.   Suffered again badly when my daughter was a toddler and then on and off.....  I just feel there is no real rhyme or reason to my hormonal state or how if at all it would impact my mental health?????   However the loss of libido and this stubborn depression is definitely not helping. I think I also feel a bit put off with the menopause nurse as she basically told me that I just had to accept my total lack of libido now I am past fifty! 

I am just a bit confused and concerned as what to do about this bleed and who to ask for help.   Sorry if I am not making much sense but I so wish I could find a way forward in this HRT maze and one day even feel like I am getting my life "back".   I know change is inevitable.  But I don't want to keep feeling like my "life is over".   Any kind of advice/support would be much appreciated.   

Thanks Michaela  :thankyou:
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Kathleen

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Re: Postmenopausal bleeding - worried!
« Reply #1 on: September 07, 2018, 08:54:53 PM »

Hello  Michihope and welcome to the forum.

I'm sure that other ladies will be along to advise you but I am also post meno and I've had two episodes of bleeding both brought on by experimenting with HRT.  The first time was a few years ago and I had increased my patch to 75mcg I  then had a hysteroscopy and all was well. The second time was recently when I stopped Utrogestan to see if  my mood would improve and after a few days I had spotting and then blood. My consultant didn't seem at all concerned and just said it was because I wasn't fully opposing the oestrogen. Sure enough when I resumed the Utrogestan the spotting stopped.

I mention all this to reassure you that your bleeding has likely been caused by withdrawing Utrogestan but if your doctor decides to send you for further investigations that is nothing to worry about and is standard practice.

I hope this helps you in some way. Take care.

K.

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MichiHope

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Re: Postmenopausal bleeding - worried!
« Reply #2 on: September 08, 2018, 04:29:27 PM »

Hi Kathleen,

thank you so much for your message and reassurance  :).   Very kind of you!  It's weird having a full blown period now after all this time.  I kind of forgot about periods - have to say that I don't miss them.  I feel so tired and drained at the moment and need to keep it together as have to help my daughter move to University this Monday coming.   

   I just don't know where to go from here.   Do I just restart 100mg Utrogestan orally for 25 days from today to see how it will affect me.   I am just so scared and unsure as I am just about surviving at the moment and I worry that my mental state will get even worse.    I just felt that when I was taking the Utrogestan daily previously that I was worse mentally? Crying lots and just at the depth of despair.   But maybe that was coincidental?   I think this is how I ended up experimenting to see how I am on and off the Utrogestan (if I take 100mg for about 10 days every month).   But will this be bad for my womb lining?   Sometimes I wonder if I need to see someone privately as I don't feel very comfortable with our health centre menopause nurse.   

I live in the Midlands and I have seen there is a private clinic run by Dr Louise Newson (Stratford).   But currently not in a job so don't know if I can afford it or if my husband will go mad when he finds out how expensive it is.   But I feel I need some help as all this confusion etc. is definitely not contributing in a positive way to my mental health.   If anybody has had any experiences re above concerns I am gratefully receiving any thoughts.    :-*
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CLKD

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Re: Postmenopausal bleeding - worried!
« Reply #3 on: September 08, 2018, 05:08:32 PM »

That's not a good start if you think that you husband 'will go mad'.  It is something to discuss, not get angry about.  Is that your assumption or does he have history when you want something?

 :welcomemm: browse round.  Maybe put the product name into the search box on here?  see what pops up from other ladies?  Make notes.

If your Menopause Nurse isn't up to date then it's not a lot having one!  Or maybe she doesn't explain things clearly enough?  You should not have to pay for advice but it's often quicker for Peace of mind, however, it is known that those supposed 'experts' don't know much more than GPs etc..

How was your mental state during your menstruating years?
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MichiHope

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Re: Postmenopausal bleeding - worried!
« Reply #4 on: September 08, 2018, 05:44:05 PM »

Hi,  and thanks for the reply.   I think my husband would understand if I really would have to go private if I am not getting any joy with the menopause nurse.  I think I am just feeling guilty if I feel I need to spend money on getting some more support.  At the same time I feel I cannot go on like this.... I have made an appointment to see my NHS menopause nurse on Wednesday so we will have to see.  Just a bit scared because I have this bleed now which happened because I have experimented with not wanting to take Utrogestan on a continuous basis...

I wonder if I should ask to be put back on Tibolone which I took for quite a few years and seemed to get on Ok with it but Menopause nurse wanted me to come off it and ever since I feel that I am getting more and more confused re different HRT regimes and what happens with my mental state. 

I had really bad PMS in the past before menopause,  depression during most part of my pregnancy but thankfully no postmenopausal depression.   So??  But generally suffered with depression on and off since my teenage years.   However since hitting menopause the depression (plus complete lack of libido) has become worse/more chronic...

I just feel like I am a confused mess and don't know which HRT road to go down.   I took Tibolone for about 3 - 4 years so I wonder why she wanted to take me off it?   

Sorry that my body and mind don't make much sense at the moment.... :'( :-\
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Taz2

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Re: Postmenopausal bleeding - worried!
« Reply #5 on: September 08, 2018, 05:51:29 PM »

Hi. You were probably taken off as pill HRT carries slightly more stroke risk than patch or gel although some docs use 60 as the cut off point. The bleed is because you stopped the progesterone so is to be expected. Some women opt to do this anyway. I don't know much about utrogestan but if you do a search using button top left of the screen it will bring up others posts on this particular HRT.

Taz x  :welcomemm:
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Hurdity

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Re: Postmenopausal bleeding - worried!
« Reply #6 on: September 08, 2018, 06:25:23 PM »

Hi Michihope

 :welcomemm: from me too!

As Taz says - you bled because you stopped the progesterone and you must have built up a bit of womb lining. Eventually if you had carried on with the utrogestan daily the bleeds would have stopped if your oestrogen dose wasn't too high. This sort of bleed doesn't really count as a post-menopausal bleed - it's a progesterone withdrawal bleed and expected!

How long have you been taking the Sandrena and did you start the utrogestan at the same time or what - can't quite work out what happened?

Normally with sequential HRT you take oestrogen only for part of the month and then  a progestogen (Utrogestan) with the oestrogen for the remainder of the month. You then get a withdrawal bleed - like a false period - due to the HRT regime. Taking progestogens continuously are designed as no-bleed HRT provided the balance of oestrogen and prog is right for you and after the settling in period of time which can be 6 months.

Sounds like your depression could have been hormonal. Have you or do you take medication for it or are you hoping HRT will sort this out too?

If you turn out to be prog intolerant then cyclical HRT is the way to go (ideally on a longer than 4 week cycle with med supervision) but you do still have to get used to the prog each month and then the withdrawal and the bleed.

If you want to try taking it continuously then just start again any time. Yes you can take on Days 1-25 and see how you get on - you can use it orally or vaginally (unlicensed but more effective - but prob not ideal on daily basis if you're in a relationship).

There is a lot of info on the menus - look up Treatments/HRT and the different types.

You shouldn't have to go privately - you just need to read up about how it all works and then experiment with supervision from the meno nurse or if she won't play ball, then go to your doc and explain what you want to do and why. You can also ask about Tibiolone - you are still young so could still be prescribed it, but maybe as Taz says you have other risk factors making it inadvisable at this point?

Hope this helps!

Hurdity x
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MichiHope

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Re: Postmenopausal bleeding - worried!
« Reply #7 on: September 08, 2018, 07:37:38 PM »

  :thankyou: ....  just busy helping Rosie to sort out her stuff for university.   It's a strange and emotional time - after 18 years living with us and now she is moving to Bristol (only child).   Thankfully we have a very positive and close relationship.   But it's important to learn to let go.... again and again I guess!  Will reply properly when I get a chance next.  Just wanted to show my appreciation for the replies  :foryou:

Michaela x
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Kathleen

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Re: Postmenopausal bleeding - worried!
« Reply #8 on: September 09, 2018, 05:17:51 PM »

Hello again  Michihope.

I remember well the times my children went to university. My daughter left home in 2008 and in the spring of that year I had noticed some meno symptoms creeping in so I was very emotional.

I know everyone says they'll be fine and so will you and it is infact true!  It just takes a little adjustment on both sides. She has done well to get university and you must be very proud of her.

I hope you find the right HRT regime for you but rest assured by Christmas everyone would have adjusted to the new living arrangements.

Take care.

K.
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CLKD

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Re: Postmenopausal bleeding - worried!
« Reply #9 on: September 14, 2018, 12:08:36 PM »

Sorry didn't catch up on this one.

Maybe once your daughter goes off to Bristol have a look-see at local costs for consultants?  You can ring the Secretaries at the various Hospitals in your area ....... then let us know.

Are U busy packing etc., it seems to be that time of year  ::)

I felt guilty for years because I was unable to work due to anxiety keeping me housebound  :'(.  DH told me over and over that it didn't matter, that he had bought the property on his wage packet and anything I brought home was for extras, i.e.  :scottie: : and 3 :catscratch: :cat88: :cat48:  :D.   As I began to recover I realised that I had to believe what he was telling me.

One family was recently shown on TV having a meal with their child away eating at the same time: via SKYPE they kept in touch once a week.  Like sitting round the table as they had done whilst growing up.  When Himself went to Uni., it was a weekly 'phone call in a drafty red box  ;D

How are you today?
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Cassie

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Re: Postmenopausal bleeding - worried!
« Reply #10 on: September 14, 2018, 02:06:02 PM »

Its perfectly normal to bleed a few days after stopping the Utrogestan, I do every month, its a bit of a schlepp but I prefer it that way, if you use the Utrogestan every single day then you should not get a bleed but when you use it for 10 days per month you will get a bleed when you stop. Hope this helps?  :-\
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