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[Sandra W]

Hello All, this is my first post. I'm 54 & have been on oestrogel and utrogestan for 3 months, started with 2 pumps which settled my symptoms but then they came back so now on 3 pumps and continuous utrogestan. Have recently started bleeding - small amounts and mainly in the morning, been going on for 12 days now. GP says not sure what to do & referred me to community gynae team. Does anyone else have experience of bleeding in first few months & for this length of time. All was fine initially but now I am concerned that my body is trying to fight it. I had been bleed free for 10 months when I started HRT. Any advice would be gratefully received - thank you!

[Dancinggirl]

I had this problem with Utrogestan.
I think quite a few women also find that Utrogestan results in erratic bleeding. Used in a sequential regime and then use it vaginally not orally, I believe it can be more effective.
I would suggest you either switch to Provera or have a Mirena fitted.
DG x

[Dotty]

If you hadn't been period free for 12 months before starting the hrt then you are not post menopause and you should be on a sequential hrt . Bleeding can be expected in the first 6 months of starting any new hrt so it's maybe just your body getting used to the hormones x

[Dancinggirl]

Dotty is right.  You probably aren't fully post meno so shouldn't be using a conti regime.  Perhaps try Utrogestan 100mg used vaginally for 12 days each month.  You will get a monthly bleed but this will predictable adn might be better than trying to do a conti Regime. DG x

[shell1972]

I'm on the same hrt as you but only have two pumps a day and had been period free for three years,i've been on this regime for 10 months and started bleeding a couple of months ago on and off x 

[Hurdity]

Hi Sandra W

 

As per the others - even if you were post-menopausal, if you are on 3 pumps of oestrogen a day and absorbing it well then the progesterone may not be sufficient to protect the uterus if you are taking 100 mg per day orally. Unfortunately the progesterone dose is only officially given as one dose for cyclical use ( 200 mg per day for 12 days per 28, or  for continuous use either 100 mg per day for 25 days out of 28 or every day).

You shouldn't actually need a referral but if they want to scan you - no harm in letting them do this because it would be good to know what thickness your lining is anyway.

If yuo are ineterested there is a massive long-running thread on your regime here: https://www.menopausematters.co.uk/forum/index.php/topic,23372.0.html

Hurdity x

[Sandra W]

Thank you for your replies. I will look at that thread Hurdity. So the question is do I drop to 2 pumps and try that again (even though my symptoms came back on 2 pumps)? I will maybe try going back on a sequi regime - can you use oestrogel in sequi or is it only conti?

Thank ladies xx

[Hurdity]

Any oestrogen (pill, patch or gel) can be used either with progestogens taken continuously or sequentially. If you need 3 pumps to cope with your symptoms then depending on how well you tolerate the prog and what your womb lining is like - you may need to increase the progesterone dose as per my post. In your position I would take it cyclically and then your bleeds would be predictable - if you could bear to have them! Most of us do not want to take increased doses of prog every day and especially not vaginally.

Hurdity x

[Sandra W]

Just following up on this as I am still bleeding 3 weeks on - if I switch myself to cyclical which days should I take the utrogestan - I am taking it continuously at the moment so it is effectively day 14. I am getting some symptoms back even on 3 pumps of gel so maybe I am not absorbing it as well as I thought. I started taking it to manage insomnia & night flushes but they were really my only symptoms so I didn't think I was that bad & would need so much oestrogen.
Starting to feel desperately unhappy with it all now 
Thanks for any advice anyone can give

[Sandra W]

Thanks StellaJane - should I stop the utrogestan now do you think or wait til day 25? And for the 12 days should it be 100 or 200mg utrogestan?
Really appreciate your advice

[NorthArm]

Hi Sandra

When using Utrogestan sequentially, the dose is 200mg (or two of the capsules) daily for twelve to fourteen days. But I'd advise you to take it at night, as it can be quite sedating. Have you seen the gynae community care people?

[Sandra W]

Thanks Northarm, no not yet apparently waiting time is 4 - 6 weeks - not sure I want to bleed for that long on top of the 3 weeks!

[Sandra W]

Hi All, so my gynae has said I should go back on a sequi regime so I stopped the utrogestan 3 days ago ready to start 16 days of oestrogel only and am now bleeding heavier than ever. Does anyone know how long it is likely to be before I stop bleeding please. I'm exhausted. Should I be doing something else to stop the bleed? Thanks ladies.

[Dancinggirl]

It should calm down eventually but sometimes stopping everything for 1-2 weeks to let the womb lining completely shed and then starting fresh is necessary.  I expect your lining has built up so it needs to shed. DG x

[Ladybt28]

When I stop my Utrogestan and I am on a 12 days sequi regime my bleeds are heavy but that is not unusual for me they have always been heavy and they last for 4 days before tailing off.  I am post meno by the way.