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Menopause Matters magazine ISSUE 75 out now. (Spring issue, March 2024)

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Author Topic: Bleeding on continual HRT  (Read 10177 times)

Hurdity

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Re: Bleeding on continual HRT
« Reply #30 on: January 16, 2019, 06:28:42 PM »

Hi there - you quoted me: "Yes vaginal use of progesterone - much more is absorbed. In fact some research shows that you can use approx half the dose of prog when used vaginally than when used orally, and it also is thought to be held in the uterus making it even more effective. For higher doses of oestrogen I would always use it vaginally because high oral doses are not well tolerated as I previously said."

Your response "I presume, for clarity, you meant higher dose of Progesterone, not estrogen?"

I did mean oestrogen - and sorry my words were ambiguous. Sometimes it's difficult to see how it reads when i know what I mean  ;D !

What I meant was - if you are using higher dose of oestrogen, then you needs higher doses of progesterone to protect the endometrium (but there are only two doses of progesterone listed - 100 mg for continuous and 200 mg for cyclical), and that being the case, because women do not tolerate high doses orally I would always use the increased progesterone dose vaginally.

Sorry - about that - does that explain better?

Good luck with it all and please keep is updated!

Hurdity x
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Autumn27

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Re: Bleeding on continual HRT
« Reply #31 on: January 26, 2019, 10:00:27 AM »

Hi All,

For anyone interested in prolonged bleeding problems, here's my update. Following an email correspondence with Dr Currie (highly recommended and worth £30!) I went to my female GP armed with info.

Dr Currie recommended further investigation to rule out a polyp or other issues. Unfortunately my GP said no. My GP incorrectly said that a polyp would have should up on the Ultrasound and that I didn't need further investigation. Despite 9 weeks of unexplained heavy bleeding.

Dr Currie also said I could try cyclical Progesterone vaginally to see if that worked. My GP said no, that it was pointless to try and that Progesterone wasn't as effective taken vaginally. That opinion differs to medical information online. However, I am now trying it anyway, as I have enough supplies to give it a go for a month or 2.

Ultimately Dr Currie recommended the Mirena, and so did the GP, so I am going to try that next, in the meantime will continue with the cyclical regime, 100 Etsradots, with 200 Utrogestan vaginally,  to see if it improves my situation and regulates the bleeding.

Thanks to all for the advice so far, you've been very helpful and supportive!



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Hurdity

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Re: Bleeding on continual HRT
« Reply #32 on: January 26, 2019, 06:24:52 PM »

Hi Autumn27

Thanks for the update - glad you have had advice from Heather Currie but what a terrible GP - contradicting one of the country's leading menopause experts (apart from the Mirena advice).

You should go to another GP and demand referral if this has been recommended by Dr Currie, and if your GP is incorrrect and s/he is being negligent in not referring you due to ignorance if this is the case? The whole point eg of hysteroscopies is to identify potential polyps or fibroids or other pathologies which do not show up on U/S scans. If you haven't been given a reason for the bleeding then this needs resolving before a Mirena is inserted and I believe that may be stated in the prescribing instructions for Mirena ( ie exclude possible abnormal reasons for bleeding first)?

I hope your bleeding eases soon.

Hurdity x
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Autumn27

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Re: Bleeding on continual HRT
« Reply #33 on: January 29, 2019, 10:23:55 AM »

Hi Hurdity,

Thank you for your response. I was quite disappointed that my GP was so adamant that I didn't need further investigations. Also the Research Fellow at the Menopause clinic had also said I didn't need them either. It is my life on the line, so I would like to know the cause of my bleeding.

I do have the option of other GP's at the same surgery. I suppose I could try one of them, it takes 3 weeks to get an appointment. I have been considering changing doctors surgery for a while now, just afraid to risk a new surgery to find that it might be anti HRT altogether. Some visiting doctors at my current surgery have refused prescriptions for HRT and I've had to get the practice manager involved. It's a minefield out there!

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Hurdity

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Re: Bleeding on continual HRT
« Reply #34 on: January 29, 2019, 06:10:01 PM »

It's just appalling that some doctors continue to refuse to prescribe HRT if there is no medical contra-indication! Good luck with your investigations (if you manage to get a referral and an explanation) and future treatment.

Hurdity x
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Autumn27

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Re: Bleeding on continual HRT
« Reply #35 on: March 02, 2019, 05:55:19 PM »

Hi All,

I'm back to report on an update on my experience with 3 months of uncontrolled bleeding on HRT. 

I seem to have finally found a solution that works for me. Following Hurdity's earlier advice, and consulting by email with Dr. Currie, I decided to attempt cyclical HRT instead of continual.

I stopped all progesterone and remained for 2 weeks estrogen patch only (100 mcg Estrodots).

I then did 14 days of 200mg Utrogestan Progesterone, obtaining the vaginal ones that come with an applicator (much easier to insert properly and insure correct dosing)

Much to my relief everything is now working as it should be, with a 4 day bleed after the progesterone ceasing.

So as I was not keen on having a Mirena and potentially creating more issues for myself, (under GA) this is a huge relief for me, and am posting this info incase anyone finds themself in a similar situation!

It's now been 7 whole weeks of being back to normal, and I feel so much better. Thanks so much to everyone who offered thoughts and for your help solving this problem!  ;D


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Hurdity

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Re: Bleeding on continual HRT
« Reply #36 on: March 03, 2019, 06:05:06 PM »

So pleased to hear that things have improved for you Autumn27 and your bleeding has stopped! Long may it last - fingers crossed eh? It's success stories like yours (hopefully long term!) that makes it all worthwhile! :)

Hear hear Stellajane (does anyone say that any more or is that too old-fashioned?!)!

Hurdity x
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Autumn27

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Re: Bleeding on continual HRT
« Reply #37 on: March 03, 2019, 10:15:00 PM »

Thank you Stellajane and Hurdity!

I am so grateful for this website and for all the lovely people sharing their knowledge.

I hope anyone else going through this will give this solution a try!



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CherryC

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Re: Bleeding on continual HRT
« Reply #38 on: August 02, 2019, 08:27:54 AM »

Hi, I'm not sure if it's ok to post on an oldish thread but here goes...
I would love to know how Autumn27 is getting on with the new sequential routine?   I find myself in a similar situation. I have been on 100 Estradot patch and 100mg Utrogestan vaginally for a few months now and I have been feeling really good. Unfortunately, bleeding (proper full on period) started about 14 days ago and has been continuous.  I had a scan in May and was told the lining was ok.  I am seeing my consultant in a couple of weeks and will see what she advises but I am considering reducing the patch to 75 (though I don't absorb all that well), or asking about a sequential route. I would like to distrurb things as little as possible now that I am feeling good in myself. Thank you for any advice and updates. x
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Taz2

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Re: Bleeding on continual HRT
« Reply #39 on: August 02, 2019, 08:37:25 AM »

Hi CherryC. Autumn27 has not been on the forum since her last post but you could send her a personal message via her profile which she might pick up.

Taz x
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CherryC

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Re: Bleeding on continual HRT
« Reply #40 on: August 02, 2019, 08:49:54 AM »

Ah thank you for the advice Taz, I will do that x
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Autumn27

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Re: Bleeding on continual HRT
« Reply #41 on: August 15, 2019, 09:34:57 PM »

Hi Cherry,

Just picked up a couple of PMS, from you and another lady asking where I'm at with my bleeding. I have had no bleeding since January- so thankfully 7 months of everything being OK. I did 4 months of the sequential regime, which stopped the continual bleeding, and helped me regulate my body, and then I decided to see if I could go back to my old regime, which I preferred.

So now I am back on my 100 daily Utrogestan progesterone and 100 Estrodot patches, and have been taking these for 3 months, with no bleeding or issues.

I hope that helps anyone who may be considering trying sequential  as an option to stop bleeding.


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Taz2

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Re: Bleeding on continual HRT
« Reply #42 on: August 17, 2019, 08:32:14 AM »

Thanks for your positive post Autumn. I too went back onto sequi after bleeding problems with conti but this was actually suggested by my lovely GP so I was lucky. I'm so glad you are feeling so much better.

Taz x  :)
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Smatt

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Re: Bleeding on continual HRT
« Reply #43 on: July 28, 2020, 07:57:37 AM »

I’m in a similar position. Getting desperate now- due to go on family holiday tomorrow and seriously considering cancelling due to never ending heavy period on 1 daily dose oestrogel and 14 days UStrogen/ progesterone (2 tablets). Should I increase tablets to try to alleviate bleeding? GP says to monitor over time- but no use this week! 😞
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