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[Traceylr]

hi Cee,
reducing the oestrogen may help, with the lining build up and break through bleeding . why not try a trandermal patch? start with the lowest dose 25mcg and see if that helps control the flushes. I started with a 50mcg patch but found that it caused occassional break through bleeding so I gradually reduced the patch size by carefully snipping ( measured) bits off. Am now down to 37.mcg patch ( changed twice weekly) and all is well , for now!
I use urtogestan 100mg every night vaginally , no probs with that either used this way.
hope this info is helpful.

[Cee]

Thank you Traceylr, that's also good advice. I love this forum, women looking out for each other.




   

[Hurdity]

Hi Cee

As has been said - it is your choice which and whether HRT you decide to use/start/stop.

When I had a hysteroscopy due to unescheduled spotting the gynae also tried to persuade me to have a Mirena fitted at the same time - which I declined.

Also as has been said you are supposed to give a new HRT 6 months to settle - although if an increased lining (thickness) has already been identified is responsible for your ongoing bleeding prior to 6 months having elapsed then you will need to sort out a regime to make sure it stays thin.

In terms of stopping bleeding and reducing the womb lining - you have several options, some of which have been outlined: increase oestrogen, decrease progesterone, change the delivery method of progesterone.

As Traceylr says and as advised when you first posted - when used vaginally, progesterone is more effective - in keeping the endometrium (womb lining) thin. This could be the first option  - used daily or Days 1-25 so that if it does build up you could potentially bleed/shed after you stop for 3 days per cycle. So that's one option. You can also try taking the utrogestan with food ie at the same time as your evening meal. This increases bio-availability so theoretically should enable greater absorption of the progesterone dose you are taking.

The other suggestion which not sure if it's been made - is to change from taking it continuously to having a cycle. Eventually this should shed the thickened lining but in a predictable manner. You would double the progesterone dose (to 200 mg) and take it for 12 days per cycle (possibly 14 to start with?) - ideally vaginally. OK you would have a monthly bleed but hopefully your worries about the lining would evaporate along with your lining!

It's also been suggested that you reduce oestrogen - this may stop the womb build up but not necessarily deal with your flushes. Also the lowest doses do not give the same protection against osteoporosis. It's a good suggestion to change to transdermal HRT at some point but as you are still young - if you are happy with the tablets then at this point no need to change I would have thought.

To ensure you get a good bleed? Not sure if you mean as a one-off or regularly. If your lining is very thick then a course of progestogen might be advised eg norethisterone - for two weeks or so to "strip" the current lining and then you can start again on whatever regime you decide - eg by tweaking the one you are on. Otherwise then changing to a cycle with a larger dose (or longer duration) of progesterone would enable thinning too.

Not sure if this has been mentioned but bleeding can also be caused by fibroids or polyps but I guess these might have shown up on your scan?

Hope these additional suggestions are helpful and let us know how you get on.

Hurdity x

[Cee]

Thanks for all the advice, I'll let you know how I get on

[Cee]

Hi sisters
I went for the camera in the womb scan and it was good news.  My womb lining is fine and they did not do a biopsy. So I'm having a chat with doctor this week but I was told by the hospital that if I wanted I could continue on the utrogestan and elleste. Thanks all x