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[helen63]

I've recently changed from Evorel 50 patches and mirena coil to oestrogel 2 pumps and mirena as I didn't feel I was getting much benefit from the patches. A few days after changing I have started bleeding like a normal period despite being post menopausal. I'm 57 so shouldn't be having periods and didn't have any on the patches apart from a bit of bleeding at the start of using hrt. My question is .... is it common/ normal to start bleeding when changing hrt regime? I thought evorel 50 patch and oestrogel 2 pumps were the same dose so didn't expect to bleed and my Doctor didn't advise me this may happen. Any info and advice would be welcome . Thank you

[Hurdity]

There is no "same dose" when it comes to HRT. There are approx equivalents based on average measurements of blood levels from a group of women undergoing a trial but that's it. How much you absorb will be individual to you. Fromn what you are saying you may well be absorbing more oestrogen from the two pumps of oestrogel which is what you wanted isn't it? You said in your post that you wanted to try the gel because you weren't getting enough benefit from the patches so for you it would be unhelpful if swapping over meant you were getting the same dose.  Do you see what I mean - you can't both expect to have the same dose and expect to have more benefit at the same time? Do you feel better is the main thing?!

Your uterus lining will now need to get used to this higher dose I presume? If you are worried about the bleeding then do mention it to your doc. Also how long has the Mirena been in place?

Try not to worry!

Hurdity x

[helen63]

Many thanks for your response Hurdity. I get what you mean, I was wanting a better result with the gel but at the moment I'm not feeling any better, just bleeding. I've had my Mirena for just over a year now and havn't bled until now changing from patch to gel. So do you think it is more oestrogen I'm getting with the gel or less  to cause the bleeding,  I'm a bit confused?

[Hurdity]

It's always difficult to say. Too much progesterone in relation to oestrogen can lead to endometrial atrophy and ulceration of the lining which can cause spotting but as far as I know this would be different in nature from the bleeding caused by too much oestrogen or when the lining is getting used to a new regime? Not sure about this though....I wouldn't have thought this would happen immediately anyway especially on two pumps of gel. It sounds like your oestrogen levels have probably increased and your womb lining just needs to adjust to a no-bleed regime but do consult your doc if you are worried though.

Hurdity x

[helen63]

Thank you, will give it a little bit longer I think as its only been 10 days since I changed. Hopefully it settles down and if not, I will go back to Doctors .