Hi duckie,
What you describe re your periods is perfectly normal. As you are perimenopausal your own hormones are fluctuating in the background. Bleeding is notoriously irregular. Oestrogen is the bleeding hormone, so if you don’t have enough (either your own, from HRT or a mixture of both), you won’t build up enough womb lining to shed. Utrogestan will keep your womb lining thin, but you still have to have built up a womb lining for the progesterone to do its ‘thing’.
How are your other symptoms? Why did you begin HRT? It does sound like you might not have enough oestrogen now and need a higher dose.
My periods were all over the place when I started HRT. I could go months without bleeding, have 2 in a month, start before I had finished the 2 week utrogestan phase. It was so unpredictable and with hindsight, I probably wasn’t ready for HRT. Personally I decided to stop and see what my body was doing naturally. It helped my anxiety enormously to do this. I’m now menopausal and am starting HRT again (slowly).
The only thing to remember is that you are not doing your body any harm. It will be okay. It’s unexplained bleeding when you are post menopausal (constant spotting, a period when you’ve not had one for years etc) when the red flags start waving and your GP will send you for a scan.
If you don’t want to bleed then a Mirena coil might be an option. Otherwise just be prepared that HRT won’t train your body to have a bleed every 28 days, it’s not like the contraceptive pill. Your own cycle will keep doing its own thing, until your own hormones stop.
Maybe try a higher dose patch to see if it helps with anxiety and produces a more regular bleed. More oestrogen is beneficial for bone and heart health anyway, so worth trying.
