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[Cassie]

For those ladies who are still currently using a cyclical form of Progesterone, approx how many days do you bleed for, is this a generally lighter bleed? I assume it depends on the amt of Oestogen you are taking?  Currently on 2 pumps of gel and 100mg of the Utrogestan for 14 days so just wondering what is considered a normal bleed?

[LittleClaire]

Hi Cassie,

I am on 100mg patch and 200mg progesterone cyclically (although have just been told today by nurse that I need to be on 300 now) and I now have light periods that last about 2.5 days, then approx 3 days of pink discharge. You could say that’s a 5 day period but the bleeding itself I only get for a couple of days. Before peri I used to get 5 day periods with 3 days of heavy/medium then 2 days of light. Not sure if it’s the peri or the HRT that have caused them to lighten though x

[bombsh3ll]

I just want to share the message that withdrawal bleeding on exogenous hormones, be that combined hormonal contraception or menopause hormone therapy, is not medically necessary.

It was built in for paternalistic reasons many decades ago, yet many women still today think they have to put up with repeated episodes of iatrogenic vaginal bleeding.

Some people will be happy with this, but everyone deserves to know they have a choice and that multiple bleed free options exist no matter what your age or stage.

[sheila99]

I'm not sure 'normal' exists. I found when it was an hrt bleed rather than from my own hormones it was much shorter and lighter. Sometimes I didn't bleed at all but it was never more than for 2 cycles. I believe some post menopausal women don't bleed at all on a cyclical regime but perhaps that's unusual.

[bombsh3ll]

If they are no longer producing estrogen themselves and are only on a low dose, it is possible that the lining simply doesn't thicken enough to shed anything when the progestogen is withdrawn.

[Cassie]

Hi Bombshell I am not able to take Progesterone daily, as it is right now, the Utrogestan just used cyclically gives me very tender boobs and I dont get the sedative effects other ladies describe, it makes me feel jittery and a bit like I have had too much caffeine. I would love if you could mention the no bleed protocols, but I think most of them contain Progestegins, which I am not keen on. In fact I was using a compounded cream and was advised on this forum, it is not safe to use for endometrial protection, despite the compounding pharmacist assuring me that it is indeed absorbed via the skin due to what is added to it so I am back using Utrogestan 100mg x 12 days a mth but not loving the idea of a withdrawal bleed at the age of 70 either. 

[bombsh3ll]

You are right that most of the bleed free options involve a progestin, however if your quality of life is suffering on micronised progesterone, it may be worth actually looking into the real world differences in health outcomes with various progestins vs progesterone, because these are clinically minuscule and very much distorted on social media, to the extent that progesterone intolerant women are really suffering and terrified of trying something that isn't "body identical".

Many women abandon hormone therapy altogether having only ever tried micronised progesterone, which is a real tragedy.

I am assuming you have already tried the progesterone vaginally? This sometimes improves tolerability.

Bleed free options can include desogestrel, norethisterone (available orally and in combination patches), dydrogesterone, dienogest, drospirenone, provera or the mirena IUS which contains levonorgestrel.

There is also tibolone.

In other countries there is bazedoxifene but this is only currently available in combination with equine derived estrogen, which makes it unappealing to many, and is not available in the UK at all.

[Cassie]

Thank you for those will read up on them and discuss with my Dr when I see her again. Yes, I use it vaginally but the cramps are also rather unpleasant, would really prefer a no bleed protocol.