Withdrawal bleed after coming off Noriday age 55

[Auntienellie]

I came off Noriday (which had also doubled up as a miracle cure for my painful periods) because I was 55 & hadn't had a period for just over a year. Exactly 4 weeks after coming off it I had what was just like a very light period lasting 5 days. This was about 6 weeks ago & I have had no bleeding since then. I had blood tests done which showed that I have gone through the menopause but I have to go back so they can (in the doctors words) tick all the boxes because I had a bleed after 12 months. He did say that it was probably a withdrawal bleed due to coming off the mini pill but that they needed to make sure. I'm relieved that I've gone through the menopause but worried in case there is a more sinister reason for the bleed. Does anyone else have experience of this?

No personal experience, sorry, but if you were taking Norethisterone it is also used as part of HRT and bleeding occurs after it's stopped ( each month) so it stands to reason that you would have a bleed.
I'd take the comments that you are through the menopause with a pinch of salt- blood tests are not always reliable and although you may well not have any periods at 55, you might start having other symptoms now you are not taking anything hormonal.
Flushes, sweats, bladder and vaginal problems often begin only when periods have stopped for good, so you may need to think about treatment in the form of HRT if this happens.

What do they plan to do next- a vaginal ultrasound scan or a hysteroscopy?

I'm due my routine smear anyway, so that & an examination to start with. The doctor who rang me with my results didn't mention anything else just told me to book a double appointment to rule out it being anything other than coming off the pill. I have previously had some menopause symptoms both before & while I was on Noriday (though nothing too bad) but haven't really had any recently. I've heard that the blood tests can be unreliable but am hoping this is not the case for me. I certainly don't want to go back to having painful periods at 55!

Why not ask your dr what they intend to do? A smear and an exam won't tell you / them anything other than your cervix is healthy.
They may be doing a biopsy of your uterine lining but if so you ought to be told this in advance and not have it sprung on you!

I will ask but I got the impression that they will just do smear & check cervix. Obviously if they find anything suspect they will do further tests. I was really just wondering if anyone else of a similar age to me had been on the mini pill & experienced a similar "period" after coming off it.

TBH if they don't send you for a scan they are being negligent. It may well be a bleed after coming off the mini pill BUT any bleed after 12 months is supposed to result in a referral within 2 weeks for a scan.
They won't find anything wrong with your uterine lining by doing a smear test. I think it's quite unusual to be on the mini pill to 55- most drs would suggest coming off it earlier because conception over the age of 51-52 is most unlikely. Did they never suggest you stopped it sooner?

I was told that as a healthy non smoker I would be ok til 55. I went on it age 50 as I was still having regular (& very painful) periods & was almost certainly ovulating. It took me a while to settle down on it but once I had my periods were still regular but not at all painful so it served a dual purpose. Coming off was only advised when I was approaching my 55th birthday.

I went on the pop after being taken off coc. As far as I understood, it was fine to stay on it until 54/55, because at that point, you can be considered to be no longer fertile. Same with mirena, only your can continue using this with oestrogen as the progesterone part of hrt (but not pop - not considred to be enough progesterone - you must take combined hrt with this)

The only other way to tell that you no longer need to take it is to do regular FSH tests and these are unreliable if you are taking any hormones. You would have to keep coming off for more reliable tests, which would defeat the purpose of taking them.

This is a silly question but when you take the mini pill do you have a break for a bleed like the combined pill or is it continuous? If you would normally have a bleed but they have petered out, I'd still want to be on the safe side and have a scan. I know my consultant would arrange that without a 2nd thought.

You can take the mini pill as part of HRT Day because my consultant offered it to me but it would be 3 a day to get 1mg.

I decided not to and use Utrogestan.

You usually take the mini pill daily and have a relatively normal cycle. It does not stop ovulation, but makes the environment hostile to eggs and sperm. New higher dose pills like cerazette are more likely to stop ovulation all together and sometimes stop bleeding (but sometimes you get spotting or more bleeding ) I expect that towards the end of menopause, even ordinary mini-pills stop ovulation, but it may recur when you stop taking it. I didn't have periods in the short time I took it recently, but had normal periods when I took it in my 30s.*

They are licensed as contraception, and as such are free on the NHS. There is not enough progestogen in normal mini-pills to protect the uterus when oestrogen is taken, although some doctors think cerazette may have enough. This is presumably 'off licence'. As far as I know, Mirena is the only progestogen licensed for contraception and hrt, (it is a small dose, but acts directly on the lining).

• I did not get a 'withdrawal bleed' when I stopped it - it took 9 weeks and 2 lots of CM for my periods to start up.

Not sure what you mean about 'off licence'. Noriday is Northisterone
www.netdoctor.co.uk/sex-and-relationships/medicines/noriday.html anc contains 0.35mgs per tablet. As far as I know there is no 1mg norethisterone tablet available so my consultant's option for continuous combined HRT using a low level of Northisterone was 3/ 0.35mgs daily to give 1mg.

There are several progestogens available to use alongside oestrogen- not just norethisterone and not just a Mirena coil.

Noriday contains norithisterone, a progestogen, in the right amount for contraception (if you take one every day as per instructions www.medicines.org.uk/emc/medicine/10450). This is what it was designed for. As preparations for menstrual problems usually contain 5 mg, your consultant used his own judgement in how to achieve the 1mg he wanted.

This explains 'off license' (not drink related!)
www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON087990

You don't seem to be able to get norithisterone on its own for opposing oestrogen in hrt. It is usually in a combined preparation. There are 3 available here:
www.mims.co.uk/Tables/882443/hormone-replacement-therapy-hrt/

AHHHH Off-label is the word. Not off-license. Brain Fail!!!!!!!!!

DayLillie - I took Norethisterone 5mgs, for 10 days, for 5 years as part of sequential HRT before swapping to Utrogestan. many women do- it's not unusual. I am fully aware of the points you make about it!
The point of perhaps taking 1mg for 25 days out of 28 cycle was to reduce the bleeding and period pain. In the end we decided to go with a bio identical progesterone instead.

I think the point you are missing is that if you use a separate oestrogen- either as a patch or gel- you can add in any number of progestogens to give the necessary progestogen needed.
That table you linked to is all about pills- I and many women don't sue pills- we mix and match all products available.

1. OP is taking noriday, an oral contraceptive for contraceptive purposes and with the happy side effect of reducing period problems.

1. It is fine and perfectly normal to do this up to age 55.

1. OP is not taking oestrogen, so this is irrelevent to the OP

1. The OP asked if anyone had experienced a withdrawal bleed after coming off Noriday or similar and so far the answer is no.

The MIMs table I linked to included pills, patches, capsules, IUDS, rings, creams, vaginal tablets, gel, so it is not just about pills. There are 15 different brands of oestrogen and 3 different brands of progesterone to use together, as well as the already combined preparations.

Yes I realise that. But the discussion moved on as they often do on threads! Are you saying I shouldn't post my comments- you sound a bit touchy???

I was answering your point - you said you didn't know that Norethisterone could be used as part of HRT and was only part of combined HRT (pills) or for contraception.

I am clueless when it comes to HRT etc. as I don't have any experience of it & have never looked into it in any depth so cannot really contribute to the discussions around it. I suppose I was really just hoping that a couple of people would say oh yes that happened to me which would have put my mind at rest but clearly that is not the case. I will see my GP & have whatever tests she feels I need. By the way I had three different blood tests relating to hormone levels not just the FSH test.

Thought I'd update in case anyone else is going through similar. I go to the hospital for a scan & consultation on Monday. Since I posted I have had another 2 very light "periods" with definite signs of ovulation but no bleeding at all in between them. GP repeated all the blood tests & this time they showed that I was as she put it "in no man's land." So although I'm gutted that I've not reached menopause at 55 I am hoping that the bleeding is just me returning to having periods after coming off the mini pill.

I have been in no mans land since coming off the pill too. It is no fun. In my case I just got more and more periods, and not necessarily any ovulation.

Still there are supposed to be good things about finishing your periods late - hope you find them, and that Monday goes well for you.

Had my scans & a hysteroscopy this morning. Thankfully I got the all clear... the doctor who did the hysteroscopy said she hadn't needed to take a biopsy as she could see that all was fine. She told me the blood tests are hardly worth bothering with & that to be having periods at 55 is not actually that uncommon. So at least I am reassured that there is nothing serious going on & that my body has just gone back to its normal pattern after coming off the mini pill.

That sounds very reassuring. I hope you can relax now.

My periods came back after 5 months and were more frequent and heavier. I had hoped I had missed the worst of it, so it was dissapointing.