Pain/discomfort and bleeding on HRT

[BlackInk]

Hi there

It's about 2 years since my periods suddenly stopped; I'm 44 years old. Blood tests at GP confirmed menopause and (due to feeling generally crap and more like I'm 144) I decided to try HRT starting about 9 months ago. It's not made a huge difference to how I feel.

Dr originally prescribed Everol Conti, then changed that to Femseven Conti to see if that helped more. Then FemSeven became unavailable and I went back to Everol.

However, before I swapped back to Everol, I started spotting (especially after sex). This went on for a couple of months. Then, just before swapping, I had a period-like bleed, which lasted about a week.

I'm now about three weeks back on Everol and still spotting from time to time. But the last few days I've had really uncomfortable lower back ache, womb ache and lower belly bloating.

Does this sound like cause for concern? I have an appointment booked at GP for end of September anyway, but not sure whether I should try to see someone sooner. Does this count as post-meno bleeding?

Many thanks if you've bothered to read this far :)

BI

I've done a bit of reading around early menopause (for my work) using some info on the Daisy Network site and my understanding is that when periods stop abruptly and before the average age (you were 10 yrs early) they can sometimes resume.

So it's possible that what you had was a period.

It's possible your ovaries have 'reactivated' themselves.

Did you ever have any investigations to find out why your periods stopped suddenly and so early?

[[https://www.daisynetwork.org.uk/about-poi/making-the-diagnosis/]]
Did you have emotional trauma / stress at the time?

It's also more usual to use sequential HRT when you are young (or the CCP (Qluaira) which gives a higher level of hormones.)

Swapping brands may well have caused an upset too and given bleeding because those patches have different progestogens.

Thanks for your reply Queenofthe Nights - I was hoping you might be along!

If my ovaries are going to reactivate themselves I would appreciate if they sounded some kind of claxon!

No investigations offered by GPs (despite me regularly bothering them because I was feeling so crappy) as they said I was just on the early side of normal and blood tests backed up standard menopause theory.

I wouldn't say I had any emotional trauma at the time of my periods stopping, but I do have trouble with anxiety/emetophobia which seems to be just getting worse and worse.

I spent 7 years TTC with no luck, then had a mid-term miscarriage. Then a year later successful pregnancy with my DS who's now 9. Breastfed him until he was nearly 2YO, another latish m/c and then pregnant with my daughter who also breastfed for a couple of years. So for quite a few years I was either PG, BF or recovering from m/c.

My periods returned to normal (maybe slightly less regular) after DD stopped BF then stopped abruptly a year or so after that.

Current discomfort feels just like bad period pains but not bleeding currently...

I will ask GP about Qluaira when I see them in September.

Thanks again!

Black my periods started to become lighter at 42, the same age with yours and I am in peri. Can I ask you if you find a cause for it, as Queen said? For me was a terrible shock!

I'm afraid not Emerald. At age 42/43 when my periods stopped it was only considered mildly on the early side (NHS considers 45 to 55 normal).
I haven't had any of the classic symptoms of menopause (no sweats) but worsening anxiety/moodiness and generally feeling suddenly ancient.
I guess they might have been more proactive if I hadn't yet had children...

I am childless Black and time is over for me unfortunately! Mother Nature is cruel sometimes! I feel old before my time suddenly too! Thanks for replying! 💐

I'm sorry Emerald.
Do speak to you GP though - they may very well be less useless than mine!

Yeah, I have visited a lot of gyns privately ( I am not in UK), I changed a few types of hrt and I am on a cyclical type for a year now. I took hrt almost immediately and I am symptom free.
It was very hard for me to find a gyn and an endo who knows! My first gyn didn’t offer any help saying just that it is natural!
I find the forum really helpful! :)

Just a quick update, feeling pretty deflated after GP appointment on Friday.

She was completely non-plussed about the bleeding. Just said it was unlikely to be anything to worry about at my age. She was defensive when I mentioned that maybe the conti HRT wasn't recommended for someone in my position and that sequi or contraceptive approach might be better. I didn't pursue it.

I also mentioned that my mum had had a tumor on her optic nerve in her early 50s and that her periods had stopped suddenly at around this time. My partner had been reading up on optic tumors (because he's worried about me) and discovered that they are very hereditary and can cause all sorts of hormonal symptoms. Now I don't personally feel as though I've got anything like that going on. But my mum had no idea either until it was picked up during an eye test. Doctor just dismissed this as a possibility and said she's never heard of optic nerve tumors being hereditary.

No examination, didn't even check my blood pressure. But I ended up walking out with a prescription for Sertraline (an anti-depressant) . Now I have been struggling with a very specific anxiety/phobia for years. I definitely am anxious but my symptoms are very physical.

I told her I was reluctant to start taking medication for it and she just handed me the prescription anyway and told me I didn't have to use it. No advice on how to take it, what to expect, follow up etc.

I feel royally fobbed off...

(Sorry, not such a quick one after all!)

can you find another GP? her behaviour is appalling frankly . She's not listening and not offering you anything. It's not appropriate to offer ADs as part of meno therapy unless you have had existing depression.

The first line for anxiety and mild depression and phobias is CBT or other talking therapies. GPs have been advised to do this FOR YEARS but some take no notice.

ps If I were you. I'd go back and calmly talk to her about all of this. Refuse to be bullied, challenge her a bit and if she can't be more helpful ask for a referral to a meno consultant.

Thank you - I can't bring myself to go back. I've seen a few drs over the past couple of years and had quite a lot of tests. I think they now think I'm a hypochondriac or that all my symptoms are caused by anxiety or that it's standard menopause stuff and I should just get on with it.

I have discovered that I can self refer to a local NHS menopause clinic, so I might look into that.