HRT and bleeding...

[Blushah]

I've been on a twice weekly eostrogen patch and daily progesterone tablet for 18 months.

I've been getting what I assume is 'breakthrough' bleeding over the past 2-3 months. It happened briefly earlier on, too.

Does this mean I need a higher dose of Utrogestan? Currently 100mg.

I'd go to the GP but it's impossible to get an appointment. I just tried again, but I have to call back 'between 8.15 and 8.25am' on Monday, when I'll be driving to work. But that's not even 'an appointment to make an appointment', it's the window which everyone has to fight in to get a routine appointment, booking up to a month ahead.

So seeing my GP right now- by which I mean 'in the next month' isn't an option.

My question is really- is this most likely to be an imbalance of HRT hormones? Or should I get onto it quicker, in which case I'll either have to take a day off work to phone and phone and phone the GP (the phone 'triage' system promises to get back to you 'in up to 4 days) or even have to go to A&E!!

All continuous regimes carry a risk of bleeding for up to 6 months.

see here

menopausematters.co.uk/postmeno.php

It's nothing at all to worry about. You will stop bleeding when the lining thins with daily Utrogestan. For the first few months the balance of estrogen/progesterone takes a while to settle down.

If you get fed up with the bleeding now, you can go back to a sequential regime which is a 4-weeks cycle with a withdrawal bleed every 4th week.

TBH your dr ought to have told you about this. Almost all users of conti HRT have breakthrough bleeding for a few months.

Just checking- you have used this regime for 18 months? So you must be post menopausal? This type of HRT is only suitable if you have not had a period (naturally) for a year before you begin.

Utrogestan is poorly absorbed by some women. When the blood serum levels fall, it's liable to cause spotting.

If you were not post meno when you started it, then it could be your own estrogen levels kicking in and the Utrogestan dose not being enough, but the way round that is to go onto a sequential regime.

Thanks. Yes, at 55 (now) I was a good 2 years post-last-period when I started HRT. I was warned of spotting, but it's now 18 months, not all the time, but annoying!

I wonder if I should try the Utrogestan PV again? All a bit sticky, but that might be a solution...