HRT

[PantsToThis]

Help! After suffering peri symptoms for a while, flushes, night sweats, mood swings, insomnia, brain fog, I had a 5 week period 😫 The Doctor suggested I start HRT, oestrodiol gel and utovlan tablets. I started 3 days ago with the oestrogen. My bleeding stopped after the first dose, so that was great, but my flushes have got so much worse. I’m getting one at least every hour, more if I eat hot food or have a hot drink. And the aches in my body are awful. Has anyone experienced this and will it settle down? I’m almost 46.

From my experience, which is what my GP also told me when prescribing, it took 3-4 months to start to feel the benefit from HRT.

Maybe try it a little bit longer OP, see how you feel after 5 days, then 7. It may take a while. Are you sleeping any better? Everything I read about HRT seems to suggest this is the one of the first improvements women notice!

In my experience, the favourite phrase of GPs with new meds is, 'wait and see if things settle down' so undoubtedly they wouldn't be much use at the moment!

The rule with HRT is you give any type 3 months to see if it helps. All meno drs say this.

Thanks everyone, yes I will certainly give it a few months as I never want a 5 week heavy period again! I was just surprised about the flushing being significantly worse with the oestrogen. Also my sleep has been even worse the last 2 nights. However, to not be bleeding seems like a huge step forward. I will persevere.

@PantsToThis It won't be the estrogen causing your hot flushes after just 3 days. You'd be having them anyway, most likely. Estrogen is not like a pain killer or a drug that works in almost straight away- it takes days/ weeks/ months to build up in your system.
Those flushes would have come anyway :)

I'm on day 6 now (oestrodiol phase) and started bleeding last night, day 5. Proper period not spotting I just can't cope with this again, I only just finished a 5 week period! I've consulted Dr Google and frightened myself that this could mean I'm having too much oestrogen now.

Oh dear, I think you need to go back to the GP, OP. Sorry it isn't working out for you. Unexplained bleeding is unsettling and so unpleasant & debilitating.

@PantsToThis I don't think you understand how HRT works. When you use HRT it gradually replaces your own hormones over a timescale of weeks and months. Eventually, if you are in perimeno, it might re-set your cycle so the bleeds are regular. It doesn't work in 5 days.

Your own period that lasted 5 weeks did not stop because you used estrogen gel for 3 days- it simply doesn't work like that. It stopped because your lining was thinner and you lost a lot of it.

The same applies to the hot flushes. A couple of days of gel won't stop them or make them worse. It's a coincidence they got worse and you need to give the HRT time to get into your system and settle everything down. It's not a quick fix in a few days.

I think that whatever you are getting now- more bleeding and flushes would happen anyway because you've not used hrt long enough to give you those.

I've used HRT for almost 12 years. Every cycle, I get a substantial bleed for around 3 days, and the amount of blood loss is directly related to how much gel I use in those weeks.

There is no way that using gel for 5 days will cause bleeding that was not going to happen anyway.

This is what can happen in peri.

Once you get to day 15 and use the progesterone, the bleeding will stop and you should start to settle into a monthly pattern.

Are you in the UK because I've not heard of Utovlan.

Thanks for the responses. You're right I don't understand how HRT works., I got it wrong utrogestan is the progesterone part of the cycle. I'm feeling a bit up and down right now with all these worrying symptoms so probably not making things very clear. I am meant to take oestrogen and on day 15 utrogestan, then when is top that it should start a bleed (if I understand that right). I am Bleeding 5 days into the oestrogen part of the cycle, after a 5 week bleed (no hormones) and that worries me. I will ring the GP tomorrow for advice. Thanks for any advice in the meantime.

@PantsToThis The cycle you are trying to set is a 'normal' cycle where you take progesterone for 12 days a month. Once this is established - and it might take a few months- you will have a regular withdrawal bleed (like on the Pill) about 3 days after you take the last progesterone tablet.

BUT you are not there yet.

The bleeding now is nothing to do with the gel.
It's your own hormones kicking in as you are in peri, and you are getting erratic bleeding which is perfectly normal in peri.

Taking 5 days of estrogen will not give you a bleed - it's pretty much impossible as it is such a tiny amount of estrogen.

Your GP will probably tell you to carry on and complete at least 3 cycles to see if it settles down.

I am thankfully almost through menopause now. OP I don't want to worry you but it can take a few years to go through it. My periods have always been heavy even before menopause. From 45 my periods got so heavy I was using super max tampon and largest maternity pad and still changing every 40 mins. This went on for about 3 days then eased off. I was teaching and could not walk around classroom during heavy periods I had to sit, and rush to change tampons and pads in between lessons. Once I was sat in chair with 10 mins to go before lesson ended and I felt blood gush out of me. I could not move. I had to dismiss class early and ask student to get a colleague/friend from office to bring my coat so I could get to loo with blood gushing from me. I had to go home. I had this almost every month for about 18 months but not as bad as that time. GP gave me some tablets which helped a bit. After 18 months the bleeding went back to 2 days each month then after another year 1 day. I experienced other symptoms like sweating and hot flushes and forgetting what I was saying mid sentence but the bleeding was the worst. I tried HRT and it did help me. Problem I had was it made me put on weight. I put on 13 lb in under 6 month. My GP made me come off it and I tried another one but it did not reduce symptoms and night sweats were really bad. I would wake up with a wet bed. It took me about 5-6 years to get mostly through menopause. I am much better now but just more tired, dry skin and hair and don't sleep well anymore. Not on HRT so eventually got through it without.

@caringcarer why were you never offered the Mirena coil or an ablation? Your experience of bleeding is really extreme and you didn't appear to be offered the right help. Now, every woman with that kind of bleeding would be offered a Mirena coil or ablation.It sounds as if you had pretty bad 'care' from your GP who ought to have referred you to a gynae. Women do not have to put up with this now.

@PantsToThis I hear you! Im on day 11 of HRT patches and day 8 of Ultrogestan tablets. I too had a 5 week Period back in May then on and off for few weeks then nothing until yesterday when I had the heaviest bleed and still am today. Stomach cramps, backache, nausea, extreme headache constantly and so dizzy it scares me into thinking Its not right to feel this way but maybe I should just ride through it too. I feel so groggy Ive literally been a slob for the last 2 day.

@PantsToThis You could ask your GP about using the Mirena coil as the progesterone element of HRT and then all you'd need is the gel. It would stop all bleeding.

Separate to your HRT treatment, have you tried to get immediate relief from your symptoms by giving up alcohol, eating low carb, taking a vitamin D and magnesium supplement? (Magnesium before bed). Also, exercise, of course, but you'll know that.
Not sleeping on a memory foam mattress too.

Such a minefield isn't it? Caringcarer that sounds awful, I've been having super heavy periods with erratic cycle length for several years now. I was changing a tampon and ST every hour and still leaking, so had mefanamic acid tablets which helped with flow a bit, but obviously not with cycle length and PMS.
I spoke to the GP again today, and like you said jingle she suggested trying it for 2 months and seeing if things settle. I've also put myself on the list to have a Mirena coil fitted. I'm not keen but I will try anything at this point. I'm hoping that a steady supply of both hormones will be what I need.

Disis73, it's so crap isn't it? Sorry to hear you're suffering too,
Diana I have stopped coffee, alcohol and most hot drinks. I eat really well and exercise every day, take a multivitamin and a separate magnesium, calcium and Vit D supplement. I've also tried herbs, acupuncture, reflexology.
The HRT was a last resort really, but if it works, I will take it. I couldn't go on like I was any longer!

@PantsToThis yep, crappy! The joys of being a Woman 😩 Keep posting on here, let us know how you’re getting on and I will too. Its good to know that Im not the only one feeling this!

The medication I was given was called transanemic acid of something like that and it helped a bit. I went to gynaecologist for HRT but that was later after periods were only some months and one heavy day. I went to try HRT for night sweats and hot flushes, feeling light headed and tired. I was never offered a mirena coil. I am just really glad I am almost through menopause now, no more periods but still hot flushes, tiredness and total forgetfulness. My younger sister is going through it now. Men have it far easier.

Your GP sounded a bit out of touch @caringcarer. Now, it's pretty standard to offer the Mirena and if your had these issues in the last 10 years the Mirena was definitely an option- I was offered it by my gynae that length of time ago as part of HRT ( not for bleeding but as the progesterone part of HRT.)
Tranexamic acid is okay but you can also buy it OTC as Feminax, so it's not exactly 'heavy duty' treatment.

Disis yes let's keep posting for progress reports! I've found all the comments on here so helpful. I'm guessing by the 73 in your name you're pretty much the same age as me, I'm a '74!
Caring, I think transemic acide and mefanamic acid do the same thing, Non-steroidal anti inflammatories. I felt needed something else as the cycle length and PMT were ridiculous. I'm glad you're nearly through menopause now, it sounds like you've had an awful time of it.
Jingle, can I ask how you found the Mirena coil? I'm really hoping by taking both hormones simultaneously my periods will stop altogether, but I know it can take a few months to settle and cause bleeding in some women.
Positive update - the bleeding I was having slowed right down last night and nothing this morning.

However, the sweats are still bad, I had to change my pyjama top twice last night. At work today and sticking to cold water and an open window! Still, very early days.

@PantsToThis yes you’re right! Born in 73 which is why Ive fought against it being the dreaded ‘menopause’ as surely Im too young for this crap!!! Its pretty obvious now, having read so much about it and your posts on here has helped come to terms with it too.
A positive (so far) for me today, no headache yet, bleeding has slowed down and not as dizzy! Last 2 days have been horrendous and not been able to do anything so the thought of playing catch up is killing me 😩🤣
Also, are you having hair loss as mine is coming out so much!!?!

@PantsToThis I've never used the Mirena. I posted to say I'd been offered it as part of HRT (not for heavy periods) because when I started HRT over 10 years ago, the Mirena and gel was considered the 'gold standard' treatment.

I wasn't keen as I'd reacted badly to the same progesterone in the Pill years ago.

Now, Utrogestan seems to have overtaken the Mirena as the best progesterone with HRT, BUT it depends on your age and what stage of peri you are at.

I didn't start HRT until almost 53 and I'd had my almost final period, so bleeding wasn't a problem.

Yes I will see how I go with the utrogestan for a couple of months.
Disis are you on gel and utrogestan like me? My hair has been thinning for a couple of years if I'm honest. My mum lost loads of hair during her 40s due to an under active thyroid (and menopause I guess). Hope I don't get it that bad as she wears a wig now. Looks great on her, but I'd rather not!