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Menopause

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Mid HRT cycle bleed

15 replies

Squaddielife · 12/03/2021 23:05

Need advise re mid cycle bleeding please...

I'm on 2 pumps of estrogel and 200mg utrogestan. Perimenopausal but with regular periods.

1st 2 months were fine but 3rd month I started to bleed only 4 days into the progesterone and 8 days later still bleeding (although its tailing off now).

I carried on with the progesterone and am due to stop taking them on Sunday after which I would have expected my bleed. Not sure I'll get one though 🤷🏻‍♀️

So, should I just carry on with the timings as they 'should be and start prog again 12 days into cycle... this would mean I just carry on with them cos I bled so early OR do I push it forward 12 days and hope it evens out?

Is it dangerous to have this erratic bleeding? I've read its a common side effect but it makes me uneasy.

Does it mean the HRT dosage / regime isn't working for me? If so why....whats 'off' ? Do I need more or less of something?

Thanks

OP posts:
ladygindiva · 14/03/2021 16:46

Watching as I've started a bleed just 5 days into my starting hrt treatment ( I have irregular periods) I think it's a fairly common side effect but hopefully someone with more knowledge will come along and confirm for us!

Squaddielife · 14/03/2021 20:49

I hope so too. Really not sure whether to stop the progesterone as planned today in the expectation of a bleed (which is unlikely to happen).

Then I'm meant to start progesterone again on day 12 but assuming I have no bleed how do I know when day 12 is?

Confused
OP posts:
JinglingHellsBells · 15/03/2021 08:16

@Squaddielife
If you are in peri, odd bleeding is not usually anything to worry about. Often, it's your own cycle breaking through. You said it was regular, but one day it isn't going to be! You are having your own period most likely.

You should start progesterone on the same day each month. (Been using it myself for years and advice from consultant.)
So, that might be the 1st or the 15th...whatever.

Don't try to fit it around a cycle unless that cycle is created by Utrogestan and it's a withdrawal bleed.

So now you have had a period it might be better to wait till 1 April and start the 12 days of Utrogestan then.

ladygindiva · 15/03/2021 08:38

Hi jingling so should I just press on with my evorel patches as planned? I am on day 6 / second patch of estrogen only patch due to start progesterone/estrogen combi patch next week with no break which is when I'm assuming my bleed should arrive after that but I've begun a period after 5 days of estrogen patch ( first week ever of treatment). I started the patches immediately as my periods have been irregular and didn't want to be waiting potentially 30 odd more days before starting. However obviously I had ovulated without realising. Im guessing if I stick to the hrt as planned it will reset my cycle after a while?

ladygindiva · 15/03/2021 08:39

I don't want to stop as my insomnia has already improved after only 5 days on the patches!

JinglingHellsBells · 15/03/2021 08:44

@ladygindiva

Hi jingling so should I just press on with my evorel patches as planned? I am on day 6 / second patch of estrogen only patch due to start progesterone/estrogen combi patch next week with no break which is when I'm assuming my bleed should arrive after that but I've begun a period after 5 days of estrogen patch ( first week ever of treatment). I started the patches immediately as my periods have been irregular and didn't want to be waiting potentially 30 odd more days before starting. However obviously I had ovulated without realising. Im guessing if I stick to the hrt as planned it will reset my cycle after a while?
Maybe keep going as planned? It's really hard in peri and also during the first few months of HRT. In time the HRT will reset your cycle.
Squaddielife · 15/03/2021 10:06

[quote JinglingHellsBells]@Squaddielife
If you are in peri, odd bleeding is not usually anything to worry about. Often, it's your own cycle breaking through. You said it was regular, but one day it isn't going to be! You are having your own period most likely.

You should start progesterone on the same day each month. (Been using it myself for years and advice from consultant.)
So, that might be the 1st or the 15th...whatever.

Don't try to fit it around a cycle unless that cycle is created by Utrogestan and it's a withdrawal bleed.

So now you have had a period it might be better to wait till 1 April and start the 12 days of Utrogestan then.[/quote]
Thank so much for your advise. I stopped bleeding on 10th (7 day bleed). Stopped prog on 13th.

So, with my natural cycle I'd be 'due on around 31st March/1st April.

You say maybe wait until 1st April & start progesterone then. Is this in the hopes it suppresses my natural period or might I just repeat what happened this month & bleed through the progesterone?

Also, if I do start bleeding whilst taking the progesterone should I continue with it or stop taking it and let the period do its thing?

Thanks again x

OP posts:
ladygindiva · 15/03/2021 10:22

Thank you jingling, I'm going to press on. Its early days but I'm sure I'm already sleeping better ( waking at 5ish instead of 2 or 3 am) and that's making the world of difference.

JinglingHellsBells · 15/03/2021 11:12

The bottom line is it's not that important in terms of safety, it's more about convenience. As you are still having your own cycles, you are having a bleed, so there's no risk of build up of the lining, which is why progesterone has to be added to estrogen.

If your cycles are regular, it makes sense to start Utrogestan on the part of the cycle when you would normally be post-ovulation ( so usually mid month.)

But there will come a time (and you don't know when!) when your cycle will not be regular, so you can't use Utrogestan based on it.

Utrogestan will not stop bleeding once your own period has started. When you are using it, the lining of the womb changes slightly to stop it growing and when you stop, it comes away as a bleed.

I'm a bit confused :) Are saying is your 3rd natural cycle came early? Because if it was regular and timed to sync with 12 days of Utrogestan, the bleed would come 2-3 after stopping Utrogestan.

There's no 100% right or wrong way with this.
Either you take the next 12 days from mid cycle, or you try to re-set your cycle using HRT by taking Utrogestan on the same day every month .

If you were using a packet of pills type HRT, you'd take the progesterone from Day 14, because the tablets are -day marked' in the pack, regardless of any natural bleeding.

Counting the days from the start of your period this time, you must now be on day 12/13 (Day 1 is the first day of the bleed) so you could start Utrogestan by day 14/ 15.

Sorry if this sounds complicated. It's probably easier if you follow your own cycle, but when you periods become far less frequent, it's easier to stick to a regime of utrogestan on the same day each month such as the 1st April, 1st May etc.

JinglingHellsBells · 15/03/2021 11:13

@SquaddielifeThe above was for you! ^^

Ginsoakedcatlady · 15/03/2021 17:07

Hi everyone, I was coming on here (first time poster on this board) to ask exactly what ladygindiva asked! I am also on day 5 and also on the combined patches and started bleeding. Also loving them so far too so praying nothing goes wrong :)

ladygindiva · 15/03/2021 18:25

@Ginsoakedcatlady

Hi everyone, I was coming on here (first time poster on this board) to ask exactly what ladygindiva asked! I am also on day 5 and also on the combined patches and started bleeding. Also loving them so far too so praying nothing goes wrong :)
Keep with it , I am. Day 7 here, and despite being on day 2 of one of the heaviest periods EVER I feel better today than I have in months. Such a short space of time and my head feels so much clearer already. No way am I removing my patches! I think Jingling is right, your cycle may reset itself so might be odd for a while but worth pressing on.
Ginsoakedcatlady · 15/03/2021 21:45

Oh yes I’m definitely sticking with it! I feel so much better. I’ve had awful pain in my hips for months which completely vanished on day 3. I no longer want to kill anyone and I feel so much happier and calmer already. I’m completely amazed to be honest. Just hoping things stay this good when I introduce the progesterone as that seems to be when problems start it seems for a lot of women. I’ve had terrible periods for years so I can handle some bleeding, fingers crossed that’ll calm down too for both of us soon!

ladygindiva · 15/03/2021 22:04

You sound a lot like me... I'm also slightly dreading the progesterone phase but I'm willing to accept a few days bad pmt a month if I can feel pretty good the rest of the time. That will be better than the last 12 months where I felt rock bottom pretty much all of the time!

Squaddielife · 15/03/2021 23:50

@JinglingHellsBells

The bottom line is it's not that important in terms of safety, it's more about convenience. As you are still having your own cycles, you are having a bleed, so there's no risk of build up of the lining, which is why progesterone has to be added to estrogen.

If your cycles are regular, it makes sense to start Utrogestan on the part of the cycle when you would normally be post-ovulation ( so usually mid month.)

But there will come a time (and you don't know when!) when your cycle will not be regular, so you can't use Utrogestan based on it.

Utrogestan will not stop bleeding once your own period has started. When you are using it, the lining of the womb changes slightly to stop it growing and when you stop, it comes away as a bleed.

I'm a bit confused :) Are saying is your 3rd natural cycle came early? Because if it was regular and timed to sync with 12 days of Utrogestan, the bleed would come 2-3 after stopping Utrogestan.

There's no 100% right or wrong way with this.
Either you take the next 12 days from mid cycle, or you try to re-set your cycle using HRT by taking Utrogestan on the same day every month .

If you were using a packet of pills type HRT, you'd take the progesterone from Day 14, because the tablets are -day marked' in the pack, regardless of any natural bleeding.

Counting the days from the start of your period this time, you must now be on day 12/13 (Day 1 is the first day of the bleed) so you could start Utrogestan by day 14/ 15.

Sorry if this sounds complicated. It's probably easier if you follow your own cycle, but when you periods become far less frequent, it's easier to stick to a regime of utrogestan on the same day each month such as the 1st April, 1st May etc.

Thats really helpful thank you. Before I started HRT my periods were regular 28 days ish but I was having lots of other symptoms. Started in Jan, took prog on day 12 for 14 days bled 2 days after stopping so all good. Same in Feb. Started prog on day 12 in March and for reasons beyond me starting bleeding 4 days later....full on period Confused I guess I probably should have stopped the progesterone at that point. I agree with you though that I'm probably best to start prog again post ovulation so it won't be much of a break this time.
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