No bleed after progesterone element of hrt

[Clusterfack]

Hi - just started Hrt - gel and utrogestan for 14 days.

5 days after finishing the progesterone I have no bleed - though before I started HRT I was usually getting a bleed every month (albeit irregular).

Anyone experienced this? Does it mean the HRT is not working?

No, it only means that there isn't enough lining to come away.
If you think about it, you've had 14 days of estrogen only then 12 -14 days of utrogestan (which stops the lining growing.)

BTW you don't need to use 14 days. I'm pretty sure the leaflet says 12 days ( days 15-26.) Some women (me ) use less than that under dr's supervision.

The more Utrogestan you use, the less lining there is so come away.

@JinglingHellsBells

No, it only means that there isn't enough lining to come away. If you think about it, you've had 14 days of estrogen only then 12 -14 days of utrogestan (which stops the lining growing.)

BTW you don't need to use 14 days. I'm pretty sure the leaflet says 12 days ( days 15-26.) Some women (me ) use less than that under dr's supervision.

The more Utrogestan you use, the less lining there is so come away.

But how is it different from before she started HRT. Even then you would have 14 days of low progesterone and then increasing progesterone for 2 weeks.

Hi @Clusterfack, I’ve been on the gel and utrogestan for 3 months. I take the utrogestan for 12 days as PP said. I had a small bleed in the first month but nothing since. Was on patches before (I had to swap because I became allergic to them) and bled somewhat erratically then too.

@JinglingHellsBells thanks - does this basically mean that my estrogen is low compared with my progestorone (which might also expain why i feel so rubbish)?

Its tricky this HRT business.

@JinglingHellsBells i was also only taking 1 utrogestan tablet (vaginally) as i was struggling with the side effects of them.

@withmycoffee There are a few reasons why this may happen
1 The level of estrogen in HRT never equals what we had before (so it's lower.) Also, with gel, the amount used can vary from 1 to 4 pumps. The less that's used, the less blood to lose.
2 The amount of progesterone may be higher than what we had before (normally.)
3 The dose of progesterone is not tailor- made for each woman. Some women need more if they produce more estrogen naturally on top of their HRT, others need less.

If women bleed too much on HRT, a consultant can advise on taking more progesterone/ reducing estrogen/ a bit of both.

[quote Clusterfack]@JinglingHellsBells i was also only taking 1 utrogestan tablet (vaginally) as i was struggling with the side effects of them.[/quote]
As my post above!
1 vaginally = same as 2 orally, says the research.

Estrogen grows the lining, progesterone stops it growing.

How much gel do you use? If you are using only 2 pumps, now after a month, you could try 3 pumps per day. That might help your symptoms. :)
Did your dr not suggest this?

@JinglingHellsBells

My doctor is against me being on HRT at all I had to go private but obviously can't keep going back to them. I've been using 2 pumps a day so far, I haven't felt much benefit if I'm honest.

Does your dr have a medical reason to be against your using HRT?
If not, you could change to another GP if possible. Drs can't just refuse treatment for no sound medical reason.

So...onto your question. If you paid for a consultation, you should be entitled to a review either at 3 months or sooner. Most good private consultants would offer this or answer a query for very little cost.

The leaflet in the box of gel does give the doses. You can increase and decrease doses to suit your symptoms. The start dose is 2 pumps, but if that isn't helping you could increase it. Leave a week or more between new doses to give it time.
Hope this helps.

@JinglingHellsBells

Thank you so much.

My GP said I was too young for peri (I'm 45🥲) despite my periods being irregular and other symptoms. I've sent her the letter from the specialist now so hopefully she'll come around.

Your GP is being ridiculous. Not a day goes without at least one post here from GPs who know nothing about menopause.
If menopause is any time from 45-55, how can peri not start at 45? Honestly, it's shocking. Even someone who is not a dr finds this out from the internet.

Yup. i've never even met her only ever spoken on the phone - she sounds pre-pubescent. She wanted to put me on the CCP to sort out the ridiculously frequent periods but it's never really agreed with me. I think i possibly don't get along too well with progesterone

@jinglinghellsbells
How can we tell if we aren't in menopause and still in perimenopause if periods stop after starting hrt? I ask because if we aren't having periods doesn't the dose of Utrogestan change to 1 tablet every day?

@gutinstinctlpl Most drs would say that by 54 (or 55), almost all women are post menopause. Using sequential or no-bleed continuous forms of HRT is not black and white. It's really about individual preference. Most women want to try /use the no-bleed type continuous type for convenience. I'm many years post meno but still use sequential and have a bleed. This is my choice. It means I use less progesterone and don't have as many side effects as taking both hormones daily. It's also supposed to have a little less risk re breast cancer. You can swap to continuous any time but if your own periods are still happening, you might get irregular bleeding with it , until they have stopped.

@jinglinghellsbells that's very helpful. Thank you.