On Combined HRT - no bleeding for last couple of months

[MaryIsA]

I've been on combined HRT for about 6/7 years now. I'm 52. The kind where you take progestogen every month. Started due to bad symptoms in perimenopause and also because I was relatively young so the oestrogen seemed like a good idea.

I hate the progestogen makes me snappy and unhappy.

There's been no bleeding for the last couple of months.

1. Should I worry about that?
2. Does this mean I might be nearing the end of perimenopause?
3. Could I move to the one where you only take progestogen every 3 months.
4. Should I just stop the HRT? - Don't feel a particular need to other than I don't like the progestogen.

Do you mean you are using sequential? (All HRT is combined unless it's estrogen only.)

Something like 20% of women have no bleed. It's not something to worry about.

It's nothing to do with peri- HRT takes over your cycle.
You won't change to a long 3 monthly cycle. No. That's hardly used at all and tend to be for women in peri.

Why did you start HRT? If you didn't have any symptoms which it helps, what's the point?

Hiya

Probably I do mean sequential. 1/2 packet white pills 1/2 packet grey pills.

It really helped with all the symptoms - that's why I started it - had a very bad perimenopause until started the HRT. But in the 6/7 years I've been taking it I've had a regular bleed every month up until the last couple of months - nothing, nada.

I don't really want to come off it - that's what I said in 4) I don't feel a particular need to come off it. But I don't like the pregestogen so much.

I wouldn''t worry. Sorry I misunderstood the don't feel a need to come off it- thought you meant don't feel a need to continue. My mistake :)

None of us like the progestogen bit much.

I think you might struggle to get the 3-monthly type via a GP now. It's called Tridestra. The older you are, the more they prefer women to use transdermal, not pills.

You might be able to use other types (gel/patch / Utrogestan) on a longer cycle (I do) but it's through a private consultant and monitored perhaps more closely than with a GP.
It's an option if you could fund it. Happy to help if you are interested.

No problem.

I live somewhere were getting a private consultation for menopause is really hard. My GP is pretty good but at the moment I'm not sure its worth bothering them if there's nothing to worry about. That matches up with what I've been reading.

Sounds like Femoston. I hate the grey pills too. My moods are shocking.

GP (private) is switching me to an oestrogen patch and progestogen taken vaginally which she says could well help with the mood issue.

Femoston is actually one of the better types as the progestin is very similar to micronised progesterone (more natural.)
It's often Norethisterone that's the worse for mood swings etc (I was on it for 6 years before switching to Utrogestan.)

The bleeding does tail off in time, nothing to worry about.

If you don’t like taking the progestogen why don’t you try having a Mirena coil for the progestogen and oestrogen via patches. I recently switched because of irregular bleeding on the advice of my gynaecologist and it suits me much better. Apparently it reduces the risk of breast cancer associated with HRT too.

@MojoJojo71 I’m thinking of Mirena coil as I don’t like the 12 days utrogestron - I believe the coil gives a more localised dose and the dose is less as it’s constant. Have you had any side effects that you haven’t liked ?

@pringlesandchocolate it’s only been a couple of months but so far I’m really happy with it, no side effects that I’ve noticed and after the first day or so no bleeding which is great.

I'm not sure having the Mirena fitted at 52 would be very usual - is it? I'm on Femeston which has suited me the best after a couple of false starts with other HRT.

@MaryIsA, I am on the same sequential Femoston too (was originally on Prempak? 10 years ago, then more recently tried gel/patches, but decided to go back on Femoston as I didn’t get on with them), but I am wondering when I will stop having periods as I am 56

@bigTillyMint If you are using sequential HRT you will have a withdrawal bleed as long as they use it. They aren't 'real' periods. No, it wasn't ever Prempak.

@MaryIsA

You are definitely not too old at 52 for a Mirena. I was older than you are now when I started HRT and it was offered to me by my gynae then. (And he's an expert)

Sorry @bigTillyMint. Misread and thought the ? meant was Femoston Prempak. Snr moment!

I wasn’t sure if I’d remembered the name correctly.
So if I went onto conti, I would stop having periods? Somehow didn’t get on with conti previously - made me feel strange and PMTish!

@MaryIsA

I'm not sure having the Mirena fitted at 52 would be very usual - is it? I'm on Femeston which has suited me the best after a couple of false starts with other HRT.

My Mirena was fitted when I was 56.

OK...I'll have a think about the Mirena. You do read horror stories but I have to remember that only those who are having issues will post about them...

I probably should have had one inserted years ago, but I was swayed by online horror stories. My only remaining side effect 16 weeks in is roughly 1-1.5 pounds of what seems to be water weight, which I can whittle off by going light on bread and pasta when really motivated.