HRT for 5+ years and random heavy bleeding

[MoveHouse]

I’m on HRT and have been for over 5 years due to early menopause (I’m late 30’s now and diagnosis was in my teens, unusual case, had egg donation IVF, with one child now tween).

I take oestrogen gel x 3 pumps a day + 12 days of progesterone tablets (normally 1st - 12th of the month)

Never had a bleed during the last 5-6 years.

Last Tuesday (27th) I noticed a slight reddish tint in my discharge.
It proceeded to turn into the heaviest period I’ve ever experienced. I was filling a tampon after 2-3 hours and leaking. This has been like this now for 7 days. Thought it was easing yesterday, and today, got caught again with a really heavy flow of fresh blood. I can feel the “pulling” down feeling and had cramps etc too. Headaches have started today too.

This is so new to me. I’ve not really had periods due to my early menopause so it’s strange for me anyway, but it’s unusual for me to have a bleed so do I need to be concerned.

I don’t want to waste my GP’s time if they just see it as a “normal” random period.

Definitely see / speak to your GP, bleeding after that long post menopause needs further investigation. It may just be that the progesterone is not keeping your womb lining thin but this cannot be assumed.

Please speak to your GP as this will need investigating.

Hi @MoveHouse I doubt it is anything nasty. But it's unusual never to have a withdrawal bleed on that HRT regime. Normally you would have one each cycle, or at least for some of the cycles. Was this ever discussed and explained when you started HRT?

This is probably because you are young, have POI, and even 3 pumps of gel is not enough when combined with Utrogestan, to thicken the womb lining enough to come away each cycle.

What's possibly happened is your own hormones may have surged (it can happen with POI) or, you have a build up of the lining that now come away.

As you are still really young, and have POI, your experience is not the same as a woman in her 50s or 60s who suddenly has a lot of bleeding.

BUT you do need to see your GP and they ought to refer you for an ultrasound scan within 2 weeks.

My guess is that this may be the first of a more regular bleed which is what most women get on that HRT regime.

(I'm on it and have been for years.)

Thanks everyone. Grateful for the replies (sorry for not replying sooner, crazy ass Friday at work!)

@JinglingHellsBells I have never had a bleed with my HRT. I have a week whilst on the progesterone around days 6-14 whereby I’m moody and have PMT type symptoms but other that, been “lucky” to not have a bleed. My consultant (2 years ago) said that was ok / normal so I’ve never been particularly bothered.

It could be a surge in hormones, which is what I’m putting it down to I think. I feel like it’s easing, certainly in the last 24 hours, but still on, so this is day 8. My plan is to call GP on Monday if it hasn’t stopped.

Thanks again for responding. I do appreciate it.

Also POI and also on 3 x pumps estrogen. Also don't ever have periods. The consultant i see assures me that this is absolutely fine.

However, unexpected, heavy break through bleeding is definitely sonething I would get checked out. I'm sure its nothing serious, but best to check in with doc.

@MoveHouse You just need it checking out. There are around 15-20% of women not having a bleed on that regime, so most do. My consultant says he 'prefers' women to have a bleed but obviously it doesn't mean you have anything wrong if not.

Have you ever belonged to or read the info on The Daisy Network website? It's a charity for POI and is consultant-led (from the menopause clinic at the Chelsea and Wesimninster hospital).