Heavy bleeding on HRT

[Fedupwithit24]

I have had bleeding issues with HRT for several years . I have fibroids so as a result have been been moved from type HRT to another by various consultants .Had a massive uncontrollable bleed back in the spring but been clear since then . Was just advised to up the does of my progesterone.
Now on Everol patches and utrogestran . Been on this for while but
of the blue , I am having another extremely heavy bleed . Unable get to a gp or consultant for a while so I have taken my patch off now hoping that this will help stop it . I may also increase my progesterone dosage . Has anyone had to deal with the same problem and if so how did they deal with it ? Thanks

My bleeds were caused by utrogestan not working for me and me developing uterine polyps and hyperplasia. A change to a mirena coil nearly a year ago seems to be working better for me.

How often do you use Utrogestan? Daily or on a cycle?
Can you be more specific over what 'up your Utrogestan ' means and what dose you take now?

If it's 100mgs daily you really need to be looked at.

If you use it monthly (200mgs x 12 days ) on a cycle and you are still flooding, it still needs looking into, if you are bleeding outside of the regular withdrawal bleed.

@JinglingHellsBells

How often do you use Utrogestan? Daily or on a cycle? Can you be more specific over what 'up your Utrogestan ' means and what dose you take now?

If it's 100mgs daily you really need to be looked at.

If you use it monthly (200mgs x 12 days ) on a cycle and you are still flooding, it still needs looking into, if you are bleeding outside of the regular withdrawal bleed.

Thanks for your replies ladies . Went on the Mirena coil which sadly didn't work for me as it just didn't sit properly in the womb but with nhs services as they were , I wasn't able to be seen for 6 months . They took it out early this year . I am under a well known nhs menopausal unit and currently taking 200 mg of utrogeston.( Originally on 100mg but advised to go up to 200 mg which stopped 1st lot of bleeding in the spring .) I have recently been scanned and had a hysteroscopy and all completely healthy . Very frustrating . I couldnt get through to the unit at all to discuss and now am not in a position to contact them or gp for a while . Things are gradually easing but sure how to progress.

A few more questions @Fedupwithit24

Are you post menopause? If not this could be your own periods breaking through. Are you are least 12 months without a natural period?

If you were on 100mg that suggests you are post meno (although some drs are quick to jump the gun with this and put women on continuous too soon and that's when they get problems with bleeds.)
So you are now using 200mgs EVERY DAY and still bleeding at odd times?

Bleeding happens when the ratio of estrogen to progesterone is too high.

So one option is to reduce your estrogen. what dose are you on?
I assume it's 50mcg patch .

You could swap the patch for gel. That way you can easily reduce the dose. 1 pump is the same as 25mg patch.

Your other option is this

Take the Utrogestan with food. This doubles the amount absorbed.
Use it vaginally- as above- it increases the amount you get.

@JinglingHellsBells

A few more questions *@Fedupwithit24*

Are you post menopause? If not this could be your own periods breaking through. Are you are least 12 months without a natural period?

If you were on 100mg that suggests you are post meno (although some drs are quick to jump the gun with this and put women on continuous too soon and that's when they get problems with bleeds.)
So you are now using 200mgs EVERY DAY and still bleeding at odd times?

Bleeding happens when the ratio of estrogen to progesterone is too high.

So one option is to reduce your estrogen. what dose are you on?
I assume it's 50mcg patch .

You could swap the patch for gel. That way you can easily reduce the dose. 1 pump is the same as 25mg patch.

Your other option is this

Take the Utrogestan with food. This doubles the amount absorbed.
Use it vaginally- as above- it increases the amount you get.

Hi , thanks again for your response . Def post menopausal. On 100 mg patch on consultants advice . Was moved from the gel onto patch because of bleeding . I think I will resume with a 50 mg patch when the bleeding has tailed off once more . Taking 200 mg of utrogestan p day again on consultants advice . Feel a bit clearer that oestrogen is the main stimulator of the bleeding altho I have also been told that not enough will also make you bleed . Understand that Utrogestan is there to stop it . What a minefield! I still have not found that correct ratio . Grateful for your input

100mcg patch is a huge dose (top of range.)

Any reason for that?

I am possibly older than you and have just dropped back from 2 pumps gel a day to 1 and a bit, which is the same as 25/37 mcgs patch.

Utrogestan can be poorly absorbed.

Are you being seen at the C&W in London by any chance as that's the only 'good' NHS clinic I know of :)

@JinglingHellsBells

100mcg patch is a huge dose (top of range.)

Any reason for that?

I am possibly older than you and have just dropped back from 2 pumps gel a day to 1 and a bit, which is the same as 25/37 mcgs patch.

Utrogestan can be poorly absorbed.

Are you being seen at the C&W in London by any chance as that's the only 'good' NHS clinic I know of :)

Yes C and W for years . Different consultant with every contact sadly but to be expected. My last blood test revealed that I was not absorbing any oestrogen at all so it was upped from 50 mg to 100g . I am of pensionable age but have had it agreed and established that hrt is essential for my well being . I think my complications stem from my fibroids which are large but not deemed worthy of a hysterectomy. Thanks again

I have noticed what seems to be better absorption with Utrogestan when used vaginally. (I'm old too :) ) I still use it on a cycle and have found that the bleed is usually later when using it vaginally, showing more is being absorbed so a longer time for the levels to fall. You might find it a nuisance to do this daily though.

@JinglingHellsBells

I have noticed what seems to be better absorption with Utrogestan when used vaginally. (I'm old too :) ) I still use it on a cycle and have found that the bleed is usually later when using it vaginally, showing more is being absorbed so a longer time for the levels to fall. You might find it a nuisance to do this daily though.

Hi, Thanks for the suggestion and I will keep it in mind . So if you apply ur oestrogen vaginally you get better absorption ? I was put on cyclical HRT a while back but it didn't work for me . I guess it's all about me getting to understand what ratio of oestrogen to progesterone is best for for me until I can access my usual profession help. Thanks again for ur thoughts