Unexpected bleeding - Evorel conti

[chimichangaz]

I'm 56, haven't had a period since 2014. Started HRT tablets in dec 2019, switched to patches late 2020 (Evorel conti). I came off hrt altogether in April due to a breast cancer scare, and restarted in about May/June time.
Earlier this week I noticed some dried brown spots in my pants. Just noticed some again this evening. Is this anything to worry about? I think one of the side effects is breakthrough bleeding (lost the leaflet..) but I've never had any before. Seems a bit odd to be starting now?

I’m in Cyprus on holiday at the moment. Have been on Evorel Conti patches for more than two years, was previously on tablets ( I’m 62). I didn’t have any problems until about a month ago when there was a slight show of blood when I wiped myself. Tried to book a GP appointment but could only get to see the senior nurse. She asked if I had missed a patch, I said I couldn’t be 100% certain but didn’t think I had done so. She arranged for me to go back for swabs to be taken, but when I went back I’d had no further bleeding so she said we’d assume it was a missed patch but to go back to her if any more problems. Came to Cyprus a few days later. On Thursday night there was a slight show of blood when I wiped myself, then yesterday we went for a walk and suddenly there was a huge showing. My denim shorts were soaked, it was everywhere. So embarrassing, we went to the nearest hotel and a kind woman got me two towels to wrap around myself, then we got a taxi back to our hotel. Went to the medical centre here and today I’ve got an appointment with a gynaecologist. All done on my travel insurance. On the plus side, at least I’m being seen quickly. No pain at all. Fingers crossed it’s nothing sinister

Conti patches

Following in from my earlier post, I’ve now seen the gynaecologist in Cyprus. She was very scathing about HRT, says she used to work in the uK but left because she thinks doctors there hand out HRT too freely and it can cause cancer and other problems. In her opinion I should come off them and take natural remedies, she says HRT just delays the menopause - people have to go through it at some point so it is better to go through it in your 50s when you are usually healthier and stronger than in your 60s or 70s. She did a smear test and I am going back for an ultrasound on Tuesday morning. Think the bleeding was from the uterus.

The current thinking is that HRT does NOT cause cancer. Watching Davina McCall documentary on 4OD where it is all explained.

Yes, I’ve seen the Davina McColl video and know that UK medical advice has now changed and drs are prescribing HRT more. I never had a problem getting HRT from my GP. However I have now been examined by a gynaecologist , so am confused whose advice to accept, ie my GP who is not a specialist, or a gynaecologist who is. I have just seen the gynaecologist again and had the ultrasound. The good news is that she doesn’t seem to think it is anything sinister, but says the lining of my womb has thickened due to being on HRT. She is recommending a DNC when I get home and that I come off HRT . Also a biopsy when I have the DNC ( which I think is routine).

@BMT1 I’m really sorry you had an embarrassing incident as it’s one of my greatest fears. I’ve been invited to a spa day prior to my daughter’s wedding and have had to tell her I’m unable to go for exactly the same reason which is quite upsetting as otherwise I would have really enjoyed a relaxing day and god knows I could do with it however, we’re now looking at doing something else instead. It’s good to hear you got an ultrasound so quick and it doesn’t look like you have anything to worry about. I would discuss the comments from the Gynaecologist with your doctor after having the DNC and before making any decisions about coming off HRT as it’s a very individual choice and there may be HRT options more suitable. Coming off is not an option for some as the symptoms without HRT are often unbearable and we know HRT carries an slightly increased risk of breast cancer but the stats are lower for the patches than the tablets. It’s all very well for the Gynae’ saying doctors prescribe HRT too much but women have and are suffering unbearable symptoms for YEARS, like myself, without help which often affects every aspect of their lives and that of their families. You also need to be aware that opinions regarding HRT can vary greatly between medical professionals in different countries. Yes you could try ‘ natural remedies’ but they are often very expensive as not on prescription, have no pharmaceutical tests/backing and often don’t have the same effect or work for everyone. I’m not sure as the Gynae’ is accurate in saying that HRT ‘delays’ the menopause’ however it does replace the hormones reduced during menopause to help restore the balance and reduce the risk of cervical cancer and osteoporosis, which is more common after menopause. Let us know how to get on.

HI am 48 and have been on patch for 9 months no bleeding for 18 months prior to this and have now been bleeding every 2 weeks for 3 months nothing major but yes an inconvenience but my GP wants me to come off HRT for a month...personally don't see the point of a month and a bit scared! She said she thinks I need more estrogen buy I get sore boobs and bloating so think I need less...its all so confusing 😕

Hi All,
Just wanted to thank you all for your contributions to this discussion. I am 60 and have been taking evorel conti for about a year now having been all around the houses to get to this point. I've been reading the discussion because I am experiencing sporadic bleeding (post 6 months) too. Seems to be quite common.

I started experiencing menopausal symptoms about 10-15 years ago - sudden hot flushes at work followed by episodes of extreme anxiety, brain fog, etc. Having sought help from my GP practice about these difficulties I was offered anti-depressants and have been taking them for about 10 years now. However, I became increasingly convinced that the real problem - menopause - had not been addressed and that the anti-depressants were a quick and easy solution to mask other, more complex issues. So, this lead me to research and I have discovered the work of Dr Louise Newson, a menopause specialist and expert (there are not many of them around!). She is eminently sensible and practical and offers sound, uncomplicated advice to women on the wide range of symptoms and issues around the menopause so I would heartily recommend looking at her social media posts on Instagram. There is also an app available called Balance which has a wide range of discussion and research threads as well as helpful information and advice. The app includes a symptom log which keeps an accurate of symptoms that menopausal women may experience which is available to print off as a record to share with your GP should you need it.

Just one small gripe @BMT1 but taking HRT does not delay the menopause, nothing can do that, it just helps to alleviate the symptoms associated with it. Definitely recommend you look up Dr Louise Newson.

I wrote on here a while back because I was having intermittent bleeding after moving from Evorel Sequi to Evorel Conti. After seeing my doctor I stopped the hrt on 06/06 and it completely stopped immediately as did the abdominal discomfort I permanently had. I honestly feel better in those terms without the hrt. I have been struggling a bit with hot flushes especially with the heatwaves and also with increased anxiety and a few aches and pains but on the whole I’m better without the hrt for now.

I thought I had solved my bleeding by taking 200mg of Utrogestan as advised by a Consultant at the hospital who my GP referred me to. Sadly not as I started bleeding today.

I'm so pissed off with it. My womb lining is totally normal so I've been advised to have a Mirena coil fitted. I really don't want one as have read some bad experiences. I suffered with horrendous period pains - fainting, doubled up in agony- and the thought of that cramping pain while it 'settles' is awful.

I don't want to stop HRT as I feel so much better on it.

Mrs Menopause, it was not just the gynaecologist in Cyprus who indicated that HRT just delays the inevitable, ie that you have to go through it at some point ( unless of course you stay on HRT for the rest of your life). Since coming back home I have been to the local hospital and had another ultrasound, a pipelle biopsy, then a colposcopy and finally a hysteroscopy ( fortunately all have been normal, so I’ve now been discharged from the gynae clinic). So I have seen several gynaecologists, I’ve also been to see a herbalist about supplements/vitamins to take instead of HRT. I guess different gynaecologists have their own opinion.

Forgot to add - whatever the case all I know is that I was on HRT for 8 years and now that I have come off it I am back to having hot sweats, restless nights etc

I have never “seen” a doctor about HRT. I was prescribed gel and oral progesterone after an email consult. Hot flushes went away, but I would bleed on the second week of the progesterone and another condition I have worsened considerably so I was switched to Evorel Sequi after a telephone consult. On that bled for almost the whole of the two weeks of combined patches. So I was switched to Evorel Conti after another telephone consult and have been bleeding ever since, not spotting, full on bleeding accompanied by cramps and grumpiness. Did an econsult with GP and as far as they are concerned it’s normal. I’m spending a fortune in sanitary protection and not being able to have sex with DH isn’t doing either of us any good. Seriously thinking that the hot flushes, insomnia and mind like treacle is preferable to this.

I too am on Evoril Conti and after having no periods have been bleeding so heavy every other week and it’s getting me down😞 waiting for a hospital appt within 2 weeks as just can’t cope with the cramps and headache after having no periods before HRT. I’m glad I read this thread because it seems we are all in the same boat!

Hi all - thought I would post an update as it's been ages since I last posted on this thread. So my last update was that my GP had referred me back to hospital but the appointment I was given was December 2023...I contacted my MP who was absolutely brilliant - raised it in parliament (where the Tory health minister completely dodged the issue and tried to blame Labour...) and also wrote to the health authority. Subsequently my appointment was changed to August 2022...and the health authority committed to shortening waiting lists for gynae procedures.

I ended up eventually having a hysteroscopy which I have to say was the most excruciatingly painful thing I have ever undergone. They took a biopsy as my womb lining was thicker than it should have been (this eventually came back clear). I had been recommended to have a Mirena coil fitted at the same time but the pain was just too great and I couldn't go through with it. I'm now back on tablet HRT from December having been asked to stop using the patches in Sept due to the thickening of my womb lining.

So I'm going to see how the tablets go but so far I haven't noticed a reduction in my ability to go from 0 to 100 raging mad, or my sleep pattern but my hot flushes have at least stopped.

I've recently (within the last 10 days) started using a magnesium spray when I get into bed and that seems to have helped a lot with my sleep issues (waking mega early and not being able to drop back off).

I would recommend to anyone who is experiencing unexplained bleeding on the patches to see your GP and don't be fobbed off! There could be a serious issue underlying it. There might not be - but the only way to know is to get it investigated. And if there are problems like I had with appointments being months/years away - contact your MP, contact the health authority and shout about it. Good luck!

I started evorel conti 5 months ago after being on evorel sequi for 18 months. I am feeling much better since I started using it. I have dreadful headaches and these have almost stopped. I am also sleeping better. I have had issues with bleeding though, pretty well constant,finll y stopped now, for now at least, but apparently this can occur whilst your body is getting used to it - healthexpress.co.uk/evorel-conti

Quick update from me - started tablet HRT in December (Kliofem) and although it didn't change my life massively for the better I was happy to continue past the initial three months. Roll forward to now, starting my 6th pack and had awful period type pains and sore lower back since the weekend accompanied by a lot of bleeding. New doc has said to come off hrt for 2 weeks, if the bleeding has stopped she will prescribe gel and a tablet progesterone. If it doesn't stop I'll be referred.

Just when I thought I was getting somewhere......

Thanks for this tip. Have been suffering by continuous bleeding for 2 months now and had enough. Have a big trip coming up so am desperate for it to stop. Will try the 1/2 patches trick!

I know this is an old thread but I'm having the same problem. Been on the patches for a year but the last few months I'm bleeding regularly. Like full on periods with only (at most) a weeks break in between.

Hi there! I was the originator of this post. The issue with bleeding drove me mad for years. Doctors were utterly useless, I went for endless scans and had various polyps removed, knowing full well in my own mind that a little polyp could not possibly be the cause of full on heavy period bleeding for 7, 8, 9, 10 days on the trot.

Then my sister in law, who is a nurse, qualified as a menopause specialist. I had already reduced my Evorel patch down to Evorel 50 and was following the instructions, ie changing it twice a week, and I was taking 1 Utrogestan 100mg a day.

Now, following her advice, I take two Utrogestan per day and change the Evorel patch every four days. It took a month or so to take effect but since making that change around a year (?) ago I’ve not had any bleeding at all. It’s such a massive relief.

So - in summary - try upping your progesterone and maybe reducing the oestrogen some.

I hope this helps you!! Good luck.

Hi, I was on Evorel Conti and bleeding terribly. The menopause specialist I used suggested that I may be reacting to the progesterone in Evorel Conti so swapped me to Evorel patches plus Utrogestan (progesterone), 2 tablets every night. Since then my bleeding has all but stopped (occasional spotting). My hair has also stopped falling out so a double bonus! Speak to your GP and see if you can try this. These are my prescription details:
Utrogestan (Progesterone) Capsules 100mg, 30, Capsules, Two to be taken once daily with your evening meal
Evorel 50mcg Patches, 8, Patches, Apply one patch twice weekly

I'm not on any tablets, just the conti patches. My doctor is referring me to the menopause clinic so hopefully get some help there. I had an mri scan about 6 months ago as, during an internal scan for an ovarian cyst, the gynaecologist said I had mucus round my cervix and particles in the cyst. She thought it might be endometriosis but scan came back OK. As a result of that the gp doesn't think its anything to worry about but a lot can change in 6 months. In the meantime I've came off the patches altogether but still bleeding 2 days later. I'll be phoning the gp back today to try and chase up the referral.

Hello lovelies,
Reading this thread with BIG EYES. I am experiencing bleeding on Evorel Conti 50 and was FINE for months 1-4. Had a bleed in month 5, 6, 7 and now 8th. I have been referred urgently to clinic gyno- Urgent referral is 105 days. I scheduled an appt. to get a scan of my lining for Monday and will be paying privately as I am scared and not wanting to wait for months while bleeding to see why! NHS is very very under it currently and wait times are shocking!
Add to that, yesterday I was doing my shower, boob check and noticed in the mirror a bit of dimpling below my nipple on a previous anchor scar line from surgery 5 years ago. Needless to say, Friday discoveries are the worst. I did call in but do not expect to hear a peep until Monday at the earliest.

Reading just how many women experience bleeds on HRT/Evorel Conti is incredible - and I suspect far worse than just what we are reading here. I am afraid to just stop the patch and "see what happens" but honestly, tempted. I have been post-meno for 10+ years. No period in more than that as I delivered my last child 16 years ago and nursed her straight thru the pause I suspect as my period and fertility never returned. I began HRT patches to address some of the symptoms I was having. Cramps in my legs, low sex drive, sleeplessness, memory issues, brain fog etc. It really helped and I felt better than I had in years in those first few months. Cut to today. Yesterday I started with the spotting, pink, a bit of brown and it stopped. This morning it is full-on, need a pad and bright red with cramping and all the fun period stuff of yesteryear. I am here to say hello and thank you for all of the information I am receiving just by reading. It is more helpful than you know to have experiences of others so close at hand. Cheers to all of us pausing.

Try not to panic. Easier said than done. I used to be on Evorel Conti and had a huge bleed, which was investigated ( ultrasound, pipelle biopsy, colposcopy, hysteroscopy) and all was well. They told me to come off HRT, which I found difficult ( not sure if it was coming off HRT or the stress of going through all the tests and worrying) but for a time I felt rank. Fast forward about 18 months and I had another bleed this January, which was again investigated ( ultrasound, hysteroscopy) and everything seems okay. The gynae said that occasionally your ovaries can suddenly burst into life again! What I can't understand, however, is why ( as your referral is urgent) you aren't being seen under the 14 day rule. On both occasions with me I was referred under the fast track 14 day rule and seen very quickly. Ask your dr why you have not been referred under this rule. Oh, and insist on General Anaesthetic if you have a hysteroscopy. They may try to persuade you that you don't need GA, but it is your right to choose it

I have bled on and off for nearly 2 years now. I have been told HRT causes the bleeding for me. I have 6 months of not bleeding then it comes back.

I've upped and changed my progesterone element 5 times. The trouble is any change to HRT can cause bleeding.

I decided to come off HRT to see if the bleeding stopped. The trouble is, stopping HRT can cause bleeding. I had a proper period and actually couldn't cope without the HRT so went back on it. So that was pointless.

I have read that for 90% of women on HRT who have a hysteroscopy for bleeding no cause is found. 40% of women experience bleeding on HRT.