Periods/bleeding and HRT

[WombatChocolate]

Sorry if this is a daft question, but I’m very new to HRT.

I am at the stage of very irregular periods. I’ve had 1 in last 6 months (not sure if Covid jab influenced things)

Am now on 1 pump oestrogel and continuous Utrogestan rather than cyclical, due to migraine with aura needing hormones to remain pretty steady.

Not sure what to expect re periods/bleeding. Will I still get any natural periods? How do I know the difference between a period and a ‘bleed’ related to HRT? Should I expect a period and other ‘bleeds’. And when people speak about spotting, what exactly is that…is it just an odd drop? How does it differ to a ‘bleed’.

I’ve never been on the pill due to my migraines, so only ever had natural periods and so am. It quite sure what people’s mean by different types of bleeding and if and when I could expect them given the continuous regime I’m on.

Oh and when my periods naturally end, will I know?

Thanks. Sorry if it’s all very basic.

Hi @WombatChocolate, we're just giving your thread a bump in case anyone's around to answer your questions.

We thought we'd also point you in the direction of this webchat with Kate Muir that we hosted today - Kate's the author of Everything you need to know about the menopause (but were too afraid to ask) -

AMA with Kate Muir

@WombatChocolate I'll try to answer but there is no definite answer to this!

Putting it the other way....women who use HRT on a cycle find they get a bleed each month. If their own periods are irregular, then HRT can re-set them.

As you are not post-meno but using it continuously, for your migraine, there is the chance your own period could break through.

This is because the amount of progesterone you use is there to 'control' the effects of estrogen you use (as HRT.)
It should prevent bleeding , ever.

However... it can sometimes take a while for this to work fully as any lining in your womb can be shed in the early days of taking continuous HRT. (Because it's already there - waiting for a 'real period' to clear it.)

Anyone on continuous HRT is told to expect spotting for up to 6 months. (For reasons above.)

Spotting is just that- not more than a panty liner can cope with, and very light bleeding.

If your own natural periods break through they may be heavier, like normal.

Basically for 6 months at least you need to expect anything and everything- your own natural periods might come along again or they may not. You might get spotting or you might not.

As long as you are on HRT you won't know when your own periods end- the only way is to stop HRT for many months to see what happens OR assume that by 52-54 they have stopped.

One extra thought - just to be clear- the dose of Utrogestan is there to balance the estrogen in your HRT. If the two hormones are working together, it keeps the lining thin and no bleeding occurs.

If you are still having your own periods, you will have your own estrogen building up the womb lining AND the estrogen from HRT. So 100mgs of progesterone may not be enough to control the growth of the lining and it comes away as spotting.

Sorry this is so long-winded!

Thank you. That is really very helpful and I appreciate your answers to me and to everyone else - you are delivering such a useful public service. There are lots of people on MN who know lots about a a particular subject and who share their knowledge freely and answer questions - it is such a boon to so many, so thank you.

I've been on HRT patches for 6 months (I'm 57 and not had periods for a few years) The first couple of months were fine but since then I've been bleeding nearly every day, sometimes heavy other times just spotting. Not sure if I should continue or stop. Has anyone been the same/similar?

Looking for advice…I’m 50 and have been on HRT for about 18 months and after a lot of trial and error have settled on Lenzetto (2 sprays a day) and take 2 capsules of progesterone vaginally for 11 days from mid cycle. When I stop the progesterone I usually get a “period” within a couple of days. However today I’m on day 7 of 11 and for the first time I’ve had a breakthrough bleed/spotting and it feels like my period is going to start - cramps etc! Anyone got any experience of this happening and why? Will call GP tomorrow but generally find them so lacking in knowledge! Thanks

Hello, first time posting on here… great site 😊

Ive been suffering for at least 10 years with peri menopausal. And only in the last few years that peri menopausal was actually mentioned to me.
Sorry for off loading . But i feel am loosing it - just turned 50,
suffering for few years and definitely now foggy mindedness, hot sweats, high BP, heart racing , not eating, cant cope with answering normal daily questions from my 16 yeard old. My periods were heavy for 8 years plus, they became infrequent and my GP has put me on Elleste duet pills as patches were coming off me.
Am 2 months on them the green pills for the last two wks makes me so ill am throwing up at midnight majority of nights, my appetite is none existent so am wetting myself majority of time ( sorry)
ANXIETY is through the roof !!! Bp 116/91 tonight. Am stressed am walking around in circles trying to sort myself out and talk to myself. Try meditation as well which i do enjoy..
Last night i must of got some shut eye at some point then woke up at 1 ish and started being sick again !!! Not slept after that.
am worried constantly, hard on myself, my partner does not and can not comprehend what am going through.
ive asked him and sent him links to try and understand. Its effecting my 16 yeard old as she hears me being sick shes worried i have a serious illness.
Am just so fed up my confidence has gone- dont feel like me anymore. Am normally bubbly happy go lucky and find myself not functioning properly and talking to myself in the god dam mirror ! And walking around in my dressing gown till late morning on weekends..
my Gp wont take blood test as she said they wont for woman hitting 50 in the menopausal area.
sorry i dont even know if ive wrote it in the right section..
my periods are still heavy …
its a terrible confusing stressful situation am going through
just want too offload and try to feel normal about it all

I'm having the same issue been on HRT Evorol Conti for nearly 5 months (no periods for 3 years ) now all of a sudden I've started to bleed don't no weather myself to stay on them or just to come off 😟😟