HRT and progesterone only pill?

[GnarlyOldGoatDude]

Would really appreciate some advice!

I’m 50 and about 2 months into HRT with oestrogen gel and cyclical nightly Utrogestan. I’ve had two incredibly heavy bleeds now, the last one lasting over a week.

Prior to HRT I’d had a coil in (not mirena) so had had very light periods for 4 years. I’d had the coil as my periods were so heavy they had made me anaemic.

At the family planning clinic prior to starting HRT, they’d also advised using the POP for contraception as they couldn’t get a replacement coil in.

Has anyone got any experience of taking HRT and the progesterone only pill? Will it help with my heavy bleeds? I’m worried I’ll end up anaemic again at this rate.

Any advice/ experience would be much appreciated

I take the mini pill, utrogestan 100mg every night and oestrogel. I don’t have any bleeding or periods at all on the mini pill, I’ve been on it 9 years now. I’m 41 and in early menopause due to autoimmune issues. I think when I initially started the mini pill I did have some erratic bleeding but it settled after a few months. I think a lot of people that have difficulties with bleeding on it don’t give it long enough. After a while it just stopped completely. I love the regime I’m on.

@Bagelsandbrie thank you! That’s just the kind of story I was hoping to hear. The mini pill is every day is that right? (The one I’ve been prescribed is). When I was last on the pill 15 years ago it had a 7 day break from memory.

Just one point @GnarlyOldGoatDude,the regime you are on using Utrogestan daily is not cyclical, it's continuous.

Cyclical is 12 days per month (2 capsules for those days.)

If you still have periods of your own, you should be doing cyclical (also called sequential.)

That will give you a monthly bleed and it may be less than you are getting now.

The other thing to try is taking Utrogestan for 14 days each month (the leaflet says 12-14 days and this depends on the amount of estrogen.)

How much gel do you use? Higher doses= more blood loss.

@JinglingHellsBells I’ve been prescribed cyclical, so 12 days on and 16 off. Sorry if I described it wrong, all new to me!

The first bleed happened in the “off utrogestan” window. The second bleed started on day 10 of 12 with Utrogestan.

I was hoping that taking the mini pill might make my periods lighter.

I was still having periods while I had the coil in, but hadn’t had one for about 3 months when it was removed.

Two pumps of oestrogen gel in the morning.

Thank you

I technically still need contraception as I don’t have a coil in, and hadn’t been period free for long enough. So the FP clinic (who I saw before the GP) gave me the progesterone only pill and said that could work alongside HRT, but wouldn’t be a high enough dose to act as the progesterone component.

Interesting!

I'm on HRT and when I wanted to swap to Utrogestan, my consultant (meno and fertility specialist) offered me another option which was the mini pill! I'd have had to take 3 per day (on a cycle) rather than one. (I didn't need it for contraception.)

I decided to go with utrogestan.

So, it sounds to me as if you could use the mini pill for both but in the right dose. I think you need some specialist help if you want to go with that :) (Meno gynae)

[quote GnarlyOldGoatDude]@Bagelsandbrie thank you! That’s just the kind of story I was hoping to hear. The mini pill is every day is that right? (The one I’ve been prescribed is). When I was last on the pill 15 years ago it had a 7 day break from memory.[/quote]
Yes with the mini pill you take it every single day. And you take 100mg utrogestan every single day too alongside it - the mini pill doesn’t give you enough progesterone for HRT on its own so you need the utrogestan as well. That’s what Dr Boden at the Newson Health clinic told me / prescribed for me anyway.