changing from sequential to continuous HRT or stopping?.

[omega4ever]

Hi, Im looking for advice / info prior to seeing GP who is pretty clueless on HRT matters...

Im 56, been on HRT ultrageston 200 mgs vaginally and oestrogel 3 pumps daily for 6 years. I was having regular periods when I commenced at 49 but was symptomatically peri menopausal. Ive generally been great on HRT, Symptoms gone/ lots of energy/ sleep well and min flushing. Over the last 6 months Ive reduced oestrogel to 1 or 1.5 pumps daily which has been fine.

Im getting sick of having monthly bleeds.. one in three of the bleeds can be very heavy for 24 hours and has led to occasional flooding and real period pains requiring analgesia and hot water bottles. The other bleeds can be very light and min fuss. Im sick of buying san pro and having a horrid period every 3 months and am looking at options.

I dont want a mirena coil/ IUS fitted.

Should I try myself off HRT for a 6 month trial and see how i feel?

Should i ask GP to switch me to continuous combined and hope for bleed free outcome.

I feel GP will try and pursuade me to stop HRT, this seems to be their default from past conversations..

When I started HRT my goal was to try and take for10 years for cardio and bone protection benefits and to enjoy and be as active in my 50s as possible which I feel its helping me to do.

If I was going to make the switch from cyclincal to continuous any advise on how and when to do this.... would it then be 100mgs ultrogeston every day and would vaginal be ok or would I need to choose oral route.

Any other options ladies???? What are your thoughts/ experiences

In a similar but different situation. Been on HRT much longer over 10 years (now in my mid-60s and see a private meno specialist who's great with advice etc.)

I decided to put up with the bleeds as there are some pros about sequential, although each cycle I do wonder why I'm doing it!

I did try continuous for a few weeks and got a daily headache as the progesterone levels fell each day ( similar to what can happen on the monthly cycle. I also had constant spotting but that's normal and can go on for 6 months.)

If you want to swap to sequential do it as soon as you have a bleed. That's what I was told. So when your bleed starts, you can use 100mgs that day. (You'd need to do it orally until the bleed stopped.)
It's up to you to decide if daily vaginal is going to work ( trickier with sex as you need to leave a gap between that and the Utrogestan.)

I can't see much point in stopping your HRT if you feel well on it and TBH many women are just starting it at 55/56, so you are pretty young still. My dr has women on it in their 80s and 90s, just for perspective.

Thanks @JinglingHellsBells. thats so helpful.

Can i ask what the pros are for sequential if you dont mind.

I am now thinking of continuing HRT for my 10 year goal and perhaps taking the ultrogesten orally instead of vaginally on a daily basis...as i hadnt thought of the fuss with this and intercourse. #

its also made me think... if im willing to take the ultrogesten orally now... as in not transdermally or intravaginally.... maybe id be better off and simpler with a stick on conti patch... then at least id get the transdermal benefits.

Is this a possibility ? Is there problems with supply with conti patches or any other issues you can think of?

I'll PM you something.