Does HRT resume periods?

[Runaround50]

Just wondered, as I’m meant to be post menopausal.

Last natural period was August 2018.
Then went on HRT gel and daily utrogestan from July 2019 until August 2020 and no period or bleed during that time.

Switched to patches September 2020 as gel wasn’t being absorbed.
December 2020 the bleeds start and didn’t stop all of 2021( 2 / 3 week gaps) .

Now on continuous oral HRT and bleeds are still occurring.

Why did I have such a huge gap of no periods/ bleeding if not post menopausal ( which bloods seemed to have confirmed) ?

Do I need a cyclical regime instead?

Very sick of all this bleeding as have become very low in iron also.

There's a couple of other threads about this OP.

Thanks OldTinHat, but im none the wiser.

It's the cyclical HRT that makes your periods resume so you shouldn't be bleeding with continuous HRT.

I am on Femoston conti and was having bleeds, my GP sent me to get it checked out (all ok) so maybe mention it to your Doctor.

There is a recent thread on does hrt resume periods. No is the answer.

If you are using continuous and bleeding all the time it either means you are not post meno (and women under 50 can be told they are sometimes when they aren't, even if their periods stop for some time.)

OR you have not got the right ratio of estrogen to progesterone to control the womb lining build up. The BMS suggests that this type of bleeding needs a higher dose- like 200mgs a day not 100mgs.

Have you ever had a scan to look at the lining or your ovaries to see if they are still active?

• 200mgs Utrogestan if using it daily,

This confuses me too. So what if you are peri and on sequential HRT. Will your periods stop when they would have if you weren't on the HRT or continue for so long as you take it, even when you are past menopausal age?

@ImAvingOops

This confuses me too. So what if you are peri and on sequential HRT. Will your periods stop when they would have if you weren't on the HRT or continue for so long as you take it, even when you are past menopausal age?

The other thread www.mumsnet.com/Talk/menopause/4527911-HRT-Do-periods-just-carry-on-forever

Your periods stop when your ovaries run out of eggs. The number is there from birth.

HRT replaces estrogen. If you still have a womb then your HRT will also contain progesterone to prevent the estrogen stimulating the lining so much that it grows and grows (and can then become cancerous.)

HRT doesn't give you a proper period or restore fertility.

In peri, the type of HRT used gives a withdrawal bleed (like the Pill.)It's not a period.

In post menopause you take a type that doesn't give a bleed.

JinglingHellsBells thank you. I was using the word period to mean a bleed because in all honesty it makes no difference to me if it's caused by ovulation or by the HRT - it's a messy pita either way!
I guess what I'm wondering is how do women know when they've run out of eggs if they are already on HRT. Presumably the HRT will still be causing a bleed because, as you said, the progesterone is stopping the womb lining from over growing. How do we tell when we need to change type of HRT to the post menopausal kind?

Placemarking.

How do we tell when we need to change type of HRT to the post menopausal kind?

It's not an exact science.
Drs say that at 54 most women will be post meno so the guidance for no-bleed HRT is age 54.

You can try before that, but as the formulations are different for peri and post meno, you might get erratic bleeding in you are not actually post meno.

It's trial and error.

Thank you.

I'm just abt to start patches and the doc said I would have a bleed (having not had one since sept) with them but to try them for a year and see how it goes. Hopefully by then I would be fully post menopause and will review them then. I think. It's def a new world of confusingness!

Mmm.. still don’t get why I didn’t bleed for 27 months if I’m not post menopause?

The type of hrt i am on now is 1mg combined, so there should be no imbalance between oestrogen and progesterone,?

Options seem

1. Cyclical regime

2. Come off Hrt for a bit to see what happens with bleeding?

The bleeding I’ve had this year whilst on conti oral, have been between 23-28 days.

@Runaround50

Mmm.. still don’t get why I didn’t bleed for 27 months if I’m not post menopause?

The type of hrt i am on now is 1mg combined, so there should be no imbalance between oestrogen and progesterone,?

Options seem

1. Cyclical regime

2. Come off Hrt for a bit to see what happens with bleeding?

The bleeding I’ve had this year whilst on conti oral, have been between 23-28 days.

So you are having a regular bleed roughly every 4 weeks.

What is the name of the HRT? Are you 100% sure it's combined continuous?

It also depends on your age.

It's known that younger women who maybe have an 'early menopause' find their natural periods can come back even after more than a year.

How old were you when you had when the 27 months started?

Do many women start HRT years post-menopause? Is it recommended? I thought there was a cut off point, but a friend said recently she didn’t think it mattered what age you started it.

I think you have to ignore the blood tests (they are not reliable anyway as my own experience of that proved.)

Go by what your body is doing. It's giving you a regular cycle, so if (user name 50?) you are 50, you're saying your 'last' period was at 48. That's 3 years earlier than the average so my money is on you still being in peri and you're one of those women whose cycles resumed after a gap.

@watcherintherye

Do many women start HRT years post-menopause? Is it recommended? I thought there was a cut off point, but a friend said recently she didn’t think it mattered what age you started it.

Not sure why women think HRT is only for peri. Don't get that!

Many women don't need hrt during peri- only once their periods have stopped, well into their 50s or later.

You can start at any time, even after age 60.

In terms of heart health there is what is called the 'window of opportunity' where research shows starting within 10 years of a last period gives better long term heart health.

Thanks, Jingling. There seems to be a lot of ignorance (with me, anyway!) about the benefits/risks of the different types of hrt/age of starting therapy. In the same discussion another friend expressed extreme wariness about hrt, as it’s not given to women who have suffered from cancer, which, again, I was unaware of. I have been contemplating asking my gp about starting, but imagine eyebrows will be raised, due to my age and years post-mp (about 8).

I really hate the bleed part of the cycle - it means I can't use vagifem or use a pelvic wand for my tight pelvic floor muscles, so I get increased bladder discomfort. I'd really like an HRT that removes the need for a bleed. I was really looking forward to periods stopping

@JinglingHellsBells I was 48 when my periods stopped for 27 months. During that time, I experienced lots of symptoms in line with menopause. After almost 12 months, I stared Hrt gel and continuous utrogestan. I was on this for 11 months ( still no bleed).

Within 3 months of starting patches ( sept 2020) bleeding resumed.

The Hrt im on now is femeston conti 1mg combined. The first month, I had slight spotting but no bleed. The next two months, proper bleeds with cramps. I did add in a bit of extra oestrogen as I felt I wasn’t getting enough. Maybe that’s been the cause of the bleeding? But I don’t know what the bleed on the patch we’re about?

@JinglingHellsBells sorry if that all sounds very confusing. I suppose the bleeding could either be a side effect of the HRT OR I’m not yet post menopausal?

I dont know:)

I am guessing from what you say that you are not post meno.
It's highly unusual to have bleeds each month using a conti HRT.

Usually there would be break through bleeding- spotting- if it wasn't working not a regular bleed.

If I were you I'd go back to a cyclical type - Femoston cyclical- for a while.

Thanks Jingling, think that’s what I’m going to do, try cyclical.
What a minefield 🤦‍♀️