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Menopause

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Original poster

Bleeding on HRT

22 replies

Pandorapitstop · 27/08/2022 06:06

I’ve been on HRT for over two years and have never got on top of the frequent bleeding problem.
I’m 58 and on continuous HRT, currently Evorel 150 patches.
Utrogestan up to 200 mg daily didn’t control the bleeding so my GP (Newson) recently prescribed Provera 10 mg daily as the progesterone component of my HRT.
But I’m still bleeding frequently, more so if anything.
I’m also on testosterone.
I’m so fed up with this bleeding and don’t know what to try next.
Maybe try reducing my patch?
JinglingHellsBells, you’re always helpful and knowledgeable on this board: do you have any suggestions?

OP posts:

user1494050295 · 27/08/2022 06:20

Hi this happened to me. I am not saying this is the case here but badger your gp. Mine booked me in for a scan and it turned out I had a polyp growing inside. Two weeks later it was removed. Result no more bleeding. The polyp pushed against the wall hence the bleeding. The gp was unsure why this happened. Good luck

Original poster

Pandorapitstop · 27/08/2022 06:30

I’ve had a recent scan as GP wanted to exclude “ other issues “ but everything was fine and uterus lining was normal thickness. It’s definitely the HRT causing the bleeding, or rather not having the balance right.
I just don’t know what to try next.

OP posts:

user1494050295 · 27/08/2022 06:37

Sorry to hear this. Unsure what else. My gp did put me on a tablet (tric….) to reduce the flow but it didn’t really work.

user1494050295 · 27/08/2022 06:38

Would the scan have picked up a polyp?

Original poster

Pandorapitstop · 27/08/2022 06:40

I’m sure the scan would have picked up a polyp. I had pelvic ultrasound and trans vaginal scans.

OP posts:

BarrelOfOtters · 27/08/2022 06:44

I had a Mirena put in in similar circumstances. I’m 54 was bleeding heavily and intermittently. Been on femeston, also hated the progesterone days.

mirena went in a month ago and a bit of light spotting has settled down, so far so good. Using oestrogen gel and testosterone gel now.

user1494050295 · 27/08/2022 06:45

That’s good to know they were thorough OP. Best of luck getting to the bottom of this

LeakyLoftHatch · 27/08/2022 06:45

Same, plus awful PMT symptoms alongside. Scan and blood tests showed nothing. I stopped the HRT a month ago, to find out what my body does by itself. So far, no bleeding or PMT.

JinglingHellsBells · 27/08/2022 07:31

@Pandorapitstop Thanks for asking me but not sure if I have any better ideas.

A couple of things and you hit on one yourself...

The patch dose is very high. Any reason for that? What dose did you start on?

For older women in their late 50s (you!) who are not in peri, it's more usual to have a lower dose of estrogen, more like 50mcg or 75max.

I'm older than you but even when I was your age I was never on anything higher than 2 pumps of gel - the same as a 50mcg patch. My main symptoms were hourly hot flushes, some night sweats and poor sleep. I am now able to get by with 1.5mgs, which is roughly a 37mcg patch. I still get a good withdrawal bleed each cycle (I've chosen not to do continuous and still do cyclical.)

The other thing is that Utrogestan is 'flavour of the month' but it doesn't always control bleeding enough because the absorption varies so much. It's only over the past year or two that it's been prescribed so much and it doesn't suit everyone.

The other option is the progestogen dydrogesterone which is in Femoston. This is very similar to Utrogestan ( almost body identical) and may work better. However Femoston is a tablet, so not transdermal. Unless you are at risk of blood clots, that's not an issue.

And- lastly- there is always the Mirena coil. That would probably sort it out well.

Original poster

Pandorapitstop · 27/08/2022 09:14

I’m on a higher dose patch as I was still having symptoms on lower doses and blood oestrogen levels were low. Newson had me on 200 patch at one time. I’ve been under their care for over two years under various of their GPs and I’ve never got this bleeding under control.
I think a Mirena might be the answer.

OP posts:

Original poster

Pandorapitstop · 27/08/2022 09:16

But when I renewed my patch yesterday morning I cut a 50 patch in half so I only have 125 on now. Whether that’s a good idea I don’t know.
I started on a 50 patch at first. Even then I was bleeding though not as frequently.

OP posts:

JinglingHellsBells · 27/08/2022 10:38

To be honest, I'd start from scratch and go down to a lower dose patch. It will take your body a while to adjust so don't expect miracles in a few days.

I've never known anyone other than the Newson clinic prescribing these huge doses.

I can't imagine what it must be like to use that dose because even on my small dose I have a relatively heavy withdrawal bleed for 2 days.

It must be very wearing for you.

As well as HRT are you also doing all the good lifestyle stuff such as exercise daily and eating a really healthy diet? HRT isnt the silver bullet, it usually works alongside doing all the other 'right stuff' as well.

Original poster

Pandorapitstop · 27/08/2022 10:52

Thank you,Jingling, yes, I do all the healthy lifestyle stuff, eating well and walking dogs every day and doing yoga. I wonder if I should drop straight down to a 50 patch or maybe 75/100 at first. I’ve got 100 and 50 dose patches so I can titrate by cutting up etc. And should I speak to pharmacist/GP at Newson or just experiment myself. Even a 10 minute phone call to them is £50!

OP posts:

Newgirls · 27/08/2022 10:58

Jeez when do periods end?!!

im 52 and still having them. I thought they would end soon!

im on sequi/conti patches

is the mirena coil the way to go? I always feel weird about it - getting stuck or whatever

Original poster

Pandorapitstop · 27/08/2022 10:59

Re the healthy lifestyle thing, I’m actually going on a yoga retreat break in Spain next month, and this is one of the reasons that I want this bleeding business sorting.
As you say, it’s very draining ( aching legs etc come with it), and it’s so inconvenient never knowing when I’m going to need tampons and pads; it would affect my enjoyment of the retreat, for practical reasons.

OP posts:

Catsinthesuitcaseagain · 27/08/2022 11:03

My heavy bleeding was caused by my HRT. Also gave me horrendous pmt. I've had to come off it and back to a million hot flushes but still preferable to the horrendous side effects of HRT for me. I don't bleed at all any more. Am currently waiting to see a specialist.
I did once have a polyp that was causing me pain and it wasn't picked up on a scan, only a hysteroscopy picked it up and it was removed at the same time.

Original poster

Pandorapitstop · 27/08/2022 11:07

Catsinthesuitcase, I had a hysteroscopy last year and everything was fine.
The dr said that the bleeding was caused by HRT.

OP posts:

JinglingHellsBells · 27/08/2022 11:13

@Newgirls If you are on sequential regime of HRT, there is a monthly withdrawal bleed. It's not a real period unless you already had regular monthly periods prior to using HRT and they are now coinciding spot-on with the withdrawal bleed on HRT.

JinglingHellsBells · 27/08/2022 11:17

@Pandorapitstop I'd just do it yourself- no point paying £50!

You could either drop down to 75 now or do it more gradually by going to 100 for a couple of weeks. That (100mcgs) probably won't be low enough to prevent a bleed during the yoga break.

I'm not you obviously, but my own experience of cutting back (I did this as a trial) was that 1.5 mgs (same as 37mcg patch) makes no difference to my bleed (although it arrives in a timely manner mostly!) . I had to drop back to 1 pump - like a 25mcgs patch- to see any real difference in blood loss.

So as you are on 125 now, I'd say you really need to try 75 and 50 to see how that feels.

Complete PITA for you having this going on when you are going away!

Newgirls · 27/08/2022 11:27

JinglingHellsBells · 27/08/2022 11:13

Thanks for replying

should I come off the patches and see what happens?! I do love the other benefits though

I assumed I was still peri and the periods would just stop sometime

Original poster

Pandorapitstop · 27/08/2022 11:28

Thanks for your advice,Jingling, I’ll experiment with lowering my dose gradually.
As for the yoga break, I’m on Provera 10mg daily but I might increase to three times a day nearer the time of the holiday as that dose has actually been effective at stopping bleeding on a recent trip away ( Newson GP prescribed a ten day course of three times a day Provera instead of my usual Utrogestan).
It was so effective that it’s why I changed from utrogestan to daily Provera but evidently it was just the 30 mg daily dose that worked.

OP posts:

Kimlolly · 16/02/2023 22:25

Hi I’m currently waiting for appointment at hospital for a hysteroctopy as continual on off bleeds on evorel conti been on them 8 months now had 2 other tests when bled while on the gel which came back normal so went on patches which was great first few months but then started bleeds my dr gave me tablets to stop the bleed while waiting for my hospital appointment but stopped them after 2 weeks as bloating me and making me gain weight northestine which I have taken years ago to stop periods when going away and had no side affects but this time have but after 4 days of stopping had really bad bleeding really heavy has anyone else had this happen after stopping them and how long did it last still using my patches as dr never told me to stop them

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