Mid cycle bleed- advice please

[Newbootstoday]

Hi I have recently started hrt- second month in. GP prescribed Evorel 50 patches and then x 2 100mg progesterone from day 15 - 26 of cycle.

All fine first month however I seem to have my period/ or mid cycle bleed today which is day 15. So was due to start progesterone this PM. Do I just take the progesterone till day 26 anyway or treat this as my period and stop the progesterone when the the bleeding stops.? I’m a bit confused and I can try and call the GP on Monday for advice but unlikely to get an appointment for a few weeks.

Does any one have any advice?

Hopeful bump

Maybe try 111 for advice or a pharmacist? Or on Monday you could explainn to surgerys receptionist and ask for a call back if no appt available? Never been on hrt. Hopefully someone medical might come along. Just didn't want to leave you hanging.

Hi @Newbootstoday, this has happened to me when I first started taking HRT. It take a few months for your cycle to sort itself out. I kept taking the progesterone as I was prescribed (if you stop completely normally the bleeding will keep going) and my cycle eventually sorted itself out. There is another helpful chat on MenopauseMatters, you could also ask there?
However, if it was me I would keep taking the hrt as prescribed until I could see my doctor. I am now on continuous HRT and I find if I accidentally miss taking the progesterone one night I feel very emotional the next day and have break through bleeding. Best wishes!

@Newbootstoday Keep it simple. I think you are a little bit confused on how to use it but that is not your fault - you've not been given the right advice.

During peri, you can't follow your own cycle. That's because it will become irregular- as it has now.

You have to use HRT to set a new 'HRT cycle'.

So, rather than using your own cycle for the 12 days of Utrogestan, you have to use a date on the calendar.

The way to do this is to choose the same day each month.

My consultant suggests women use the 1st of each month ( Day 1 for Utrogestan and keep to that for 12 days) or any day as long as you keep to it.

If you wanted to, you could allow your bleed to finish - it is probably your own period- not a withdrawal bleed- and start Utrogestan on 1st Jan.

OR you can take it today for 12 days, and then again on 17th Jan.
If you start it today, you may get a slight withdrawal bleed in around 14 days' time (2 days after the last Utrogestan.)

@CelesteM You don't keep bleeding when stopping Utrogestan- when the lining is shed, it's shed, until the next withdrawal bleed (or a normal period.)

Ah that’s makes more sense @JinglingXmasbells my gp never explained it like that! So I’ll just take the utrogestan starting on the 1st of every month for 12 days. Thank you!

@JinglingXmasbells when I started continuous HRT I had break through bleeding, I did completely stop my hrt as I became quite scared about what was happening. I kept bleeding for for over two weeks, this did not stop. My doctor prescribed a higher dose of progesterone to take until the bleeding stopped which it did after two days.

I believe dr currie has said that higher doses of progesterone may be needed for higher oestrogen doses. A Gp friend told me after recently training with her. Not sure how that relates to cyclical dosing though as that was for continuous.

50 isn't classed as high though

That's different to the OP's issue, though.

She's on sequential/cyclical.

You are on continuous. Bleeding for up to 6 months when using continuous is a known/ common issue and women are told to expect it. It takes up to 6 months when using continuous for the lining to become thin enough never to bleed (and increasing the progesterone isn't always necessary- it's just a 'time' thing.)

It's a shame your dr never explained this when you started it as you'd not have had all that worry.

Again, it's different to the OP's issue. The BMS advice is that for women on continuous HRT, 100mgs a day may not be enough if they are using a very high dose of estrogen, so it may be increased to 200mgs a day.

The OP was trying to use sequential, timing it around her own periods. That's impossible, eventually, as periods will change during peri. They might be every 2 weeks, every 6 weeks, every 12 weeks. so it's impossible to choose 'day 15'.

It's just frustrating that GPs don't seem to understand the basics of prescribing, or bother to explain, if they do.