If I do the whole 2 weeks on / 2 weeks off utrogestan when am I likely to have a period / bleed?

[Xrays]

There’s a long backstory to this (multiple chronic health issues including lupus and Addisons, early menopause aged 37, been on HRT since, now aged 42). I’ve been on continuous HRT since I started as I had been on the mini pill for 9 years and hadn’t had any bleeding in that time and it was assumed due to various reasons that I was post menopausal. So I started continuous HRT - oestrogel 2 pumps, utrogestan 100mg every night and the mini pill as no one could tell me for absolute certainty whether I was completely post menopausal or not. (I do not and did not want a coil for birth trauma related reasons). This regime was working really well for me until about 6 months ago and suddenly all hell broke loose and I started to get a lot of irregular bleeding. This has now turned into a regular monthly really heavy period. I was initially under Newson health and was then seen in the nhs under a menopause specialist. I contacted them to ask what was happening and I had an internal scan which was fine. I am booked into have a womb investigation and biopsies. This will be several weeks / months from now at my request as I have a disabled child I need to arrange childcare for and due to birth trauma etc reasons I need to have this done under general anaesthesia (they did try without and I couldn’t do it).

So - here is my issue - consultant has suggested swapping to 2 weeks on / 2 weeks off utrogestan but if I do this when am I likely to have a period? At the moment I seem to have them this time of the month and the real argggh of it is I have the first holiday I’ve had for 15 years booked for this time next month and I’m thinking crap I’m going to have a horrible debilitating period then 😞😞 If I start the new regime now is it likely to alter that? Is there anything I can do??

I am so annoyed with it all. Up until 6 months ago I was never having any bleeding at all and now I’m looking a period swimwear and feeling so fed up with it all!

Hopeful bump…. 😬😬

The bleed usually happens 3 days after the last progesterone tablet.

The best thing to do is to lengthen the estrogen only part and start Utrogestan so that your bleed will come once you are home. If you allow 12 days(it's 12 days not 14) for the Utrogestan then add on 3-4 days to wait for the bleed to start, that should work.

Regarding the change in your cycles- it does sound as if your fertility may have resumed. There is a charity called The Daisy Network for women with POI and on their website they do say that after POI it is quite possible for cycles to resume- so that is probably what you're having.

If your scan was fine I'd query why you need a hysteroscopy and biopsy especially as your bleeds seem to be coming regularly like a period.

Thank you so much for replying.

So if I’m currently still going the continuous thing if I start the oestrogen only part say next week and then aim for the utrogestan 2 weeks / 12 days after that my period should be after my holiday… 😬😬🤞

I’m not entirely sure why they’re so adamant they want to do a biopsy. Really fed up with it all to be honest and half tempted to just stop the HRT all together but then I hated the joint pains and hot flushes I had - and I have a history of bowel cancer in my family and understand taking HRT lowers the risk of this. The menopause consultant (nhs gyne) says that although a scan is reassuring and I’m very low risk they can’t rule out cancer without a full biopsy / investigation etc.

Very interesting about fertility being resumed. I don’t want any more dc 😆 but I wonder if that’s what’s going on.. I think my early menopause was / is due to Addison’s, it’s common in women with Addisons and at 37 they found I had zero oestrogen. It’s all very strange. Does that mean I don’t need the HRT then or is it the HRT itself that might have reversed it? It’s all so confusing.

There is a tiny risk you might bleed slightly within a few days if you stop Utrogestan (daily). It's impossible to say as your own periods seem to be controlling the bleed, not HRT.

If you stop it now, today, then it may be over before your hols. But whatever you choose to do, don't stop the 200mgs x 12 days just before your hols.

They can tell a lot from scans nowadays. I can understand they want to be sure, but cancer would normally show on a scan with thick lining etc. Have they tried to insert the scope before and can't? Or do you not like the idea of that without a GA? (I've had it done and it wasn't as bad as I thought.)

Does that mean I don’t need the HRT then or is it the HRT itself that might have reversed it? It’s all so confusing.

You'd need more tests to answer this- tests on your FSH, ovary scan to see if there are any follicles, etc- can they offer that?

Have you looked at the Daisy Network website? There is info there and they have a forum but it's private and I think there is small fee to join.

I will have a look at the Daisy Network. Never heard of that before so thank you.

I really appreciate your advice about the utrogestan.

They tried to do the biopsy as part of the scan procedure but I found it too painful and to be honest psychologically I just found it upsetting. I had a really traumatic difficult vaginal birth with my first dc now aged 20 (!) so much so I developed ptsd and severe pnd as a result so with my second dc now aged 11 I had an elective c section. I can cope with smear tests but anything more invasive than that just really triggers me and I can’t do it. I’ve recently had a cystoscopy under general (had painful bladder syndrome since I was 14 and it was getting worse so they wanted to investigate and it just reconfirmed the diagnosis) so I’m assuming the pain / whole thing will be similar or less than that (I’m already on Ovestin as part of the bladder treatment).

I find it very strange that I literally haven’t had any bleeding whatsoever for so many years now and now I suddenly seem to be having periods again….! Bodies are very odd.