And I thought Menopause meant menostop!

[WhiteHairReally]

Since going on HRT I bled constantly. After six months of paying even more money to the sanitary care industry I broke into the savings and consulted a specialist Meno Dr. We have been tinkering with the HRT cocktail for almost a year, and I’m still bleeding. I’ve had all the appropriate tests for anything else. I am now on 5 pumps of Lenzetto ( my estrogen levels were stunningly low) and 200mg Utrogestan with three days off the Utrogestan every 25 days.

Result! I bleed for 25 days and have 5 days off. The reverse of having periods! My husband calls me a Perky Bleeder, (the HRT has lifted me from a very deep despond) which is droll but it really isn’t supposed to be like this. I am nearly 60 fgs.

I had a series of Mirenas, initially for heavy periods after my last child was born, late last century and whilst many other friends on it stopped having periods, I continued to have monthly bleeds.

Does anyone have any ideas what I can do? Am I just a bleeder?

Have you asked them about more drastic options like uterine ablation or a hysterectomy? You have such a long standing pattern of it, even on the Mirena, that you may well just be a bleeder! Probably just some genetic quirk. I'm assuming they really have done all the appropriate tests, although that may not be a safe assumption. You could also just keep tinkering with the HRT. They really don't understand why this kind of thing happens, so it's trial and error trying to stop it.

Are you sure your life wouldn't be easier with no HRT. I am your age and haven't had a period since 53. No HRT and doing really well. Plenty of exercise etc. It's sounds a nightmare so l don't see any advantage.

Thank you both Polly and June for your responses.

I have thought about both of your suggestions and I admit I’m very wary of both. Hysterectomy does seem terribly drastic and I really was incredibly low before HRT. The Meno Dr confirmed that with an estrogen level so low, (after eight weeks of serious HRT, I got up to the giddy level of 113 -below 90 doesn’t register) no wonder I was feeling so awful.

Trying not to feel too desperate.

@WhiteHairReally I've been told that blood tests for estrogen are inaccurate and that's not just for women in peri. (This is nothing to do with the cost of the test by the way.)

Evidently, the tests can show very different levels over a day and can be meaningless. But some drs are still doing these.

Is the Dr you see a recognised menopause consultant (and not just a GP working as a menopause dr?)

You are on a very high dose of estrogen and TBH the way to reduce the bleeding is to try to reduce the dose.

Another thing to try is how and when you use Utrogestan.
Taking it with food actually almost doubles the efficacy.

Although the directions for use say take on an empty stomach, this is mainly to reduce side effects which in some women can increase if it is taken with food.

have you ever tried your utrogestan vaginally? i have heard that it works better sometimes for those with persistent bleeding. it does sound unusual but you say they've excluded any non-hrt related cause, i presume you've been offered a scan? you dont have any other vaginal/uterine symptoms that aren't explained by your life stage?

Thank you so much for engaging with me and my plight.

Interesting to hear that blood tests for estrogen are considered inaccurate as my consistently low results are what is driving the Meno Doc’s prescribing of more and more estrogen, which you suggest is making the bleeding worse. Certainly, since shifting up from 4 to 5 squirts of the Lenzetto, the bleeding is much heavier (I taken it down to 4 again.)

Do ‘most women feel their best when their estrogen levels are between 250-500?’ Really?

the Meno Doc is a GP working for Naomi Potter's Menopause Care outfit.

I did see the recognised menopause consultant in my city, before going to the Naomi Potter crew. The consultant didn’t listen, stuck a Combi patch on my behind and told me that there was ‘no such thing as testosterone for women.’ My confidence in her was not great.

I currently take the Utrogestan at night. I was taking it vaginally but currently orally, as part of the Meno Doc’s increasingly desperate tweaks.

will try it with my evening meal (except when socially unacceptable!)

I’ve had a scan and a biopsy.

I have another £195 a pop Zoom appointment with Meno Doc in September. I will try out your suggestions on her. Am I wasting my money on a Dr on a screen who just seems to feel increasingly sorry for me. It seems an expensive way to extract sympathy.

It’s OH and my wedding anniversary at the weekend. A friend made a mildly lewd suggestion about what we might be getting up to. I was tempted to retort that I’d be ‘celebrating’ by buying an industrial scale moon cup.

Once again, thank you so much for your ideas. Any recommendations of really good menopause practitioners would be very welcome.

At least you have not lost your sense of humour @WhiteHairReally :)

If you take Utrogestan with food be careful of the timing as you probably know it can make you sleepy or dizzy (so not safe to drive etc if that happens.)

The other option is to have a mini snack (like a biscuit or some fruit) just 15mins or so before taking it at bedtime.

Out of interest I had a browse online earlier about absorption and one website I found said that Lenzetto in particular can give false readings because one of its ingredients (something to do with it being a spray) can stay under the skin and this can skew a reading.

In all honesty, I'd try lowering your dose first before thinking of another dr.
It can take 12 weeks to adjust to HRT and that included increasing or decreasing a dose.

If you could bear to, how about stopping your HRT for a couple of weeks. Then start again on 3 sprays which is the same as 2 pumps of Oestrogel. Add in the Utrogestan for 12 days on a cycle, and see what happens.

And enjoy your anniversary.

@WhiteHairReally - when did you start on HRT, had your periods stopped by then and for how long? Have you always been on a regime where you take utrogestan every day or have you tried the cyclical regime? Unless your periods have stopped for a year before you start the continuous progesterone, you are likely to have chaotic bleeding.

Ask on the menopause support network on Facebook it's a really knowledgeable group about all things Menopause and HRT.

Sorry for my apparent silence. I thought I had posted, but obviously it didn’t have enough stamps on it.

I didn’t start on HRT until I had not had a period for over a year, as I wanted to avoid the bleed involved in the cyclic approach… the irony of this and my current situation is not lost on me!

If I remember rightly, I got to 11 months period free, three years in a row and then, back it came to taunt me.

I can’t remember exact dates without looking back at diaries (I’m away from home at the moment.)

The fact I have five day breaks from the bleeding could be considered ‘a result’. I had been bleeding continuously for six months, although not as heavily as I’m doing at the moment.

Ho hum. And thank you once again.