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Menopause

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HRT question

6 replies

Newgolddream70 · 26/09/2023 08:43

I am on Evorel 100 patches and I have just been prescribed a new progesterone, Provera, as I didn't get on with Utrogestan.

I've been a bit naughty and not taken any progesterone for two months' now but, I am still having a bleed so I am assuming my periods haven't stopped yet. Would it be safe for me to take the oestrogen without taking the progesterone because I'm still have a period? If I'm having a bleed, surely the lining must be thin and therefore safe, would you agree?

I feel so much better not taking progesterone as it really affects my mood.

OP posts:
Bringonthesunforthewashing · 26/09/2023 08:52

No you can’t do that!

You have to take the progesterone - I would love not to have to either.

I have pmdd so very sensitive to progesterone, I have no choice than to take it if I say on hrt because I am peri.

JinglingSpringbells · 26/09/2023 09:35

Not sure if you mean can you skip the progesterone just this week/month while you are bleeding, or longer term (because you think you are still having natural periods.)

When you say you are 'still having a bleed' what do you mean?
One bleed after 2 months, or 2 bleeds one month apart?

First, you do have to use some progesterone with HRT, for the reasons you know. You can't use just estrogen long term.

The bleed you are having now may be a period OR it could be a spontaneous shedding of the lining as it's become too thick (because 100mcg patch is a high dose.)

If it's spontaneous shedding (and you haven't ovulated) then that's a sign that the lining has become too thick.

For women who are intolerant to all progestogens, they can have the option under medical supervision to extend the estrogen-only part of the cycle. There is also a tablet form on HRT called Tridestra which is a 3-month cycle and can suit women in peri. (It gives a bleed every 12th week.)

However, you really do need to do any of this with medical advice.
Specialists can prescribe and monitor longer cycles (for example 6 or 8 week cycles instead of the usual 4 weeks.)

But this usually means you will monitor the lining, maybe every year, with a scan and this is often privately, because the NHS won't usually offer these scans purely as 'check ups' unless an NHS specialist is asking for that.

Sorry it's such a long answer. You should keep using progestogens, and if you need or want to move away from the 4-week cycles, you are probably going to have to see a private menopause specialist who can authorise it and can monitor it all for you.

Littlemissprosecco · 26/09/2023 09:42

No, you are putting your health at risk, it’s not naughty, it’s stupid!
sorry to be blunt

Eebygumball · 26/09/2023 10:59

I’m on evorel 50 patches and I take provera every 3 months for 14 days (so have a bleed every 3 months). I’m 53 and irregular periods so the 3 month cycle seems to be a standard option as per the NHS website. So it’s certainly possible to be prescribed a longer period but your GP should be able to advise whether you would be suitable for a 3 month cycle. I’ve had no problems and this cycle suits me well.

JinglingSpringbells · 26/09/2023 11:16

That is true @Eebygumball and the 3-month option is a recent addition to the NHS guidance. Possible issue for the OP is her patches are max dose and there are some recommendations recently to increase progestogen with 75 or 100 patches. The BMS suggested upping Utrogestan to 300mgs x 14 days on cyclical for women on high doses of estrogen.
OP should speak to her GP as Provera might need increasing if she does longer cycles.

Hayden123 · 26/09/2023 21:49

Hi, I am on the evorel patch and utrogestan tablets. I’m a bit confused with the take from day 15 to day 26. I first started them on my first day of my period for 12 days. So does that mean I take them now 12 days on 12 days off? Thanks

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