Bleeding on combined patch

[OchonAgusOchonOh]

I'm 58 and had gone through menopause before starting HRT. I was on the combined patch but had bleeding so moved to the seperate oestrogen patch and progesterone tablet. I had no bleeding with that but didn't get on so well with this (headaches and light headedness).

In the meantime, I had some uterine polyps removed so went back on the combined patch. All good for 5 months but I have had fairly heavy bleeding for the past 2 weeks. I assume I couldn't have polyps again so quickly (about 10 months since the last lot removed) so is it just that the combined patch doesn't suit me or is there anything I can do to stop the bleeding?

You need to be seen again.

Could polyps have grown again that quickly?

You’re having unusual bleeding, so you need to be seen.

Obviously I will discuss it with my GP.

However, the last time I had bleeding it was the combined patch, not the polyps, as the bleeding stopped when I changed patch before the polyps were removed. Bleeding on the combined patch seems to be fairly common so I'm wondering if anyone has experience of this and how they dealt with it or am I stuck with the seperate patch and tablet, which I'm not a fan of.

I’ve lost track of all the HRT combos I’ve tried (including combined and oestrogen only patches - I’m 58 this month.

I did have bleeding on continuous for over 6 months but it’s settled down now I’m on separate oestrogen and progesterone - currently gel and utrogestan.
Consultant from meno clinic recommends I should have coil fitted as this seems to be the gold standard for delivering progesterone and managing the endometrium. I spoke to the GP who talked at length about ‘might be able to fit it’ but in the end I said I would just stick with my current regime, as it’s as good as it’s ever been!
Why is meno treatment so bloody difficult?

I know, it's a pain isn't it?

I wasn't a fan of the progesterone tablets but they weren't as bad if I took them at night time as I was asleep for the side effects 😁. I reckon I'll have to go back on them again though as the bleeding is no fun. I thought when I had 5 months of no bleeding that I was sorted but obviously not.

Would you try the Mirena Coil?

That might be an option I guess. I always assumed the coil was pre or peri meno but from what you're saying it sounds ok for post meno too?

@OchonAgusOchonOh
I’ve just double-checked the letter sent to my GP and this is what the consultant from the meno clinic said:
Please consider change of progesterone to Mirena coil in view of high BMI and recent demise of first-degree relative due to endometrial cancer. If this is not acceptable I would suggest doubling the dose of utrogestan to 200 mg oral daily.

She defo wanted me to try the coil although I’m no longer bleeding. I am overweight and nearly 58.

And, she finished the letter with this:
I would like to mention that for women who are overweight, they are a much higher risk of cancer of the womb and it is extremely important that should they be on HRT that they are progesterone which is adequate to support and reduce risk of cancer of the womb. For this reason you should be taking double the dose of utrogestan daily which is 200 mg every day. A better option for you would be to use a coil with progesterone such as Mirena coil which is known to reduce the risk of endometrial cancer significantly.
New Year’s goals - force myself to do some exercise!

That's interesting.

I have the same new years goal. I have put on a fair bit of weight since the start on covid - I'm working from home a lot more so snacking a lot. Up until peri meno I could eat what I wanted and if I did put on a bit of weight, cutting back slightly sorted it out within a month. I miss those days...

Age 56 and still having regular periods. (My mum had periods until she was 60!) Started HRT Evorel Conti & have not stopped bleeding for 6 weeks. Think I should have been put on to sequi. Anyone else with similar issue?