Should I be bleeding on utogestron/oestrogel?

[Leopardmatches]

Hi I take progesterone for 12 days a month and two pumps of oestrogel daily.

I’ve just realised that I’ve not bled for about 4 months. I sometimes have a little breakthrough bleed, blood on wiping, but that’s it. I’ve just had a smear test that was ok. I’m early 50s.

I am loath to make an appointment with doctor if this is normal as it’s a pain getting one.

Probably means you are in menopause now

I've been on that combo for around 10 years (and post meno for all of those years.)

You would normally expect a withdrawal bleed. However, I've been told that some women don't - around 1 in 4.

It depends a bit on how stimulated your womb lining is by the estrogen (we all react differently.) I bleed a lot but I know other women my age who hardly do at all. (Nothing to do with natural periods as we're too old for those!)

I take progesterone for 14 days. I had a bleed this month but nothing at all last month.

Thanks.

i was bleeding to begin with. And I had a few irregular bleeds but the doctor said that the amount of HRT I was on wasn’t enough to stop/alter my natural cycle so I was probably having a breakthrough bleed and a period.

Then I think I had a few light ones and now nothing.

is my womb protected if it’s not shedding the lining?

OP,

I have almost the same question. 48yrs old. Was using Evorel Sequi patches since Sept 2021, now using Elleste Duet tablets as the patch adhesive was causing issues. My last HRT bleed, which was more than just a smear when wiping, was Easter 2023 ! I had a period August 2023 (I'm sure because of the PMT beforehand) and nothing since then.

So what is happening with my uterus lining ? Its strange how the majority of ladies on here have bleeding problems lol ! No pun intended. And others, nothing.

@SuperBlondie28 are you going to go to the gp and ask? I’m under a specialist so I can’t go to my GP and it’s almost impossible to get in touch with the hospital. If I have to I’ll do it but it’s such a mission!

I’m exactly the same. 51 and take utrogestan 12 days a month and oestrogel 2 pumps every day. No withdrawal bleed for many months . I think I’m now in menopause. NHS gyne did not seem bothered when I told him.

But what about the uterus? Ha!

I have my HRT review in November so I'll probably ask then. Unless anything occurs before then. As you say, it's so difficult to get to see a GP and then getting one who knows their stuff re: meno, HRT. I had a 16 week gap between periods, saw GP, who said they'd only investigate if I was trying to get pregnant. This was back in 2015. I wasn't even 40!

Progesterone stops the lining growing so theoretically there is nothing to shed. Progesterone prevents the lining thickening and reduces the risk of uterine cancer as a result.
So if there’s no lining you won’t bleed.
It’s more likely that you are now post menopausal but if you continue to use oestrogen you need to take progesterone to block the effect of oestrogen on the lining.

@Angrymum22 thanks so much for explaining this so clearly. That’s put my mind at rest. That’s much clearer than the professionals have managed to explain things.