probably stupid question but HRT and periods: when will they end!?

[bestbefore]

Am on HRT (Evorel Sequi patches) and have a "period" most months (some months it's hardly anything other months it's full on teenage style 😒). Obvs am on these as I was still having periods before starting the patches. I still have my uterus etc
What happens to the bleeding? When will it end if I carry on with the patches - everyone says you can stay on HRT as long as needed/ you like!? I'm really keen on it as it does help me and I want to help prevent osteoporosis having seen my mum deal with multiple broken bones in her back. But I really don't want to keep having periods?
I've been on the patches for 2 years now and don't think I've ever had them reviewed (which would probably be a good idea but my GPs are crap and just reissue the prescription when I ask)....
thanks!

I'm in the same boat, even down to my mother's osteoporosis. I'm 64 and on Novofem tablets. I get a period every 28 days exactly. I can time it starting down to a few hours. Its usually short, but VERY heavy to the point I have 2 days where I dare not leave the house.

No idea how to stop having periods, but stay on HRT. I discussed with the practice pharmacist and came away none the wiser.

I really hate running my diary to make sure I can stay at home 2 days in every month. It fucks up holidays and days out. But, on the other hand, breaking bones from osteoporosis terrifies me more.

Are either of you taking progesterone? It's essential, as far as I know, for endometrial protection. If not, I would ask for an HRT review immediately with someone knowledgeable. If you must, go private.

You are having a period each month as your are on sequential hrt. It is most likely not an actually period (depending on age), but a withdrawal bleed.

If you change on to continuous hrt, you will not have a monthly bleed.

I’m on continuous HRT (evorel conti) and still have a period every 3 weeks, so I wouldn’t count on that working. GP said it’s my natural hormones coming through.

I have a mirena coil which stops all bleeding. I was on oestrogel, now using Evorel patches.

@thenightsky oh goodness, I'm 50, this is madness...I can't keep bleeding for the next 14+ years....
@JungsWordTest yes the patches I am on are "Evorel Sequi patches contain both estradiol and norethisterone — imitators of the female sex hormones oestrogen and progesterone"

@JungsWordTest Yes, I take progesterone too. So many orange pills, then switch to white, then back to orange.

The thinking where I live is that most woman will have naturally ended their period by age 55, and then are encouraged to change to continuous hrt. The difference is that the progesterone side is now daily on conti, as opposed the 2 weeks only in the sequential. This is what causes the withdrawal bleed on sequi. There is not usually a bleed on conti as there is every day progesterone in the patch (or whatever method you choose).

Obviously there are some who still get a bleed as per pp, I did for a couple of months after I changed.

As you are only 50, it is possible you are still having a proper period though. My dr confirmed i was in actual menopause by doing a scan, so just went onto conti right away.

You can stay on sequi. You don't have to change over. But you will most likely continue to have a withdrawal bleed.

thanks all
It's all so very complex and I don't hold out much hope of help from my GP. I don't think I've ever seen anyone f2f about it. But I'm also a bit rubbish at sorting this sort of thing out...

Hi OP, I changed to Everol for oestrogen and Mirena for progesterone. It's a game changer. No periods any more.

I had to have my mirena taken out and replaced a week later recently and flooded for a week I was begging a GP to put one back in!

Why don't you ask to go over to continuous? Just one patch changed twice a week.

In the guidelines, it does say if you have been on sequi for more than a year, you could change over. Seeing as you have for two years, it seems you should be able to.

Ideally it would be great if you were able to have an appointment and have a scan. The gynae can confirm if you are still in peri or in full menopause by seeing if you still have eggs. Still some eggs ....in peri. No eggs... in meno.

@thenightsky, OMG! I am approaching 60 and am still bleeding (can be period-like or just daily spotting) despite having a Mirena. I am on Evorel patches - was on 100, now reduced to 75, but no signs of the bleeding stopping 😩

I have had 2 hysteroscopies in the past couple of years with nothing found (so must be hormonal) and have been told I have adenomyosis 🫤

@Highlighta you say gynae - I have never seen one! I will try and get a GP appt though thank you.

There are 2 types of HRT continuous and sequential.
sequential is when progesterone is taken for 12-14 gays a month only and causes a withdrawal bleed when stopping the progesterone. This is for women who are naturally still having periods.
continuous is continuous progesterone and is for women who haven’t hand a natural periods for 12 + months and is the non bleed method.
if started on sequential the guidelines say you can switch over to continuous when 56 as you won’t know when your natural periods have stopped due to automatically having a withdrawal bleed.
if you go on continuous to early or when still having periods you can have irregular bleeding.

Right... I'm going to get continuous as I've been having HRT induced periods every month for the last 10 years! I was led to believe that if I had a womb, then I NEED to shed the lining every month to prevent cancer.

I'm going to print some of the comments on here off to take to GP. I've never understood how it all worked until I read @Highlightas clear posts. Thank you.

It's pretty straightforward @bestbefore

Your GP ought to have explained....

There are 2 types of HRT

1 Sequential that gives a withdrawal bleed and will till you're 90+ as long as you're using it.

2 Combined continuous HRT = bleed free.

You can choose which you want.

The first is safer in some ways for long term use (slightly less risk of breast cancer.)

The second avoids the bleeds.

Most women can use 2 (combined continuous) when they are post menopause or over 54.

It's your choice so have a think on what you want.

Sorry @Christine0708 I posted before reading yours!

@thenightsky let us know how you get on!
I'm so glad I'm not the only one confused by this!

You too @bestbefore I'd love to not be tied down to the house 2 days a month anymore.

@JinglingSpringbells no worries you explained it better then me x

Have a read on the balance website or menopause matters loads of info on HRt there
https://www.balance-menopause.com/menopause-library/hrt-doses-explained/