Confused about period when newly on HRT

gingergingerginger · 2024-02-27T07:45:36+00:00

I've recently started on one pump of Estradiol and 200g of Utrogestan from day 15-26. One of my potential peri symptoms is increasingly heavy, long and closer (for me) periods. I started taking the HRT mid-cycle and it's been 2 and a half months now. My first period was very heavy, as expected, since I'd only just started the HRT. My second period started on day 28 (so 2 days after pausing the Utrogestan). It started off light and then went super heavy and lasted for 7 days. My third period is meant to be now, but it just hasn't started. I am day 33 (so 7 days after pausing Utrogestan) and all I've had is the tiniest dab of spotting. No pad needed. I do feel like I need to bleed, though. Is this normal? I'm only very early in peri. I'm 42. Not sure I should even be taking the HRT tbh. What's dictating the bleeding? Is it my hormones or the HRT?

JinglingSpringbells · 27/02/2024 10:58

HRT isn't usually prescribed for heavy periods. The usual treatment is the Mirena coil.

Can I ask why your GP offered HRT?

Are your periods irregular? Are you having other symptoms like flushes, night sweats, mood swings, weigh gain?

If you are still having heavy natural periods, HRT is unlikely to help because all it's doing is adding more estrogen and this thickens the womb lining= more bleeding.

Is your GP menopause trained?

Original poster

gingergingerginger · 27/02/2024 11:12

JinglingSpringbells · 27/02/2024 10:58

HRT isn't usually prescribed for heavy periods. The usual treatment is the Mirena coil.

Can I ask why your GP offered HRT?

Are your periods irregular? Are you having other symptoms like flushes, night sweats, mood swings, weigh gain?

If you are still having heavy natural periods, HRT is unlikely to help because all it's doing is adding more estrogen and this thickens the womb lining= more bleeding.

Is your GP menopause trained?

Thanks. No, it wasn't prescribed for heavy periods. It was prescribed for other peri-type symptoms I have been having (brain fog, hot flushes etc..). I mention the heavier, longer, and closer together periods because my understanding is that that is another sign of peri-menopause. So putting it all together with the doctor it felt like and HRT trial might be appropriate.

I don't want a coil or the POP.

The main reason for my post is to ask if the NOT starting a period 7 days after stopping the progesterone is normal because it seems quite extreme for it to just stop my periods. That said, maybe it'll start in the next couple of days.

OP posts:

ClaudiaWinklepanda · 27/02/2024 11:14

I'm in the same boat, OP, no rhyme or reason to what's going on with periods, I'm starting my 5th cycle of HRT now.

JinglingSpringbells · 27/02/2024 12:16

The main reason for my post is to ask if the NOT starting a period 7 days after stopping the progesterone is normal because it seems quite extreme for it to just stop my periods. That said, maybe it'll start in the next couple of days.

When you use HRT, the HRT usually overrides your own hormones (although this can vary depending where you are in peri.)

HRT can't 'stop' your periods. The bleed each month on HRT is a withdrawal bleed. It will happen even when you have no natural periods because the action of taking progesterone, then stopping, creates a bleed.

However, if your womb lining isn't very thick, sometimes the bleed won't happen on that cycle but it will usually happen next cycle or maybe even in between (during early peri when you own hormones are fluctuating a lot.)

It's nothing to worry about unless you went for months and months without a withdrawal bleed.

Everyone is different. Some women on HRT find their womb lining increases in thickness a lot with the estrogen from HRT. Some have heavy withdrawal bleeds, some have next to nothing.

TorroFerney · 27/02/2024 12:50

I've been on it a couple of years now, like you gel every day and the estradiol 14 days. Part of the reason I went on it was that I was having 2 periods a month and, although very light, the accompanying pmt meant I was either murderous/wanting to self harm or bleeding on any day of the month.

I sometimes have periods sometimes don't. This month I had a day where I bled but the dark stuff you get at the beginning/end of a normal period. Last month I had nothing, month before that I had period pains and more of a proper period. Like you i sometimes feel I should be bleeding as I have that heavy feeling but don't.

So a mixed bag! What i am not getting is the horrific pmt/self harm stuff though. I wee in the night a lot when on the estradiol though but i can cope.

TorroFerney · 27/02/2024 12:51

JinglingSpringbells · 27/02/2024 12:16

The main reason for my post is to ask if the NOT starting a period 7 days after stopping the progesterone is normal because it seems quite extreme for it to just stop my periods. That said, maybe it'll start in the next couple of days.

When you use HRT, the HRT usually overrides your own hormones (although this can vary depending where you are in peri.)

HRT can't 'stop' your periods. The bleed each month on HRT is a withdrawal bleed. It will happen even when you have no natural periods because the action of taking progesterone, then stopping, creates a bleed.

However, if your womb lining isn't very thick, sometimes the bleed won't happen on that cycle but it will usually happen next cycle or maybe even in between (during early peri when you own hormones are fluctuating a lot.)

It's nothing to worry about unless you went for months and months without a withdrawal bleed.

Everyone is different. Some women on HRT find their womb lining increases in thickness a lot with the estrogen from HRT. Some have heavy withdrawal bleeds, some have next to nothing.

That is really helpful as I sometimes do have a fleeting worry that my womb lining is building up.

JinglingSpringbells · 27/02/2024 14:26

@TorroFerney If you go many months with no bleed, see your GP and maybe ask for a scan.

Original poster

gingergingerginger · 27/02/2024 15:09

JinglingSpringbells · 27/02/2024 12:16

The main reason for my post is to ask if the NOT starting a period 7 days after stopping the progesterone is normal because it seems quite extreme for it to just stop my periods. That said, maybe it'll start in the next couple of days.

When you use HRT, the HRT usually overrides your own hormones (although this can vary depending where you are in peri.)

HRT can't 'stop' your periods. The bleed each month on HRT is a withdrawal bleed. It will happen even when you have no natural periods because the action of taking progesterone, then stopping, creates a bleed.

However, if your womb lining isn't very thick, sometimes the bleed won't happen on that cycle but it will usually happen next cycle or maybe even in between (during early peri when you own hormones are fluctuating a lot.)

It's nothing to worry about unless you went for months and months without a withdrawal bleed.

Everyone is different. Some women on HRT find their womb lining increases in thickness a lot with the estrogen from HRT. Some have heavy withdrawal bleeds, some have next to nothing.

Thanks. I feel like I really didn't know this. I thought that it would just sort of augment my own natural hormones but that I would still have periods as my body wanted them (as opposed to withdrawal bleeds). I now feel very confused about whether to continue taking it. I am not entirely sure how much it's helped with my symptoms either, to be honest.

Need to give this all some thought.

OP posts:

iamyourequal · 27/02/2024 19:08

I am not entirely sure how much it's helped with my symptoms either, to be honest.

You are on a really low dose at 1 pump a day, so you might not feel much different. You could mention this at your 3 month review. Did the GP do any blood tests on you before suggesting HRT, to rule out anything else and see if peri seemed the likely cause?