Terrible terrible stomach cramps on HRT

[thaneofglamour]

Is it normal for period pains (for want of a better expression) to be more extreme on HRT?

I started HRT about a year and a half ago and have tried a few different kinds. Couldn't do patches or gel.

Now on Elleste 2mg. For the last week of the pack (I'm in my 4th month now) I get really really painful breast pain. Then when bleeding starts it is immensely painful, radiating down the left side mainly , all the way down the leg. Painkillers aren't helping. The bleeding itself can be very heavy too. Tried buscopan, nurofen, paracetamol. It doesn't feel like losing night sweats is worth this.

I went on HRT mainly because of night sweats with the odd bit of quite bad PMT but I have never known pain like this on bleeding even when I had quite bad period pains in the past.

I don't know if something it up with doses. It does seem to be the progesterone and then the withdrawal from it that is the porblem, although my skin itches in the first few days of oestrogen, too.

I had this when using Norethisterone which is in all patches and some tablet forms.

I've had less pain on Utrogestan. You could consider the Mirena coil perhaps.

he only other option is to try a longer cycle (not monthly) which is 'allowed' by NICE. But you'd need to use a separate estrogen (tablet, patch or gel) along with a separate progesterone - Utrogestan or Norethisterone- and your GP might need to ask for help with the dose of the progesterone unless they are clued up on longer cycles. (The bonus is the bleed is less frequent and can be ever other month or every 3rd month.)

I had to completely stop HRT because of the same sorts of issues. Kept trying different types, doses, different progesterones etc and nothing worked, the bleeding just became more and more severe and painful. I just got fed up with it all and stopped it and now just take the mini pill (progesterone only) and don’t have any bleeding at all, which is how I was before HRT. I do struggle with fatigue and anxiety now whereas the HRT did help with those but I’d rather those than the constant heavy bleeding.

Food for thought. Thanks both.

Obviously, I don't want to give up on HRT . Awful stomach cramps stopped me from going on holiday last year and that was during a hiatus so I was desperate to get back on but a year and a half in literally everything I have tried has caused issues in some way and it's getting me down. The least worst might have been lower dose Elleste, possibly but that was the first thing so might not cut it now.

Just for info, Femseven conti patches use levonorgestrel not norethisterone.

Went to see menopause nurse who was a bit at the end of suggestions to be honest. Pondering allergies to progestogens etc.

The cramps got so bad I had to go to urgent care for assessment.

Have now had a scan to look for stuff like cysts etc. So staying on current HRT for now.

Just really quite bored of my HRT 'journey'!

Hi @thaneofglamour I was just wondering if they found any cysts or fibroids? I'm experiencing really painful cramps on hrt and not sure what to do

Hello!

No, nothing like that found. I have since then had my gallbladder removed but I am not convinced it is connected. I changed medication to Estradot + Utrogestan which seemed to help a bit but not fully resolved. Had a biopsy last week but the procedure found no polys. Scan said ovaries were fine.

Everything else , like gallstone attacks , IBS type stuff, ovary pains - all seem to get worse in about day 23 of a cycle. I even had my worst bout of covid then!

The only thing no medical person ahs ever suggested is endo.