Just curious about...Bleeding

[SuperBlondie28]

As the title says, I'm curious about bleeding during perimenopause.

So many threads with ladies saying their periods are closer together, heavier, more painful than before peri started. Then there's me, my periods got further apart, lighter and lighter and I don't even seem to get a withdrawal bleed now. I'm on sequential HRT (gel and tablets) now. Have been on HRT since 2021.

I'm 49 years old in November but the light periods have been going on for years. Some light bleeding in March of this year and a bit today but zilch in between.

Am I abnormal somehow ? I'm a naturally curious person about biological stuff BTW lol ?

And no, I wouldn't prefer heavy painful regular bleeds. Thanks for reading my question.

Because you're on HRT, the bleeds are not your own periods any more. They will be withdrawal bleeds and usually start 3 days after the last progesterone tablet.

Some women don't have withdrawal bleeds usually because the HRT estrogen is a low dose.

If you're using a medium dose of gel (2 pumps) and 200mgs of Utrogestan for 12 days a month, you'd expect a bleed.

Do you have any peri symptoms because if you do it would suggest the estrogen dose is too low.

Thank you for replying back. Yes, 2 pumps of gel and 2 x tablets 12 days a month. I've been on it since just after Easter this year. Evorel Sequi patches before that but the glue caused a skin reaction eventually.

I haven't had the classic hot flushes, but have had low moods, poor sleep, aching body, headaches and the worse thing, digestive issues which I NEVER had before. Irregular periods since 2013. Been tested for underactive thyrod on a regular basis as my mother has an underactive thyroid.

I'm on 3 pumps.
Some months I bleed before I've finished the 12 days of Utrogestan, some months 2-3 or even 7-10 days after. This month no bleed at all.
I'm 52.

If you've had irregular periods for 11 years it could be your are VERY low in estrogen. Even without all the typical symptoms.

You may need more than 2 pumps of gel.

As an aside, you should ask your GP for a bone density scan because long-term loss of periods (ie not regular) is a risk factor for bone loss.

Thank you. I will ask during my next HRT review about bone scans. My mother has very fragile bones (although she is nearly 78 yrs old) and never took HRT. Which is partially why I decided to give HRT a go. It was a struggle though with the GP getting it.

I will try with 3 pumps of gel and see how I go.

If you have a family history of osteoporosis, you definitely need to be monitored. This is what GPs should be picking up. You are eligible for a DEXA scan due to your Mum.

You shouldn't up your dosage without consulting GP though... GP will probably need to change dosage of progesterone too to balance out.

Its so difficult to be able to ring and get a GP appointment to ask a simple question at my practice though. The same as many I expect. I had my HRT review last November and I'm certain it was a pharmacist that rang me, rather than a GP or nurse. I mean they were helpful, but not helpful with technical questions. Thanks though