Out of cycle bleeding on HRT

[SpamhappyTootsie]

First of all I want to say I will be seeing the GP. Tried at the end of last week, no luck. Will try again this coming week.

Been on HRT for 8 months. 3 pumps Oestrogel and 2 x 100g utrogestan vaginally for 14 days per cycle. All fine, significant reduction in the symptoms I have been experiencing.

In July, I was 4 days into the utrogestan when a bleed started but I also had Covid and both times I’ve had it before it affected my menstrual cycle. Bleed lasted 7 days, steady, not excessive amounts, not really painful, but longer than my usual period.

Figured Covid had reset my cycle as it had done before, so I started the utrogestan again this month according to beginning of previous bleed. 5 days in and the same thing is happening. Light period every day, on day 6 now. Feel ok, bit tired now but take an iron supplement and eat well.

Until the GP can see me what do I do? Online info from reputable sources tells me different things! Should I stop all the HRT until I can get an appointment? Do I make more of a thing of it with GP reception and insist someone sees me?

Don’t stop your medication. Any unusual bleeding needs to be seen, so you’re doing the right thing by seeking an appointment.

Thank you @DustyLee123 . I’m not too worried as I know Covid (and other viruses) has an effect on my cycle. But then again, a bit worried in case the utrogestan isn’t working as it should and what I’m seeing is the result of that….or coincidental womb cancer……or……..
I’m also totally confused now about the timing of my utrogestan, which cycle to time it by! GP will be great, I’m sure, if I can get in to see them.

I know you should see your GP but TBH lots of women have this on HRT especially if they are in peri. It can often be your own periods breaking through for a start. No one gets endometrium cancer 'just like that' after 8 months on HRT.
In women using only estrogen (which is what used to be prescribed decades ago) 1% would develop endo cancer after a year.
You don't need to stop your HRT. I'd stick to whatever you're doing. If you're on Utrogestan, take it till the 12 days are completed, then start it when it's a month from starting this time.

Thanks @JinglingSpringbells I know it’s not likely to be cancer after this short time, but a tiny bit of worry crept in there, side effect of researching how to rebalance HRT!
Am in peri, 53, periods short, sharp and heavy for past 25 years, this is completely different, sort of what I imagine women mean when they say their periods are light and no trouble.
Will definitely get it checked out.

I think most people, including myself, don't set the Progesterone cycle on your period cycle for this very reason. My periods are pretty random, sometimes they are within the cycle, sometimes not, so I start my Progesterone on the same day each month, regardless of period timing. Occasionally this means I take it during or directly after a period. It doesn't really matter. I also miss some periods completely..... I had a four month break once, and have just had a two month break, but now just had a period on cycle.

Thanks @KnittedCardi . My periods have always been regular (apart from when Covid or pregnancy shifted them) so think GP started the progesterone 15 days after first day of bleed to keep it simple. I’ll see what she says. It’s just inconvenient because I’m missing a lot of wild swimming this summer holidays.

You keep to the same cycle of utrogestan once you have started, ignoring bleeds. About 6 months into hrt, I had a period after 2 weeks, then again after 2 weeks and regular since. It's just peri, in your case coupled with covid. Nothing to worry about unless it's constantly happening, it's impacting on your life, or the bleeds themselves are unusual in some way, causing you fatigue and so on.

@SpamhappyTootsie
I could have written your OP! I’m in exactly the position as you.
Have you any update? Has it settled?
I’m going away for month travelling and feeling wary that my cycle and bleeds are being pretty random and havent settled since starting HRT 8 months ago…

Hi @moderationincludingmoderation , sorry to hear you are having the same issue. I saw the GP and she wasn’t concerned, said it was likely to be me approaching the menopause ‘proper’. All was ok again until Easter just gone, when I got Covid again and my period reset. I think it’s just something my body does when it gets Covid!

thanks for the update @SpamhappyTootsie
Sorry to hear you’ve had Covid again and that it messed things up again! My cycles pre HRT were also prone to getting out of sync due to viruses. I’m a bit fed up as i only finished a ‘period’ about 10 days ago, and now I am having another. Lighter but beyond spotting now. It started about 4/5 days into this cycle’s progesterone. Last month was similar, random spotting/light period soon after period proper, but I hadnt even started the progesterone.
I might see what my GP says.. though I feel like I am more clued up than her tbh!
i heard Louise Newson talking about how she actually recommends a higher dose of Oestrogen in Peri and then working back from that.. I’m on 2 pumps a day and 200mg of Prog for 12 days.

I had breakthrough bleeding too after about 1 year of hrt. I had patches though, not vaginal hrt. Saw a gp who sent me for urgent ultrasound scan and my endometrium was quite thickened. So had gynae appointment for biopsy. Hrt was stopped but definitely a suspicion of cancer. Not definite.

I would suggest definitely see gp but if there is a gp at your surgery who has a special interest in menopause and hrt, then it makes a huge difference. Not all GPs know exactly how to handle the situation and what the options are.

I was wondering about this - I'm unsure whether I should go to GP. I'm on the Oestrogel pump packs, and Progesterone tablets. I'm also on the Desogestrol pill, so hadn't had a period for years. GP didn't tell me my periods would start again, because of the Progesterone I think?
I've been bleeding for over a week now. Generally feeling so much better since I started hrt 6m ago. Is quite heavy bleeding normal?

I cant work out if its because of the progesterone or wondered if oestrogen fluctuates some months then maybe up the lining is built up too much so it sheds more often/heavier.. ? So
hard in Peri I guess as its all so up and down.