ustrogen and oestrogel???

[Smokedsausagesupper]

Hi
Post menopause
I was on patches for around 6 months but had regular bleeding monthly (almost like my periods started again)

GP sent me for a scan and biopsy all OK but gyno suggested I change to gel and tablets which I feel great on all symptoms much improved etc etc but still bleeding a bit (not as much)

Just had my 3 month review and doctor not too happy about the bleeding and basically hinted that if it dosnt settle down in the next 3 months I will have to come off it.
Obviously no way do I want to go back to feeling as I was.

The original GP said that I could try 4 pumps and one tablet but this GP said that I would need to increase to two tablets if I increase my gel??
Currently on 3 pumps.
She said that will likely give side effects.
Why is all the advice so conflicting?

Also two seperate doctors have said if I'm ok with occasional bleeding then it's not doing any harm to me just how I'm made.

Confused and worried and trying not to go down the merina coil route as had a complete nightmare last time with a coil.
Any one on 4 pumps of gel and one tablet?

The new British menopause society guidance would suggest that a higher dose of progesterone (ie 2 tablets of Utrogestran daily) is given with high dose oestrogen. 3 pumps of gel is classed as moderate dose, 4 pumps high dose. increasing the progesterone dose may also help control bleeding. However it’s off licence. Personally I’d recommend mirena but if you’ve had a bad experience with it before I can understand your reluctance which is fair enough.

@Smokedsausagesupper Are you in peri or post menopause?

There are so many posts here almost daily from women whose GPs have put them on the wrong type of HRT and then they get bleeding.

If you've not been period-free for 12 months, you should be using sequential HRT, which is estrogen every day and a progesterone 12 days a month. You would then have a regular withdrawal bleed every 4th week.

If your periods stopped 12 + months ago, you can use continuous HRT which is estrogen and progesterone every day.

Using continuous too early usually means a lot of bleeding because the dose of progesterone isn't enough to control the womb lining, as your own cycle is continuing alongside HRT.

The usual dose of gel is 2 pumps.
It's increased if that doesn't control your symptoms.
If it's on a cycle , for 2 pumps of gel it's 200mgs Utrogestan for 12 days.

If you use 4 pumps, then you do need to take 200mg of Utrogestan every day.
OR 300mgs for 12 days per monthly cycle.

The most important thing is whether you should be on a sequential or continuous.

Sorry if you're on the right sort, but it's not clear where you are in menopause (peri or post.)

Post as mentioned in original post 😀
On the correct type ie continuous.

I see that now but some GPs assume post menopause too early.
And some women are unsure if they are post menopause or not if they start HRT and their periods are all over the place.

Ok- so if you use 4 pumps you need 200mgs every day.

3 pumps is debateable- if you bleed then you need 200mgs otherwise 100 a day.

If none of those work, there's also the Mirena coil.