Referred for scan, told to stop HRT

[PressPauseontheMenopause]

Can anyone help me with some advice? 🙏🏻
I've been told by GP to stop HRT for at least 6 weeks prior to scan. Scan is because of 2 consecutive months of very heavy bleeding after usual 10 days of 200mg/day progesterone.
Two days in and I am weepy and forgetful - it's a return to pre-HRT symptoms and I'm feeling so anxious about how to manage my job in particular. I'm a therapist and really need to be able to concentrate snd process information.
Would be grateful for any experience or advice as to whether my GP is correct. Thanks so much.

I had a similar experience. I was on oral HRT, had some unexplained bleeding, GP was concerned and told me to stop taking it while I waited for a scan. I was in hormonal free fall for a few months which was scary as I’d been a mess before starting HRT.

I had the scan and nothing untoward was found but the gynaecologist recommended that I switch to the coil for progesterone and transdermal oestrogen (gel). It took about 7 weeks to settle but since then I’ve had no issues and I’ve been very happy with the regime.

I hope you have a similar experience. Hang on in there, I remember how horrible it was being off HRT.

I was the other way around. Wanted to go on HRT but due to unexplained bleeding, had to go through all the tests & scans first. Everything came back all clear. They need to see what's going on without the synthetic hormone input.

Thanks for your help - glad it worked out. Dreading the next few months, to be honest...

Thanks for your input - glad you're OK. It's hard waiting but sounds like it has to be done 😬

I had post menopausal bleeding in July and was referred for a scan on the two week pathway. I was told NOT to stop my HRT thankfully. I had to have a hysteroscopy last week and as a result the gynaecologist doubled my dose of Utrogestan to 200mg per night (I’m on 2 pumps of Oestrogel).

Is the 200 mg every night peppersauce

Ah thanks for this - seems like different GPs say different things...

Yes it is.

Hi OP I've had a few scans and a hysteroscopy since starting HRT and never told to stop taking it.

Why don't you call the scan unit and ask them?

I'm another who didn't get told to stop taking mine when waiting for a scan.
I think the bleed was linked to my progesterone levels though. They were too low with the patch so I've changed to oral.

Thank-you both for responding - I have 2 friends who've been scanned (by the same unit I will be) and neither of them had to stop HRT. I think my bleeds may be progesterone related - I only do 10 days x 200mg for a 75 patch. Good idea to phone the unit, I'll do that x

It might be as straightforward as changing to 12 or 14 days. Hopefully thats all it is.

Thanks 🙏🏻
My GP said once the scan is done that she can switch me to continuous (so 100 mg every day, I think) progesterone... she said that this is protocol once you're 54, which I didn't know.

Why are you using only 10 days? Was this reduced dose suggested for a reason?

The dose is 12 days or 14 days. You're on a high dose of estrogen so that's also more of a reason to use 14 days.

There is also guidance that says any bleeding on 200mgs x 12/14 days can be upped to 300mgs, to control bleeding.

The stopping hrt before a scan is new and it's a bit odd. I think the guidance is 'patchy' and GPs have to use their own judgement.

I've had scans and investigations with my consultant and never had to do that.

It seems pointless and illogical because the lining is bound to reduce when hrt is stopped. So it's not giving a true picture of your lining on that HRT dose. and the same thing may happen again once you go back onto hrt.

If you're not taking enough Utrogestan, surely your GP should have increased that first before stopping and investigating?

I wasn't told to stop HRT when i was sent for a scan - but my bleed wasn't that heavy and stopped itself after 5 or 6 days(it was actually just like an average period and not painful)

I had a scan and then a biopsy. All was normal. The consultant told me not to take that brand of hrt again.

However, this was all around 2018 with that hrt shortage. After a failed change of brand, reverted to the original brand on GP advice.

I have had a couple of bleeds since then but i have noticed, before the bleed started, anxiety came on me. So i figured the hrt just wasn't strong enough. If i feel any anxiety coming on now, i double up the hrt for a few days and that calms me down and no bleed occurs.

Mine is a brand available in 2 strengths and im on the lower dose so doubling up isn't really off lisence as such - it is just like taking the stronger dose.

Hopefully your bleed will also be due to the hrt rather than anything sinister and you can resume the hrt asap!!

if you look up on Dr Louise Newsomes website you may find some helpful info....as she says, if the bleeding is likely HRT related then why stop it before a scan which is looking to investigate the cause! the old fashioned attitude by GP's was, if you stop HRT and the bleeding goes away then the women just needs to come off the HRT...obviously women generally want to stay on it! you probably just need more progesterone (or try a coil) if the scan is all clear.

ps and the "this is protocol once you're 54" comment is very odd ,i've never heard that before...seeing as some women go full meno in their 40's and some much later in their late 50's you don't medicate based on 1 age.

I was going to say the same. I am 58 but only been on HRT for 2 1/2 years, so was initially put on the two week regime, and haven't changed yet.

It's unfortunate that GPs don't explain this properly.

Their 'starting point' is that they push women to use progesterone every day once they are post-meno. This is 12 months with no natural period or aged 54+ because very few women are having periods after 54. The logic behind this is it's a lower risk for endometrial cancer than sequential. But what GPs never tell women is the risks of breast cancer are slightly higher with daily progesterone.

The downside of using combined continuous HRT too early is bleeding (rather than a predictable withdrawal bleed.) And that means investigations to sort out the cause - which could be the HRT or not.

It's actually a choice to use combined continuous not mandatory. I know a friend aged 70+ who is still on sequential and I am too, many years post meno.

GPs should inform women it's a choice but most are simply following 'guidance' which is after 54 put women on combined continuous.

Just wanted to send hugs of empathy. I'm a therapist too and I'm worried about managing without hrt (just been referred for a scan due to having a period on hrt). It's hard when our jobs require that extra level of mindful awareness and our hormones have other plans!

I hope you find answers and it's sorted out soon.

I had to stop my HRT for 6 weeks too - same reasons. It was really, really tough 😔everything ached, I was weepy, had brain fog and low mood. I took Black Cohosh supplements which GP suggested and it did help a bit.

Scan was normal and I went straight back on HRT and even more grateful for it than I was previously. I'm really 🤔 about the guidance to go 'cold turkey' as it's so detrimental if you're really suffering with menopause symptoms.

Hope all will be ok with your scan🤞

Yes - agree. V strange...

Thanks so much 🙏🏻

Thanks so much for replying - that sounds a nightmare and totally confirms the need for the meds. Glad you're back to normal xx

Ah thanks ❤️ yes, it's a tough job if you feel under par yourself. I've actually had the appointment date through today for next week, so I'm left a bit 🤔 about why the need to come off HRT