Hot flashes back after 3 years on HRT

[BizzyMissy]

I'm 53 and have been on HRT for 3 years, currently on 3 pumps of Oestrogel and 200mg Utrogestan sequentially 12 days each month. Last October I had an FSH test which showed I had not reached menopause. I still have a very, very light bleed for a couple of days around day 10 of Utrogestan most, but not every, month.

Everything has been fine except this week I have started having hot flashes, 2 or 3 a day, during the daytime. Has anyone experienced this? I know it might not be perimenopause related but I had a slew of blood tests for unrelated reasons about four months ago and everything was normal (vitamin D which I supplement, thyroid, no diabetes etc). Also had a mammogram a year ago which was fine.

I think I'll make a GP appointment but it's likely to be at least two weeks away. Wondering if it's worth increasing Oestrogel to 4 pumps in the meantime to see if it helps. Anyone have any advice on whether there are downsides to this?

Thanks!

The light bleed on sequential HRT will continue for as long as you use that sort. It's not linked to your own fertility/ menopause status.
It does though usually (but not always) start from a couple of days after stopping Utrogestan.

It may be that you're not absorbing the gel very well- are you following all the instructions 'to the letter'? (ie where to apply, not over body lotions, etc etc.)
Just that a full bleed is more likely each month.

FSH levels by the way aren't very accurate when using HRT or in peri so maybe disregard that?

You could increase to 4 pumps of gel but the guidance is you should also (perhaps) increase Utrogestan to 300mgs x 12 days to avoid break through bleeding as 4 pumps is considered a high dose.

Thanks @JinglingSpringbells . It did cross my mind that it might be an absorption problem although I’ve been taking HRT successfully (ie resolves symptoms) for three years and haven’t changed medication or the way I apply the oestrogel in that time so not sure why I’d suddenly have a problem with this unless I had a faulty tube of oestrogel which feels unlikely.

I was also expecting a withdrawal bleed after finishing each cycle of utrogestan and have mentioned to more than one GP and the gynaecologist I saw last October and they say it’s unusual but haven’t suggested any changes. It was also the gynaecologist who chose to do the FSH test to see if I had reached menopause (I don’t have any other reason for this as our family has been complete for some time).

Will try the GP again! Had forgotten how awful the hot flashes can be. Thanks again.

Have you tried a different bottle, I know they can't get to the bottom of this and there is apparently no problem, but I had one batch that my symptoms came back on.

Think I'll try that. Thanks @Runskiyoga .