Advice on sequential HRT

[nonsensicalmess]

Hi all. I've been perimenopausal since late 30s - started HRT just before I turned 40, and have been on sequential HRT for 4 years now. 2 pumps of oestrogel plus Utrogestan for 2 weeks of every month. My symptoms are well controlled and I generally feel good. I have had a change in bleeding for the last few months however - my bleed used to come at the end or after I finished the progesterone tablets. Now it comes in the first week of starting it, so much earlier. I don't get a second bleed and there are no other causes for concern - it's not heavier or different in any way. Has anyone else experienced this and is it something to flag with a doctor? Wondering about timing and when to move to continuous HRT.

Any advice/experience appreciated!

Hi OP!

I would say (as someone who has an obstetric background but is familiar with women's health) that it's probably best to speak with your GP. Sequential HRT usually causes irregularity in bleeding during the first few months but it seems slightly peculiar that this has changed.

Someone who still has a womb is required to take combined HRT (albeit sequential or continuous) but using combined HRT is only beneficial when you haven't had a period for 1 year.

Speak with your GP just to get an all-over check to see if the current pathway you're on is still suitable for you! Better to be safe than sorry! Sending you well wishes :)

Thank you - I’ll try to speak to my GP this week. I hadn’t been thinking this was anything of concern, but am slightly worried now!

I wouldn’t say it’s an urgent change that requires you to be worried , but you should definitely have a review! According to guidance, you’re supposed to have a yearly review but I know many don’t (no thanks to the GPs)