Bleeding on continuous Utrogestan

[Perly]

Hi, in December last year my GP switched me from Evorel Conti patches to Evorel 50 with continuous Utrogestan, which I take every night before bed. I was told to swap because a scan showed I had thickening of the womb.
For the past week I have had continuous bleeding, like a period, which shows no sign of easing up. I am 60 so haven't had a period in many years. Is this to be expected? Or is it something I need to see my GP about? I did read that this can happen within the first 3 months of changing, but thought I'd check if it should be a cause for concern.
I was very happy being period free for all these years so am a bit annoyed to be faffing about with pads etc at this time of life. Thanks!

If you've moved onto continuous after a sequential regime, bleeding can be expected for 6 months.

I'm not sure if I've misunderstood but you said you were on Evorel Conti.

Conti=continuous with progesterone daily, as part of each patch, and would be the same as using Utrogestan daily. Why would your GP change that?
The type of progesterone in patches is stronger than Utrogestan.

Thanks for your reply. I will have to double check later, but yes I am pretty sure I was on the Evorel Conti patches for many years. I can check when I am back home - I have an old pack somewhere.
I am not sure what the reasoning for that was. They said the change in prescription was to protect my womb lining.

It's worth checking but also checking that they know what they're doing.

If you'd not had a withdrawal bleed for many years since on HRT it does sound as if you were on conti.

Did you have a scan because you had a problem of some sort?

POST MENO OPTIONS https://www.menopausematters.co.uk/postmeno.php

See this table here with the hormones in all types.

PERI MENO OPTIONS - https://www.menopausematters.co.uk/perimeno.php

So there is no reason to swap, as Utrogestan isn't as strong as the Norethisterone in a patch, unless you have stated a preference for a body-identical form of progesterone.

Ypi May have been changed to utrogestan as it’s a bio-identical form of progesterone (known as micronised progesterone). Evorel conti contains a synthetic progesterone called norethisterone. There is some evidence that women absorb and tolerate micronised progesterone better than synthetics, so this may be the reason the GP changed you onto a different regime even though the dosage is not that different. If you’re unclear though, you should
go back and ask - it’s important to be fully informed so you can advocate for yourself if you don’t feel right.

@Resilience

The evidence is that it's often less well absorbed and some women are told to double the dose from 100mgs to 200mgs daily.

OP I had a bleed (was on HRT gel) and phoned the GP - she said I was right to call as any post menopausal bleeding should be checked. It is probably nothing, but I was referred for a scan (which showed thickening of the lining), then a biopsy and a blood test for ovarian cancer.

There may be a routine / innocent explanation but in your shoes, I'd want it checked.

Thanks @JinglingSpringbells- that’s different to what I’d read but I’m not a Dr and it goes to show how important it is that women have their HRT regimens explained to them properly. Off to read some more now…

Hope all was well for your checks. I also had a scan, blood test and biopsy last year as I had some spotting. Luckily it was nothing serious: it was probably caused by a polyp which has since been removed, but that’s when they also saw the thickening of my womb. I’ve contacted my GP for advice now. You are right, it’s best to get it checked.

@JinglingSpringbells
thanks, I’ll have a good read of those links later.
These are pics of what I was on until December, and what I am taking now.
You are right, I was referred for checks and scans after some spotting. Luckily it was only a polyp, but they did also discover that my womb lining was too thick. Biopsy and blood results all came back ok.

Speak to your GP and query it.

From the pics you've posted, I'd assume the patches were continuous. You need to read the box/leaflet inside if there is one which should show you exactly what each patch contains.

If they ARE conti, every patch will have 2 hormones.

I don't understand why you've been swapped.

The treatment for a thicker lining (hyperplasia) is actually larger doses of Norethisterone (this is also the treatment for women who may not be on HRT ) or the Mirena coil.

Bleeding when changing to any different type of HRT is common.
However, you do need an appt to talk this over and question why they have changed you to a different form of progesterone.

The only reason I can think of is that you may be a poor absorber from transdermal patches so they think oral Utrogestan may be better- but as it's usually not so efficient, it seems odd.