HRT advice please

[highlandponymummy]

I'll try and keep this as short as possible. I'm on Progesterone every day, and Estriol and pessary twice a week. I'm 60 and 6 years post menopause. Started taking it due to horrendous hot flushes, mood swings and vaginal dystrophy. I've been on it 3 years with no issues. However for the last year I've been bleeding on and off. Was advised by GP to double Progesterone tablet and then I bled constantly. They are now going to try a new tablet. However, I can no longer have interiors as it is just too painful and getting worse. This was one of my chief reasons for taking it initially. Has anyone come off HRT successfully please? I just don't really know why I'm taking it any longer. DH has said he doesn't care about the sex, my health is more important. I don't want to spend months trying different medication if I can help it. Thanks if you've read all this!

Am I right in understating that you’re only using oestrogen as the Estriol cream and Vagifem/Vagirux pessary? No systemic HRT like an oestrogen patch, spray or gel?

You don’t need to take progesterone if all you’re using is the local, topical vaginal oestrogen.

In terms of the vaginal atrophy, many women find they need more than twice a week. I would talk to Gp about increasing the frequency.

There’s a brilliant Facebook group for vaginal atrophy where the ladies will explain how they use it and what to say to a reluctant GP who thinks twice a week is enough.

Sorry to clarify I'm on Estradiol 10 mg pessary twice weekly, evorel patches twice weekly and 100 mg Progesterone tablet every night.

Ah ok so you do need the P with the patches.
I updated my post slightly above to say you likely need to increase the frequency of the pessary and/or try the oestrogen cream. Different formats work better for different women and you can also use both - the pessary inside and the cream over the vulva.

You need to use vaginal estrogen more often- maybe go back to the every day for 2 weeks, then drop back to 4 times a week.

The pessary used to be 25mgs- so more than twice the dose- and for some reason the manufacturers changed it to 10mgs. This means some women need to use it more.

You could also try reducing the patch strength and that might stop the bleeding so you don't have to take 200mgs Utrogestan every day.

You say you wonder why stay on HRT.
Well, without trying to see what happens, you won't know. I'm older than you and after trying to stop, my night sweats are still there.
You may find you still have flushes etc when you stop.