HRT and Bleeding, is this normal?

[Leafycat]

11 months on HRT. Never settled into a progesterone withdrawal bleed. It was always earlier, but periods were lighter than before so I was OK and waited to see if it settled into a pattern.

Things have got worse. Periods are lasting 9-12 days. Then I have intermittent spotting for a week then another full blown period. This one is heavy, Day 2 and I’m filling a mooncup every 2.5hrs. I’m exhausted with the whole thing. TIA

I’m 44 if it makes a difference.

I had this when my progesterone was lesser than needed to balance out the estrogen. I reduced estrogen a bit (1/2 pump) and increased progesterone by 2 days (I was taking 12, increased to 14 days). This brought both hormones into balance and the bleeding reduced to very low. Might need some trial and error.

Thank you @DoItLikeAWoman did you ask GP before doing it or just manage yourself?

I just did it myself. Both were within acceptable range. Estrogen can go up to 4 pumps and progesterone up to 14 days.
My GP did suggest going to 3 capsules per day instead of 2 if needed (which would’ve needed prescription change) but I didn’t need to go that far. I tried 14 days and that was enough.

what Dosage are you on at the moment?

Thank you. 2 pumps of gel a day. I take 2 progesterone tablets from the 1st to the 12th if every month. So it’s a 30/31 day cycle rather than 28. That will be reducing my progesterone a little bit too. I saw it as a tip on here and thought it sounded sensible to follow a monthly plan rather than 28 days.

I had symptoms since 43 and started HRT at 45. The imbalance can happen anytime. Just rebalance and you should be ok - unless there are other problems you are not yet aware of.

You probably need to do 14 days of progesterone and see if that helps.

The main issue is that you're very young and your own cycle will be overriding HRT rather than the other way round.

It's worth considering other options like the Mirena coil.

For uncontrolled bleeding like yours, the BMS does suggest 300mgs progesterone if 200mgs isn't working.

Or you could change to a different type like Norethisterone. This is one of the older synthetic types which comes with pros and cons, so you need to think about those. It's far more powerful than micronised progesterone (and is the type of progesterone in patches).