Do I need more?

[Ladybird3355]

Hi, I started years ago on everol 50 combined then increased to 75 with ultrogestan at night. Last year I went up to 100 patch and 200 mg of ultrogestan. This was ok for a while then I felt awful so in the end the Dr (not mine) said I was being over treated and to go back to 50 patch and 100mh ultrogestan. I then saw my usual Dr as I still felt off (more like the old PMT symptoms etc) She advised that I go up to a 75 and stay on the 100 mg ultrogestan as it seems I am not tolerant to too much progesterone but she said a 75 would be better to suite my symptoms.
The problem is the 200mg sorted my light bleeding. I am about to go on the 75 as I have put it off as I went on holiday but the light bleeding is still every 3-4 weeks (and I have another beach holiday ion 3 weeks). Has anyone been in the same situation? I know it's happening as I get very hot, sore boobs etc just like my old periods. In the 6 years I have been on this I have never gone longer than 3 months without a light bleed. Is it just my hormones are not balanced? Thank you

There is very straightforward protocol for this which your GP should follow.
The guidance is that if there is bleeding several months after a change in dose, you should be referred for a scan.

But the main point is are you post menopausal?
Bleeding every month makes it look as if you still have a cycle and it's a period.

How old are you now?

To use combined continuous HRT you need to be over 54 or with no ovarian cycle for at least 12 months, otherwise the regimen is sequential HRT.

Just to add, I have been on continuous for 18 months

See my post :)

If you weren't 100% sure you were post menopausal, you may not be ready for combined continuous.

I was put on continuous 18 months ago as I had been on sequential for over 5 years. I am 50. I know, it feels like that as I feel PMT. Just want to go on holiday without having to worry about bleeding. It's only light but lasts 4-5 days

Well it looks as if you are not post menopausal!
You started HRT at 45 (youngish) so it's quite likely that at 50 you are not post menopausal. Average age of menopause is 51.

Your GP needs to join the dots a bit more.

It seems incredible that with a monthly bleed, your GP is not thinking these are real periods.

There is no rule about swapping to continuous. I've been on sequential for over 15 years, am well into my 60s, and prefer it. My consultant is fully supportive on this.

You'd be better working with it as if it's a period, going back to sequential and having a predictable bleed.

I thought that but have asked 3 different Dr's and they have all said the same. It does feel like my system is still working in the background. I'll go back and see again. Just wish I could have something to cover my while on holiday as not knowing exactly is a real pain. Thank you

maybe you could be more insistent and say that unless there are any medical reasons for staying on combined continuous, you'd like to go back to sequential for a while.

There is no real reason to move to combined- there are pros and cons for each type- so it's not a case of 'having to' change to it.

Some GPs like to emphasise the lower risk of womb cancer, on combined but there are other risks that way, which don't apply to sequential.