Abnormal bleeding after being HRT for 4 years

[Hadenough2022]

I’m 54 and I have been on HRT for several years and Im now on evorel 75 patches and utrogeston 12 days a month. I’ve found until recently bleeding has almost stopped. However a couple of weeks ago I had pretty heavy bleeding for about 5 days and now two weeks later it’s starting again.
has anyone experienced anything similar?
I’ve also got polycystic ovaries which I have read is a risk factor for cancer.
ive made a drs appointment but it’s not for another week.

I am actually just sitting waiting for a scan for exactly this. My gynaecologist asked me if I had missed a patch as this could be the cause. I can’t actually remember. Do you think you might have?

No not missed a patch but I may have not taken the progesterone correctly.
good luck with the scan.

@Hadenough2022 Please don't worry.

You're supposed to have a withdrawal bleed each month on sequential HRT. It's more unusual that you didn't for all those years. Did you never mention this to your GP or did they not ask at annual reviews?

Abnormal bleeding is women not on HRT who bleed when their periods have stopped completely. Or women on continuous combined HRT (bleed-free sort) who have spotting or bleeding.

Have you never had regular monthly bleeds at the end of the progesterone tablets?

The PCOS won't make any difference. At 54 you're likely to be post menopause and your ovaries won't function any more.

You don't need to see your GP although if you do they will say it's normal to bleed on sequential HRT.

Have you increased the dose of your patch ? If so, that will be the reason.

Do see your GP. I was persuaded, including by posts on here, that my pre-menopausal irregular bleeding on HRT was normal and to be expected and by the time I got checked out, my endometrial cancer had spread (though as far as I know I’m fine now!) It’s unlikely to be that with you, but still worth checking, it sounds unusual enough for you.

Hi yes I did have bleeds but they had gradually tapered off and were always quite light.
ive been concerned as it was very heavy and then further bleeding two weeks later.

That must have been a worry glad you are ok

I’m 54 and I have been on HRT for several years and Im now on evorel 75 patches and utrogeston 12 days a month.

Does 'now' mean you have changed from one type to another or one dose to a higher dose?

There can often be a hiccup with any change and there is medical guidance online saying this and advising 3 months for a new type to settle.

No not missed a patch but I may have not taken the progesterone correctly.

What do you think you may have done incorrectly?

I didn’t take my progesterone for 3 days and had the heaviest bleed I have ever experienced - worse than lochia after giving birth. I had a follow up ultrasound etc with no issues found - so it was put down to the missed progesterone. I’m on continuous progesterone - take it every day - ran out and took a few days to get some more. Never doing that again!

I’ve been on evorel 75 for over 12 months so not a recent change.
re the progesterone there is a possibility I didn’t take them one night, but no more than that.

You're taking 2 capsules for 12 days? or 14 days?

75 patch is considered higher.
Expect you know this.
Low dose is 25, then there's 50 (medium), 75 is higher and 100 = very high.

You might just need to take more Utrogestan. I linked a day or so ago for another poster to the BMS guide on this - 75 patches may need 300mgs ( 3 capsules) for 12 or 14 days a month.

I'd not panic but see your GP as planned and discuss lowering the patch or increasing the progesterone. That's in the guidance for bleeding like you've had.

Thank you for your advice