Mini pill with hrt? Ok?

[Pinkswim]

Been on cyclical hrt for 12 months. Oestrogen gel & utrogestan. My 4 weekly bleed is horrendous. V heavy, v painful. I have a history of this ( fibroids, bulky uterus, adenomyosis). Things had started to get better when I hit menopause but then started with menopause symptoms hence the hrt. Now periods getting bad again. Gp advising to stick with cyclical hrt but start taking mini pill too (I don’t need contraception). When I have taken mini pill several times in the past to help with periods, it has made me bleed every day. Even with a double dose. I don’t want coil. Question is, if gp thinks I need more progesterone, why not just up my dose of utrogestan?? If I do add mini pill do I take every day or just same days as my utrogestan ( day 15-26)? Thanks. Tired of these painful periods. I am almost 54.

Could you ask your GP if they might offer Tranexamic acid? Taken during the bleed.

Or more Utrogestan.
Seems odd to add a different progesterone as well.

Other option is the Mirena coil.

Tranexamic acid I have tried, lessens the heaviness of the bleeding but prolongs the period. A coil doesn’t suit me. What if I skip the mini pill and take an extra utrogeston? @JinglingSpringbells

It seems better to increase the Utrogestan. Or do a a shorter cycle ( 3 weeks ) OR there is also the option of almost combined continuous- like 21 days out of 28 on Utrogestan. So you might get a slight bleed at the end of the 21 days.

What I don't understand is , unless it's your preference, why your GP isn't suggested combined continuous? At 54 you should be post meno and it would help control all this bleeding. You don't need to stick with cyclical at all at 54 unless you are aware that you are still having natural regular periods.

There are proc and cons for each but have you thought about it?

@JinglingSpringbells yes I have thought about it, gp said she didn’t think I was ready for continuous hrt yet. I see what your saying and makes sense yeh maybe take for 3 weeks. Just thinking so do I then start day day 8 instead of day 15 of my cycle? I have a feeling that would make me bleed earlier than normal but I can give it a go. Thank you for your advise. Much appreciated. 🙂

You'd start on Day 1 of your cycle and go through to Day 21. (This was an option I was given and tried it, but stopped because of side effects of using it daily.)