HRT - will I bleed forever?

[Rispknee]

When I started on HRT just over a year ago I was having periods approx every 60-70 days.

I have three pumps of gel daily and progesterone tablets for 12 days every month. I have light bleeding for 4 days, ten days after starting the tablets.

It's very predictable and manageable, but does this mean I will have these "periods" forever, or until such time as I stop HRT.

As I understand it the progesterone is taken to avoid thickening of the womb lining and does so by shedding it in the same way as a period. So, if I keep taking oestrogen, I need to keep bleeding?

I also want to know the answer to this!! How do you know when you've gone through menopause if your body is being "forced" to bleed each month??

Yes, that too!

I had investigations for this and they fitted a coil - I have this and two gel pumps and haven’t bled in 4 months (after weekly bleeding)

I think the answer is 'yes', if you keep taking progesterone.

I had a mirena coil fitted, which I believe stops the lining thickening at all so no bleed is necessary, and have had no periods for years*. That's got to be one of the few benefits of menopause!

*I still get the odd bit of spotting as my own hormone cycle is still rumbling away in the background, but I'd say it is no more than a bit of coloured mucus once every couple of months or so.

I won't be going down the route of a mirena coil, been there, done that, had a year from hell as a result!!

I think the doctors will soon advise you to switch to progesterone once every day. Then there is no bleed

Just came on to search for an answer to this question!

I was taken off HRT for 4 months due to separate health concerns. When on HRT I had periods, more or less regular. The 4 months I was off it, I did not have a period. I’m now back on HRT, different to before, patches and progesterone tablets for last 14 days cycle and I’m back to having a period when stopping the tablets, much to my annoyance.

I queried this with my dr, who said she suspected since I was having periods again, I was still in peri menopause. She said it was not a forced period. I’m back soon for a review, so going to ask about this again, and if will it ever stop naturally despite being in this HRT regime.

its the downside of HRT I guess, if it does cause bleeding. Having been taken off HRT suddenly, I do not want to do that again as it was horrendous so I’ll put up with the monthly bleed.

And the only positive of menopause, no periods.

Oh, OK. So how does that prevent the thickening then? I thought it was the shedding that does that.

I'm on it once daily and still get a bleed. SO UTTERLY FED UP with it.

You can take the mini pill alongside the utrogestan and oestrogel (you take the mini pill and one utrogestan tablet every single day instead of the 12 day thing) and I haven’t had any bleeding whatsoever doing that. (I’m 44, been in early menopause since 37 due to autoimmune issues).

The progesterone stops thickening of the endometrium; with continuous progesterone there’s no bleed, whereas with cyclical progesterone there’ll be a withdrawal bleed after each course of progesterone finishes. The usual recommendation is to switch to continuous HRT after 1-2 years on a cyclical protocol, or once you reach 54.

I always understood it was a withdrawal bleed and expected when the progesterone ends, but actually mine is always 10 days in, with 2 more days of tablets to go.

My bleeding definitely doesn’t follow the cycle of the progesterone tablets! Occasionally it does but my cycle has been anything between 19 and 40 days in the last year! It’s a bloody nuisance (literally)

I haven’t bled for years and as I am on continuous progesterone. You could ask to switch?

I would suggest two things talk to your GP about either/or:

1. double the progesterone to see if that makes a difference
2. get a coil fitted

You should not be bleeding but I went from a coil to tablets and bled for 9 months until I went back on the coil and stopped within a few months.

@Rispknee

You're on cyclical HRT (also called sequential.)
This means if creates a cycle, like a normal period, but the bleed is a withdrawal bleed, not an actual 'period'.

This will keep happening as long as you use sequential HRT.

When you are post menopausal (usually by 54) or have had no period for a whole year ( a natural period, not a withdrawal bleed) you can start on combined HRT which is progesterone daily. This will give bleed-free HRT.

see this link www.menopausematters.co.uk/postmeno.php

Have you misunderstood the OP's post?
She's on sequential HRT which has a bleed every cycle. That's normal.

It's not the same as bleeding at odd times on combined continuous HRT

It's not an exact science. Women absorb progesterone differently and yours is falling a bit early.

However, many women on higher doses of estrogen ( 3 or 4 pumps) need more progesterone.
You might want to try 14 days a month (option on leaflet.)

I think if this happens then you should still be on cyclical/sequential hrt as you’ve still got a natural cycle. I may be wrong but my meno doctor said that I can’t change yet even though my periods are lighter because she suspects I’ll still get breakthrough bleeding on continuous. Can’t wait till the buggers stop though, they are the bane of my life and horrendously painful 😥

No. It’s not the withdrawal bleed that stops the thickening. It’s the progesterone. By only taking it for half the month the lining is allowed to thicken then shed.

once you have stopped your periods or if you have been on sequential HRT abd have reached the age of 52 I think, they will put you on continuous HRT. This means progesterone daily and you won’t bleed.

ir that’s what’s supposed to happen. I still get the odd spotting. If I miss a single progesterone pill I will spot for a couple of days.

but typically you stop bleeding on continuous HRT

Ask to change to a tablet form with no breaks. Then no periods

No bleed HRT is daily estrogen and daily progesterone.
It doesn't have to be tablets. It can be patches, gel +tablets, spray + tablets, or tablets. But tablets are now slightly dated owing to higher risk of blood clots.

No bleed HRT is for women aged 54 or over, with no natural periods for 12 months. Used too early, it means there is often spotting or more bleeding which can result in unnecessary investigation.

Most women who are having periods or even irregular periods use sequential HRT at least to their early 50s.

Your Dr is right.

I haven’t read all the comments so sorry if already mentioned, I started HRT about 10 months ago, mirena coil, gel (two pumps a day) and progesterone tablets. I was still bleeding (still am) so was sent for scans and turns out I have four uterine fibroids. These are causing the bleeding so I’m now waiting for an appointment to see a gynaecologist.
it’s exhausting bleeding every day!

My periods stopped completely, started HRT, tried various combinations of patches, gel, tablets and I bled constantly. I couldn’t be doing with it so I finally stopped taking it.