Please help with post meno bleeding

[TeapotTallulah]

I was post meno for a year. Went on HRT. It was gradually increased until I started on 75mg patches in December. In jan/feb I got horrendous breast pain which I’d not had since peri. In March I had a very light period then breast pain went and I thought that was it.
Since then I seem to back in some kind of cycle. Breast pain/low mood, spotting for a few days then back to normal.
I’ve had a scan which was normal and GP examined me, also normal.

My menopause symptoms actually seem to have got worse these last few weeks. Mood, aches, dizziness etc.

Does anyone know if HRT can start periods up again after being post meno? It’s so weird that I seem to get actual PMT before I start spotting.

Thanks for reading so far, the internet is a minefield.

I had this, did lots of tests and all came back fine for sinister causes, so I stopped HRT and now feel completely fine. I am not prepared to cope with bleeding at my age.

Yep, happened to me. Blood tests showed my oestrogen level to be much higher than it should be. Now I've stopped the Oestrogel I have no more period like symptoms.

Thank you both so much for replying. I just can’t help thinking that I need to reduce my HRT patches. I feel like I’m having actual (very light) periods again rather than unexplained bleeding.

im going to get an appointment for next week and ask to go down to 50 again.

Thank you. I don’t know why but it’s good to hear I’m not the only one to experience this.

You are possibly not post meno @TeapotTallulah

It’s so weird that I seem to get actual PMT before I start spotting.

It looks 95% certain you are not post meno.
If you are having regular, light bleeds it seems very obvious that these are most likely periods. And you've got all the PMS symptoms too- moods, sore boobs, etc.

12 months with no period is a guide but not all women fit that criteria.

How old are you?
HRT for post menopause is for women aged over 54 OR with no natural period for 12 months (but there will always be women who have a period after 14-15 months or longer.

The best thing to do is to revert to sequential HRT taking progesterone for 12 days a month - maybe for another 6 months or more.

But you should see your GP to have a scan to check your womb lining as well.

@JinglingSpringbells

I’m 51. I went nearly 18 months without a period then about a month after my HRT patch was increased to 75 I started with really sore breasts for about 6 weeks. I eventually had a period but it was very light. Since then, no periods but spotting every month and definitely PMT.

I’ve had a scan, inside and out, and it was all clear.

I’m just not sure if HRT can make periods start again? I’ve never had sequential, started with continuous and just keep increasing the dose.

annoyingly, my symptoms are actually getting worse. I was going to ask to have patches increased again but obviously I can’t do that now.

Ive been so dizzy and fatigued this week but today has been the worst. So tired I can hardly think straight (the reason I started on HRT)

Would you advise going to see a specialist? I have private health through work. I’d have to stump up the initial £150 but wondering if it might be worth it?

Thanks for responding 🙏🏻

What was the reason for starting hrt, OP? Were you having troubling symptoms?

I'm trying to work out how old you were when you started HRT.

It's not unheard of to have more periods after a while if they 'stopped' before 50.
And- did they really stop? Even a few drops of blood, or brownish discharge would be counted as a period in late peri.

HRT cannot restart periods. Periods stop when your ovaries are empty of eggs. HRT doesn't create more eggs.

A consultant who is an expert in fertility should be able to see follicles in your ovaries which would show you're not post meno. (A lot of scans aren't done by doctors or gynaecologists.)

As you're on patches which contain one of the stronger types of progesterone, it's unlikely you're having spotting because of the estrogen dose. The amount of progesterone usually controls the bleeding pretty well.

It might be worth thinking about using sequential especially as you're just 51 and having PMS signs.

Definitely consider seeing a specialist but make sure they are good with HRT - all gynaes have their own specialisms. Sounds like you need to talk through it all with someone who can offer you advice and options.

I wasn’t having the classic symptoms, I’d had hot flashes years earlier and they’d stopped. It was more for a very very low mood, anxiety and a very persistent head pressure which made me feel like I was drunk all the time. It was really miserable.

I had my last period at 49 in September.
i started HRT 11 months later at 50 in August.
I kept increasing until I got up to 75mg in December.

Until the March after that, I had nothing. Not pink, not brown, literally nothing. My periods up to my last one were very spaced out. I went 11 months before I had my last one. I was in peri for years. Probably around 10 years. Was having night sweats in my early 40s.

I didn’t know about the follicles in the ovaries and I didn’t know they couldn’t just start up again so that’s taken that off the table.

I did start vaginal oestrogen in February but my boobs were sore before that so not sure if connected or not. I started on tablets but have now moved to cream. I thought that had solved it until two days ago when I got brown discharge again 🤦🏼‍♀️

Thank you - you clearly know your stuff!

There are two possibilities here.

1 You weren't post menopausal when you started HRT- 11 months might appear to be but there are plenty of women who go for 11 months then their periods appear and carry on (and off) for ages . The rule is you start counting again if it's 11 months and wait till it's 12 months! It's more likely that someone in their early 50s is post meno after 11 months but maybe not 49.

2 It always takes at least 6 months for no-bleed HRT to work - the leaflets and all info online says spotting etc is expected for 6 months. However, if you're also having PMS symptoms and feel like it's a period- well, maybe it is!

The simplest answer to it all is to change the type of HRT to sequential for a good few months then try continuous again.

You might get to the bottom of it with a scan - but you need someone very good at this- not just a 'nurse or radiographer who does scans' - because a good consultant can see what's going on with your ovaries (they shrink, post meno.)

Maybe pursue the private option if you want to?

Sorry I don’t think I’m made myself clear. I went 11 months without a period before I had what I classed as my last one. So I went 9 months without, then 11 then 18. So they were very very few and far between.

I can’t understand why mood would plummet and my breasts would hurt before a (small) bleed if it was caused by something that wasn’t a period.

and to be honest, at the point, it’s the horrible pressure/dizziness that I’m struggling with. I thought that, along with all the other stuff might just mean that I needed to up my patch and double up on the progesterone. I don’t think they’ll do that now though.

Ive just been looking up Claire Spencer at Spire hospital and their website says vaginal bleeding can be a sign of menopause due to vaginal atrophy - which I DEFINITELY have. Also, the pessaries/cream state it can cause spotting for first 6 months so I’m wondering if the symptoms are down to lack of oestrogen and the spotting is down to the cream?

Its just impossible to tell.

Thanks for all your information, it’s so helpful x

Re. the vaginal creams etc causing bleeding.

There is no endometrial build-up from using the creams or pessaries. If there was, women would take progesterone as well.

Some bleeding is usually from either the 'trauma' of inserting the cream with the applicator, or the fragility of the vaginal walls - which can bleed when they are thin.

I'm a bit sceptical over the bleeding when using these products, simply because the leaflets in the products are the same as in ALL HRT. There's been a huge drive to get them changed because they are not relevant.

I think you need to go to a specialist and get some tests to get to the bottom of what's going on. You should have a blood test for your FSH, estrogen levels, a scan of your womb and ovaries, and an inspection of your vagina to see if there is still atrophy.

Bleeding for 6 months on continuous HRT is normal so it's really whether you're beyond that now and why it's happening.