Bleeding and migraine after stopping HRT

[terceira]

I'm 52 and stopped HRT 3 weeks ago because I suspected it was causing my ongoing unprovoked vulval pain/irritation. My pain does seem to be improving but still too early to say. I was on HRT for about 3 years, various formats but have been on Evorel 75 patch and Utrogestan 100 tablet for about a year. I am also on topical oestro (vagifem) which I am continuing with because the pain/irritation started well before I went on vagifem.

However this week I have had some heavy (but stop start) bleeding and a 4 day migraine. I had fairly regular hormonal migraines in the past but they stopped when I was put on Utrogestan (previous progesterones had no effect).
I no longer had any migraine meds so I saw an OOH GP yesterday and was prescribed the combination of meds that usually works for me. They mostly got rid of it but am a bit headachey today.

I am absolutely convinced that my migraines are due to progesterone fluctuation but almost every Dr I have spoken to about them says it's the oestro.

The OOH GP said I should contact my GP re stopping the HRT and the bleeds and migraine, which I will do but am just wondering whether anyone else has experienced this? And whether it might be possible for me to take Utro but without any oestro?

I am reluctant to restart HRT fully until I at least have a better idea of whether it's causing the vulval pain and if it is can then try to narrow down which hormone is the cause.

Thread about the vulval pain here so I don't have to type it all out again (I no longer believe I have CV):

https://www.mumsnet.com/talk/womens_health/5384456-vulval-pain-possible-cytolytic-vaginosis-but-no-discharge-and-ph6-what-else-could-it-be?

It's fairly classic to get side effects when stopping the progesterone part of HRT.
Prior to HRT I always used to get a migraine headache just before a period (when our progesterone falls) and I still do now (not every cycle) on sequential HRT.

It's a bit odd you're bleeding because that suggests you are not post menopause yet. Using continuous HRT should mean your womb lining is too thin to shed at all, so maybe your own cycles haven't actually stopped?

Not sure about your vulval pain but it could be vulvodynia (there is a national support site for this) and in theory HRT shouldn't make it worse.