Talk to me about peri periods

[HedgeWitchOfTheWest]

I’ve been on HRT (Evorel conti) patches since January, and had a massive improvement in symptoms.

Periods were back to being regular (only a change in overall cycle length previously).

But suddenly I had a 34 day cycle followed by only a 4 day period (usually 8 days), though it was about 80% as heavy as normal (normally very heavy).

Then this week, after only 20 days I started what I thought was a period. But that’s turned out to only be 3 days of very light. (Or one spotting, one light, and one essentially spotting).

What do I do? Is this to be expected? I’m 44.

I should add that I’ve been doing 16:8 for about 6 weeks (essentially dropping one whole meal, ~300-600 calories, per day) and I go to the gym 3-5 times a week (and have done for years). My weight is the same as (about 4kg heavier than my lifetime normal) it has for the last couple of years.

I feel like I’ve got a bit of pelvic bloating, but I can’t tell if I’ve just become fixated on my convex lower belly and it’s been this way since I had my kids many years ago.

Just a bump.

I’d like a magically insightful definitive answer (joking, obviously) - is it the fasting? Is it just perimenopause? Is it something I should worry about?

And if I can’t have a definitive answer, please can you share your experiences.

I was advised that you couldn't be on Conti while you had periods, I was changed to Sequi when my periods returned.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/continuous-combined-hormone-replacement-therapy-hrt-tablets-capsules-and-patches/who-can-and-cannot-take-continuous-combined-hrt/

If it was me, I would return to my GP.

Maybe I am on Sequi. The one with progestogen for 2 weeks out of 4

Obviously, your first port of call is the GP is you have any concerns with irregular or unusual bleeding.

My experience (not medical advice) is that my periods have been going haywire on Sequi. I am not sure if its my age or caused by the HRT. I can be days, weeks, latest one has lasted a month and its a mix of flooding or light spotting.

I couldnt tell you if the same time has elapsed between them any more just that I am always prepared.

I know sequi is meant to help stabilise your cycle, so maybe its time to pop back to the GP for a chat?

Good luck x

In theory on sequi HRT you should have a regular-ish withdrawal bleed, once a month, usually 3-4 days after the last patch with progestogen in it.
Sometimes the withdrawal bleed comes sooner depending sometimes if you've not absorbed enough progesterone or been late with a patch.

You don't really have 'real periods' once you're on HRT as the HRT resets your hormones into an HRT cycle (like the Pill does if you ever on that- a Pill cycle.)

However, there can be some blips usually because some months you will still ovulate even on HRT (if you're on the younger side) and this can result in a real period out of timing with the HRT bleed.

It's nothing to worry about and there is no solution other than swapping to a Mirena coil which may give better bleed control.

Thanks both.

The first 7ish months my cycles had been much more regular than previously (and the usual length and flow). It’s only the last month (and 2 ‘periods’?) that it’s gone wonky.

I had pretty bad burning mouth a couple of months ago, which has finally gone, so maybe it’s the hormonal bonkersness going to a new level (though interestingly my old symptoms haven’t come back, just shiny new ones).

Mine were horrific until I had mirena coil. After prev being regular as clockwork I’d have one that would start and stop, then couple of weeks later have flooding…then nothing for 6 weeks, and so on. I finally lost my shit when I flooded in an airport wearing linen trousers even when I wasn’t due on for another two weeks. Once I had the coil they stopped very quickly, not had a period since.

How did you react to the coil? It’s my next suggested treatment due to the flooding I now get.

I have heard some horror stories as to how some people react to it, so I have so far said no to it.

(sorry for the derail OP)

I had the mirena after my second pregnancy. It was fine, I still had periods but they were very light. But it did coincide with a period of intense anxiety and other similar quietly-not-quite-coping type feelings. That coincidentally suddenly went away around the time I had it removed.

I’m reluctant to go back on it. Just in case it was the mirena that made me feel that way.

Having said that, my sister and a bunch of friends swear by it.

My sisters have both had very bad experiences, as have a few friends.
My GP is terrible for appointment waiting times. I worry that if I have it fitted and I react badly it takes a long time to remove.

To update: I’m on day 17 of bleeding.

Last cycle was only 19 days with 4 day period.
Cycle before was 34 days with the usual 7 day period.

what do I do? I’ve already got a GP appointment booked in a fortnight. But why will/can they do? Is this just par for the perimenopause-course?

Day 17 as in you've been bleeding for 17 days? Or it's day 17 of your cycle and you've just started bleeding?

I've had similar- I'm on cyclical (14 days progesterone only), but don't get a regular withdrawal bleed. It was coming early before I ended the progesterone, last month it was w weeks late with terrible hot flushes etc.

My specialist said its my own cycle occurring on some months and not others. My hormones are unstable.

So she's suggested a higher dose of both estrogen and progesterone, still on a cyclical regime. Higher estrogen to stop the symptoms, higher progesterone to try and control the bleeding better.

If I'd been bleeding for 17 days straight though, I'd go to the GP. Aside from anything else, I'd want my iron levels checked.

*2 weeks late

Yeah, 17 days bleeding. And not insignificant- about half a menstrual cup a day.

Maybe I’ll see about getting an appointment sooner. I already take iron supplements.

I can bleed for weeks at a time, usually heavy. I bleed for all of August. My iron levels are seriously low and I take tablets.

Not much can be done, it’s always been written off as peri x

I can’t see how Mirena, a low dose of local progesterone, can cause symptoms systemic, tablet progesterone doesn’t. If you google the amounts of hormone it doesn’t make sense the Mirena would do this. But then I’m a massive advocate, haven’t had a period since I was 30 and wish I’d got one at 20. It’s been life changing

Oh @chipsticksmammythat sounds awful, you poor thing.

This is why I’m not rushing to the doctor- it’s probably hormonal, and what realistically will they do?

@HiggleaI get your perspective, I really do, which is why I’m hesitant to say that the mirena caused my terrible anxiety, but the two definitely coincided. I was worried about starting HRT because of it.

I think some tablet/systemic progestogens do for some people too.

The mirena has a different progestogen than the Evorel patch does, which is different again from the body-identical micronised progesterone you can get separately.

This is the problem, it’s all so complicated. “Oestrogen” is a category of something like 8 different compounds. Which are/should be being produced by my ovaries? Which do I need to remain healthy? (Oestradiol?) Why does no one consider the testosterone (produced at something like 6x the concentration of oestrogen normally) that I may or may not have.

Every time I think I’ve understood something, it turns out to be way more complicated.