Bleeding more frequently when HRT has been tweaked

[Bellini12]

I was on a regime of 2 pumps of oestrogel and 2 weeks of utrogestan progesterone tablet. After a couple years of this I felt like my symptoms were getting worse; terrible insomnia, anxiety and frequent heart palpitations (all checked out and heart is good).

Dr moved me up to 3 pumps of oestrogel and 1 progesterone tablet nightly. Since this, I have gone from monthly periods to a period every 20 days and now every 14 days! I’ve had 5 periods since beginning Sept!

Obviously am a bit fed up with this (they are normal periods with pain - not just spotting). I’m 53 and over having periods now.

Has anyone else had this? I do feel like my symptoms have improved - sleep is better and palpitations have almost stopped so don’t want to change but am fed up with bleeding every 2 weeks.

Whenever I’ve gone up or done in my HRT doses I’ve bled more frequently although it’s never been a full on period as I have the mirena coil, I’ve been told this is normal but if you’re worried I’d give your gp a ring

I am having more or less a proper period every 2 weeks now. It was as a direct result of going up with my HRT.

I will go back to the Dr but wondered if it may settle down or if anyone else had this experience?

@Bellini12 This is a bit confusing.

If your GP has out you on combined continuous HRT ( that's 100mgs progesterone every day) you should not bleed monthly at all because that type of HRT is for women post menopause with no natural periods (or very nearly like 2 - 3 a year.) It's normal to get some spotting for 6 months.

See this medical guide https://www.menopausematters.co.uk/postmeno.php

The other sort of HRT- sequential - is designed to mimic a natural cycle and you'd have a withdrawal bleed once a
month.

Had your periods stopped for 12 months before HRT? If not, you shouldn't be using combined continuous as the low dose of progesterone won't control your own cycle.

Sometimes when you increase the estrogen dose you have to also increase the amount of progesterone. The British Menopause Society had a guide on this (it's online) and they recommend 200mgs a day of Utrogestan with 3 pumps of gel IF you're getting breakthrough bleeding.

Or you'd go back to sequential which is 200mgs x 14 days in a month.

Talk to your GP and maybe question why you're on continuous combined if you're not post menopause.

Thank you. That’s really interesting @JinglingSpringbells
I started HRT 2 years ago when I was 51 and I was still having monthly periods. I went on it as was starting to get menopausal symptoms and the HRT helped with these.

However I’m baffled as the private menopause specialist that I first saw said I could move over to continuous progesterone after a year! I didn’t and waited over 2 years but as my symptoms got worse again it was the GP who recommended I go up an oestrogen pump to 3 and also go onto continuous. I had just turned 53 and she said NHS guidelines said that was the age to move up.
But it does sound like my body isn’t really for it yet. I could cope with spotting but this is fortnightly periods.

I do find it all a little confusing on how to get the balance right.