Switching from sequential to continuous progesterone

[PeriMeri]

Looking for some quick advice from anyone who might have any experience. I’m in perimenopause, been using sequential HRT for about 6 months, which has helped in some regards but I’m struggling with ongoing pain. I had a scan which showed a simple ovarian cyst, a tiny fibroid and an ovary which is behind my uterus (the sonographer asked if I’ve ever had an endometriosis diagnosis, which I haven’t, but said that can cause things to move out of place).

Anyway long story short, GP has suggested trialling continuous HRT to see if it helps with pain/discomfort, and some v heavy periods, and I have a packet of lower dose progesterone ready to go. Last night was my last dose of sequential progesterone and I’m trying to work out whether to start the lower dose tonight or have a break: GP suggested carrying straight on, but my period is overdue (normally I start during the progesterone phase) and I feel really uncomfortable and bloated. I’m just unsure whether I should take a break for a few days or crack on. I realise erratic bleeding is a possibility anyway, but I’m willing to give it a try for a couple of months, just unsure about breaking or carrying on. Would appreciate hearing from anyone who’s done similar, thank you

How old are you?

I’m 50

Carry on, no need for a break

I could have written your post - same fibroid and a disappearing behind uterus ovary. I was also asked whether I had been diagnosed with endo (I haven’t).

I’m 52 and are still having heavy and regularish periods. I was given HRT close on 2 years ago but never have really been able to tolerate Oestrogen- after a few days of using it I get awful symptoms (lightheaded, anxious, ringing ears, sore breasts). I take a daily 100mg progesterone capsule though and this has helped calm my anxiety and I sleep better. Stops the waking with panic and racing heart in the early hours. If I don’t take it I sleep really badly. I’d just start taking it now if I were you. My periods still keep coming despite the daily progesterone

@PeriMeri
You should wait till you have the bleed.
That means you complete the whole cycle.

Otherwise you are likely to spot for a while because your womb lining will be ready to shed and half the amount of progesterone won't stop that.

Once the bleed is over, start daily.

When you say 'low dose progesterone' that means a capsule of 100mgs yes?
That's the same as you'd use for sequential but half the dose.

Thank you @JinglingSpringbells , that’s what I was looking for. And yes, it occurred to me that if my lining had built up it would need somewhere to go.

yes the dosage is now 100mgs compared to the 200 I was on sequentially. I had a night off the night before last, then took one last night (100mg) so thinking maybe to stop and then start again…

the only thing I wasn’t sure about is because my period is late, as it is now, if it would still come (normally my cycles are shorter), wondering if the cyst is messing things up or if it’s just peri…I guess there’s no harm in having that break as I would have done anyway…

A cyst won't mess up your periods- unlikely anyway. I had a cyst for 2 years when on sequential and nothing changed.

Yes, you should stop and wait for the bleed.
The advice is 'complete the cycle' which means including the bleed. You probably only need to wait 7 ish days before it's all over.

Try not to worry :)

@beholdtheidiot sorry I missed your post. Very similar circumstances! Do you suffer with pain too?

I’m fortunate in that I can tolerate the oestrogel but take a fairly low dose. Like you, progesterone really helps me sleep. Glad it helps you. Would be happy for my periods to stop, but sounds unlikely just yet

No problem! Yes I get a lot of right sided pain, usually around ovulation but it can come and go at other times of the month. This is the side the ovary hides on. My periods are really heavy now and the 100mg of progesterone daily has no effect on that at all sadly. I hoped that it may start to help to keep the womb lining thinner so there’d be less to shed but there doesn’t seem to be any effect on my cycle nor the loss. My periods still come anywhere between 24-28 days like clockwork. I’m beginning to think they’ll never stop. I’m nearly 53 and had quite enough of bleeding now.

@beholdtheidiot That amount of progesterone is just not enough for women having natural periods.

It's only useful for women post menopause (or very light irregular periods) who have HRT estrogen in a dose which the progesterone balances (so the womb lining stays thin.) And even then it can take 6 months before spotting stops.

Has your GP not suggested a Mirena coil for the bleeding?

Can I have a mirena at my age? I’ve not been to GP for ages so I’ve just hoped to ride it out and pray my periods stop soon

I did thr switch. It took a good few months to settle down so I did have periods randomly during that few months but now haven't had one for ages ! It's brilliant

You can have a Mirena right through to your 60s as long as it can be inserted . You're only 52.