New to HRT and massively heavy soaking period

[Anonemouse1]

Hi All,

Wonder if this is normal? I haven had a period since November. Started hrt patch, a tablet pessary and progesterone tablet each night. I started this on Saturday, had some bleeding yesterday and then woke up soaked by a heavy bleed. Today I've had a combo of the ultra tampons and thick sanitary pads and soaking through both about every 3 hrs and with gushes of blood rush.
Read the clinics leaflet and it does say to expect bleeding and contact them after 6 months. Cannot imagine bleeding this heavily for 6 months. Is this normal, will the bleed settle or stop? Or should I go back to the clinic and pay for another consultation?
Thanks.

I had a 20 day period when I first started HRT. It was a miserable experience. I ruined sheets and had to wear the big tena pads to bed. It settled down though.

That said, you sound worse than me. I think I'd be ringing the nurse tomorrow for some advice.

You probably should not be on progesterone daily.
That is for women with no period for 12 months or over age 54.

What's likely to have happened is this is your OWN period with blood collecting since November and coming away now.

Started hrt patch, a tablet pessary and progesterone tablet each night. I started this on Saturday,

Your bleeding is not connected to HRT as you've only been on it for days.

This is what can happen in peri.

The bleeding that happens on continuous HRT ( the sort you are using) is usually light spotting, if anything.

But as you're in peri you should be using cyclical HRT anyway- not continous.

I had post menopausal bleeding, having to change at least every 2 hours and was told to visit the doctor straight away for some medication to reduce the blood loss. It worked and eased off after a couple of days.

What strength patch and how much progesterone? Sounds like not enough progesterone to me (no expert!)

This sound miserable. I hope it doesn't last 20 days for me. Will give the clinic a call tomorrow. It's a private one but think I need to pay up as I don't want this going on for longer.

Thank you. I had two very heavy periods like this before the periods stopped in November. (Kind of hoping they would just go away but without any other symptoms) I'll ask about sequential treatment

You're still in peri.
The bleeding is not linked to hrt as you've only used it for 2 days.

Having a very heavy bleed after missing 3-4 cycles is normal.

It's not nice, of course, but it's nothing to do with your HRT.

You might want to ask about the Mirena coil if your periods are irregular and it may stop them altogether.

How old are you?

Your periods need to stop for 12 months before you can say they have stopped for good.

Will defo call them tomorrow as need help.

But you are not post menopausal.
So that is very different.

It's Evorel 50 patch, utrogestan 100mg and vagifem estradiol 10 that I've been prescribed. On my first patch, take the pessary daily and the progesterone each night.

I'm on continuous and I'm still in peri. Periods hadn't stopped and I'm not 54.

Thanks a coil was mentioned in the appointment as a possible thing to look at the future.
it's reassuring to think this maybe still the perimenopause bleeds, even though it's annoying.
I'm 48.

The dream right, so over periods!

I had the heaviest periods ever whilst on the patch - then I went on the oestrogen
gel and the bio-identical progesterone tablet and my periods are back to normal. The change from synthetic progesterone to bio- identical is the only thing I can put it down to.

You should take an iron supplement to prevent becoming anemic. Anemia can also make periods heavier

I'm not sure but I think I'm on a bio identical one but will ask.

Good point. Will pop to Holland. Barret tomorrow and get some. I've just eaten all the chocolate in my cupboard for iron, plus to make me happy.

Yes, some women are but these are the medical guidelines. There can be exceptions.

https://www.menopausematters.co.uk/postmeno.php

POST MENOPAUSAL -
Continuous combined therapies.
"Period free" or continuous combined therapy can be used by women who are 54 + yrs, or more than one year since last period at any age. The criteria should be fulfilled in order to offer such treatment to women who no longer have a continuing ovarian cycle, so that steady levels of both estrogen and progestogen can be achieved. When there are steady levels of estrogen and progestogen from daily administration of both, the womb lining stays thin. Although some bleeding in the first 6 months of therapy is common, there should not be bleeding after that and the lining does not go through the stages of stimulation and then shedding as it does during a normal cycle and with sequential therapy. Start with low dose preparations and increase as necessary for symptom control. The products marked * are licensed for osteoporosis treatment/prevention.
See below: WHY AND WHEN TO OFFER CONTINUOUS COMBINED THERAPY.

When?

• Patient known to be post-menopausal at whatever age, ideally by having at least one year of amenorrhoea (no periods).
• If sequential therapy started while still having periods, wait till age 54 years. At 54 years 80% of women will have cessation of ovarian function and are likely to settle on continuous combined (period-free) therapy.
• Change from sequential to continuous combined by finishing the current sequential pack and start new therapy at the end of the expected bleed.