58, on sequential HRT, bleeding before end of progesterone phase - move to continuous?

[hildaogden99]

Sorry, have posted about this before. I'm 58 but still not considered post- menopausal as it's not been a year since my last period, although my "periods" for the last year or so have been nothing more than random, light spotting. However, blood tests suggested I should be post-meno. Due to this & my age, I've been fully checked out and all fine, I do have a long history of fibroids though which are still there but have apparently shrunk a bit and may or may not have contributed to the spotting.

I'm just finishing my second month of sequential HRT (2 pumps oestrogel per day & 200mg progesterone for 2nd half of the month). Really wanted continuous as sick of bleeding but GP wanted me to do sequential initially with a view to moving to continuous after 6 months. Month 1, I started bleeding on day 14 of the progesterone but before my body would have missed the dose iykwim. Heavy period followed so not impressed. I'm now on day 12 of month 2 and started bleeding today so expecting the same again. I understand from reading posts here/Google that it's not an issue to bleed before end of the progesterone phase but still not thrilled by it.

While HRT has improved most of my symptoms, I do not want anymore bleeding! I will discuss at my 3 month review but wanted to he prepared as my GP doesn't seem particularly knowledgeable about HRT tbh (despite apparently being one of the menopause specialist at the practice!). I'm thinking of pushing for continuous but not convinced that will improve matters.

Would be grateful for any experience or advice.

Thank you!

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

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.

If you want to start continuous, you should be able to now. You shouldn't need your GP's approval as you already fulfil the criteria above. (written by an NHS consultant.)

The way to do it is to start the daily use of progesterone as soon as you have completed the 12/14 day sequential cycle.

Thank you, I was aware that I could take continuous due to my age regardless of whether my periods had stopped but my GP looked at me blankly when I mentioned it and said we could review in 6 months. I have a 3 month review soon so I think I'll just tell her that's what I'm doing. Hoping it will stop the bleeding & stopping though!

I have recently started Evorel Conti at 59. (Still having periods 55 and was on sequi/ pills). Week 10 Evorel Conti and intermittent spotting/ light bleeding. I have composed message to GP to send Monday in case wish to review but also all information seems to suggest spotting/ light bleeding not uncommon for 3 to 6 months of starting hrt or changing form/ dose. I am keeping a diary.
Whilst on femoston 1/10 I always had my withdrawal bleed.

The medical guidance- see the quote above- is that spotting is usual and expected for up to 6 months.

Thanks, JinglingSpringbells.
I haven't sent message yet and if I do I suspect they will suggest continuing my diary.
I like the patches but despite the reassuring guidelines find myself bothered by the spotting. Silly I know as physically not a bother and clearly a very common early side affect!

Ooh I’m exactly the same as you - second month in starting sequential hrt and started bleeding day 8 of the progesterone part. On day 6 of bleeding now - wondering what will happen when I stop the progesterone in a couple of days time - am I just going to continuously bleed 🤷‍♀️ I got some slow release iron tablets yesterday just in case I get low 🤷‍♀️. I’m 47. Really hoping this regulates my bleeding as I got put on the hrt for various symptoms but mainly as I’d gone into 17/18 day cycles.

@Insidenumber09 you will get withdrawal bleeds on Sequi patches. Mine are conti so supposed to be bleed free. Not quite yet... fingers crossed within 6 months. Keeping a diary...

I am on the gel, 2 pumps per day then 14 days of progesterone capsules. Hopefully bleeding subsides for all of us and regulates 😫 thought I had cleverly booked a camping trip while on the progesterone part (I.e before withdrawal bleed) but that may not be the case now 😐

So I had to have a phone appointment with the GP as I realised I'm running low on oestrogel and 3 month review not quite due. Spoke to a different GP and mentioned switching to continuous and she said this wasn't recommended because I'd not gone a year without a period as I'd still had spotting. I said but I'm 58, and guidelines say continuous is fine after 54 regardless. She said the gynae who carried out the investigations regarding my spotting had recommended cyclical so they would have to refer back to him to find out the reason. She said she would write to him but that I should stay on cyclical until they got a response. Sigh.....

Mmm...interesting. I was put on sequential hrt when 55 as still having periods. Recently changed to Evorel Conti (although assume periods have stopped naturally by 59 I don't know for sure and experiencing some bleeding). Still within 1st 6 months on Evorel Conti.
So, in the possibly unlikely event I still have a natural underlying cycle, because of my age, Evorel Conti ok? Will it stop any underlying cycle?

Hi, sorry to jump on this thread but it’s th topic I was looking for advice on! I’m 50 and have been on oestrogel 3 pumps a day and utrogestran 200mg for 14 days for 17 months and it’s generally helped many of my symptoms. I feel much better on the progesterone 14 days and wondered if I could swap to 100mg each night to see if my mood improves as I feel down after my period has ended and perk up in my progesterone phase. Any advice please?