How long did bleeding take to settle on continuous progesterone?

[GlomOfNit]

To stave off another (possibly unwarranted) hysteroscopy and to curb the very very slight thickening of my womb lining I had last year (hysteroscopy showed NA) and my rather erratic bleeding pattern under HRT (and observed before I started HRT a few years ago, to be fair) I've agreed to go onto continuous progesterone. I was told it'll take a couple of months to settle down (as in, bleeding and spotting). I'm nearly a month in and my bleeding and spotting is all over the place. I know it's only been a month - but how long did it take any of you for the bleeding to just ... stop? Bloody hell, I'm looking forward to that eventuality!

I'm 53 in a few months and GP and gynae both pointed out that I'm at the average age for menopause so continuous isn't a big deal now. I'm assuming that if I'd been fitted with the Mirena (this was pushed last year at hysteroscopy, but very much at the last minute - literally as I was sitting in my operating gown ready to have the hysteroscopy done under GA) the erratic spotting and bleeding would be much the same? But it's annoying, I actually soaked into the mattress a little bit overnight when I thought I was only spotting, and I'm having to use my mooncup a lot. What sort of time frame can I expect?

(Gynaecologist advised that if erratic bleeding pattern hasn't settled by 6 months, further investigation/hysteroscopy recommended.)

I was told it'll take a couple of months to settle down (as in, bleeding and spotting).

The guidance here says 6 months (written by an NHS consultant who has contributed to the British Menopause Society Guidance, so ought to be a reliable source.)

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.

100mgs a day of Utrogestan won't control your own cycles if you're p not post menopausal.

Mine never did. After 3 years I have now given up on it. I tried four different types.

I do wonder - some months I get a lot of cervical mucus at the same time each month and about 8-10 days after my withdrawal bleed (when I was using utrogestan sequentially) which made me wonder if I am actually still popping eggs out sometimes. But other than that, how DO you tell you've stopped ovulating/menstruating once you're on sequential HRT when your bleeds are presumably prompted by the withdrawal of each cycle's progesterone??

I'm giving it a go since this has come from the gynaecology department at the local (good, and big) hospital rather than just from GP.

I'm about 3 and a half months in on Evorel Conti...age 59. Previously on oral hrt. Still having periods at 55 before starting hrt.
Anyhow, I had a few weeks clear and now intermittent light bleeding spotting. Keeping a diary.

As @JinglingSpringbells says, can take a few months to settle round spotting/ bleeding when starting/ changing hrt. I am monitoring and will make gp appointment at 5/ 6 months in unless symptoms worsen.
I sent online message to gp to see if wanted to see me now. Surgery acknowledged message in generic fashion but not asked me to make an appointment.

So, just hoping all will settle down and if it doesn't it will be irritating!
Your bleeding sounds heavier than mine but well within 6 months window.

But other than that, how DO you tell you've stopped ovulating/menstruating once you're on sequential HRT when your bleeds are presumably prompted by the withdrawal of each cycle's progesterone??

You can't.
Either by stopping HRT for a year to see if you have natural periods, or assuming that by54 you may be post meno (80% of women are by 54.)

If you're having signs of ovulation you don't seem to be post menopause yet.

I'm giving it a go since this has come from the gynaecology department at the local (good, and big) hospital rather than just from GP.

It's worth bearing in mind that being a gynaecologist is no guarantee of expertise in HRT. Many menopause consultants also work in fertility or endocrine disorders and they are the real experts.

Even gynaecologists come with their own areas of expertise. and can be 'general' or have extra training in other areas - ie menopause, early menopause, endometriosis, infertility, surgery, etc.

Most of them now have online bios which detail their training and experience.

It took 5 months, but I am on 200mg of utrogestan daily (and perimenopausal)