Age 43 on the pill, periods changing- what to do next?

[Om83]

I went on the pill 5 years ago at 38 as was having a load of issues ( losing my mind amongst a whole range of others), all of which fit with perimenopause symptoms and all of which have gotten better with the pill (and regress again on my non-pill week).

At the time I went to the GP had tests for early hormone changes, all normal, denied HRT so chose the pill instead.

over the last few months I have not been having a normal period on my week off the pill, only some small brown clots on wiping, barely even need to wear a pad!

how did your periods stop- was it just there one month and not the next? Or do they fizzle out like this with strange non-periods?

does the fact I’m on the pill and ‘forcing’ a bleed contribute to these strange periods and maybe if I wasn’t on it they would be irregular and longer between?

I am quite scared of coming off the pill to test so not really an option for me as I don’t want to risk going back to how I felt previously. Equally I am a little scared of swapping it to HRT as the doses will be different, but how do I know when I need to swap to HRT?

Can I just stay on the pill and wait for my periods to completely stop on their own and then go over to HRT? I know the pill has more risks and I am on a low dose combined pill (20/75) if that makes any difference.

Is this the start of my periods stopping is what I guess I’d like to know?!

What pill are you on? Is it high in progesterone and just controlling your bleeding well?

I went through a stage of this around age 36, they were closer together and ultra-light, I wasn't on the pill or anything else. At around 39 they became ultra heavy and I started getting menopause symptoms so went onto hrt.

They've continued to come pretty regularly but have been closer together, further apart, heavier lighter... It sort of comes in phases for a few months. It's been about 5 years since they started to change.

I actually wish I'd chosen the pill over HRT as it can override the fluctuations better, especially in younger women. I haven't found HRT a very easy ride because my own hormones are doing loop-de-loops in the background. But I feel sort of committed now.

I wish menopause was a bit more uniform and predictable. If someone could just hand out a timetable with milestones I feel it would be much more manageable.

I’m on millinette which is low dose one at 20mcg estradiol and 75mg progestogen, it seems fine - no break though bleeds or anything, it’s just literally on my weeks break that my period is becoming a non event!

When I was 36 they started to come closer together, every 3 weeks, lighter and then heavier, and coupled with the hormonal ups and downs I felt like I only had a few days of sanity in the middle of my cycle! That plus night sweats, anxiety, hairs growing out my chin and acne breakouts I had enough!!

thats interesting that your can still feel the effect of your own hormones in the background, maybe as the pill is a higher dose it’s keeping me more stable so maybe I shouldn’t be in too much rush to come of it! And like you say, once you’re on one thing I feel committed as I hate messing around with my hormones and causing further ups and downs!!

I have read up about menopause but I just have no idea if this actually means anything or just another delightful unknown!!

Yeah that's about how it went for me around that age too.

I definitely feel the effect of my own hormones crashing around behind the HRT causing chaos. Every time it gets very bad I think about changing over to the pill instead, but I get migraines so I'm a bit reluctant to try such a massive switch.

My problems are all caused by my own hormones fluctuating rather than an absolute low level of estrogen, so it's not an easy fix with HRT.

If I was braver, I would change. I'm pretty certain by the time I'd have to stop taking it at 50 I'd be through menopause. It's a lot easier to use HRT with an absolute low level of hormones than ones going up and down.

Since the estrogen in your pill is quite low and the progesterone is high I think it might be that it's controlling your bleeding well. I'm on a high dose of body identical progesterone and it's really reduced my periods.

I was offered your COC pill by the endometriosis clinic because it stops endometrial growth well. The consultant who offered it to me said that because it has low estrogen there's much difference in terms of risk between that and HRT - how true that is I'm not sure of. I do think the body identical hormones have a better risk profile.