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No withdrawal bleed on sequential HRT

1 reply

SociableLapwing · 20/10/2026 16:44

Hello all, just wondering if anyone has experienced this?

I'm 41 and started sequential HRT four months ago due to peri symptoms (zero libido, urinary urgency and night sweats mainly). Two pumps of oestrogel, increased to three in month 4 due to no improvement in my symptoms. I take 200mg Utrogestan before bed for the first 12 days of the month.

To begin with I was also taking the Levonorgestrel mini pill for contraception, but stopped this just over 2 months in and switched to condoms as I was getting awful headaches and fatigue during the Utrogestan phase and felt that having a third (synthetic) hormone in the mix could be confusing things.

Other than in month 1, I have not had any withdrawal bleeds at the end of the Utrogestan phase and I'm starting to get a bit worried. My last bleed was around 7 weeks ago, shortly after stopping the Levonorgestrel. I've had two full Utrogestan cycles since then and no bleed, just cramping and a bit of pink-tinged mucus. Pregnancy tests are negative.

My understanding was that the drop in progesterone after the Utrogestan phase should trigger a bleed. It's still early days but I've been scared by the warnings of oestrogen causing the endometrium to thicken etc.

Thanks in advance for any advice/reassurance! This HRT journey has been a rollercoaster so far and I feel like I spend my life researching one symptom/side effect or another :(

FlissMumsnet · 20/10/2026 18:59

We really sympathise - we can't offer any useful advice about medication but we're sure other users are in the same situation so wanted to give this a bump for you.

Hope you can get things sorted soon.

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