MJ and post-meno shenanigans

[Galadali]

Post-menopause ladies... Have any of you noticed any gynae/hormonal changes? I'm just coming to the end of week 4 on MJ and my last period was 5 years ago. (I'm 55, not on HRT). Two weeks ago I had what reminded me of ovulation symptoms (sore boobs, discharge, etc) but obviously dismissed it as, well, I'm 5yrs post-meno. Today I woke up with very obvious period pains and I'm now in full flow. I'm horrified. I've been living my best life the past few years after 40 years of menstrual hell. Having googled, it seems there's a few anecdotes of MJ restarting periods, but no research or scientific link as yet.
Has anyone had similar? I'm terrified I've kick-started something and I'm going to have to go through another menopause! So far, MJ has been amazing for me and I've been smugly sailing through with no side effects. But this, I'm not sure it's worth it.

I am 56, and prior to starting MJ last June I was 2 years post meno and very few symptoms.

Once I lost around 3-4st, lots of menopause symptoms returned - the most bothersome being worse than I had ever experienced before hot flashes at night meaning 4hrs of broken sleep every night, vaginal atrophy, and low mood. No periods though. I don't know if MJ retriggered the symptoms or if it was the weight loss (fat stores estrogen - so perhaps less fat less estrogen, or perhaps losing fat was releasing stored estrogen).

I was at breaking point with the lack of sleep, my work was being impacted so I have started HRT for the first time and it is really helping the sleep (I sleep through the night now and don't need to get up 2-3 times for a pee either!) I have had a couple of light periods since starting along with cramps and sore boobs, but it appears that is fairly normal in the first few months of HRT while they get the balance of estrogen and progesterone right.

Any post-meno bleeding needs investigated, make sure you speak to your GP.

I did. I saw the GP and was referred to gynae, where they discovered I had about 30 fibroids which were rupturing from time to time causing bleeding. I'm waiting on a hysterectomy now, please see a gp. It's not to be worried about but needs investigation

Whoa! What a bloody (literally) nightmare, @Galadali . Please get checked out. I'm 53, 4 years since a period, 5 weeks into MJ and nothing like that so far, fingers crossed.

I am not post menopause but if you go on reddit you will see that loads of women experience what you have - periods restarting and other symptoms. It absolutely affects our reproductive system and it’s the drug, not the weight loss. I’ve never heard of someone’s periods restarting after normal weight loss, yet there’s hundreds of reports of this happening on MJ. Someone made a thread about it a while back and got angry backlash from people claiming that it’s impossible for periods to restart once you’re in menopause and that the only explanation for bleeding is cancer. Yet anecdotal evidence suggests otherwise.

My own experience of MJ is that I was on the pill for years and took it back to back with no break for bleeding. As soon as I started MJ, I got bleeding. Due to interaction between MJ and the pill, I got the mirena coil fitted and am still getting bleeding that seems to coincide with increasing my dosage. Hoping it eventually settles down because it’s a PITA.

@WeAllHaveWingsGosh what a nightmare for you. Just when you think you're done and dusted, eh?
I did start HRT a few years ago but came off fairly quickly as it (also) restarted my cycle and I felt like I had constant PMT. The past 2-3 years have been plain sailing, so this is a major blow. I'm scared my GP will advise coming off MJ when it's doing me so much good in other ways

@Finallydoingit24Oh that's interesting, thank you for posting. I'll check out Reddit. I'm not particularly concerned that it's anything but a period as it 100% feels like a period (currently in bed with nurofen and a hottie). I'll see if I can get a GP appointment though.

I had bleeding and was referred to the hospital. Biopsy etc all normal and the gynae said to consider upping my progesterone.

@Friday1234 did you see the links to the very recent advice on HRT oral progesterone when using injectable weight loss drugs.

https://thebms.org.uk/wp-content/uploads/2025/04/23-BMS-TfC-Use-of-incretin-based-therapies-APRIL2025-C.pdf

https://www.pcwhs.co.uk/userfiles/pages/files/resources/glp1contraceptionhrtarticle.pdf

The advice is to change to non-oral progesterone methods (utrogestan vaginally, IUD, patch) or upping progesterone dose, either when upping MJ dose or it any symptoms of reduce progesterone efficacy.

thats interesting! The gynae at the hospital did know I was taking mounjaro but this was back in February so it maybe that’s why it wasn’t a factor in our conversation. She said if bleeding continued to consider taking it vaginally, upping my oral dose or getting a mirena. The first would be my preferred option, but I don’t know if that means I just shove my oral pill up there?!

I am considering the same if my bleeding doesn't settle down as would prefer to stick with the micronised/body identical progesterone if possible.

My understanding (from MN menopause board) is yes the current capsules we have just get shoved up there, but it needs to be high near the cervix. Sounds like you have access to a good Dr at the hospital if they have suggested, will approve it, as many GPs won't as it is off license.

There are Utrogestan pessaries with applicators, but they are 200mg and off license for HRT (they are for fertility treatment I think)

I also read in a post somewhere the 100mg capsule fits in the Ovestin cream applicators, but there comes the second issue - I use Ovestin twice weekly and Ovestin cream + Utrogestan vaginally cannot be inserted at the same time. The Ovestin cream can coat the walls and impact absorption of the Utrogestan. Not quite sure what to do there! Perhaps space out - will need to cross that bridge when I get there.

How is everyone getting on with post meno bleeding on MJ?

I have had a hysteroscopy - results back and biopsy is clear but have thickened womb lining.

I am seeing my GP on Fri and on a list for a coil. I have been taking double prog but no improvement - worse if anything I am bleeding heavily every other week now and absolutely exhausted with it that I have just started taking iron supps.

Oh what a nightmare! I hope you find some answers/relief soon.

Personally, I've had no further bleeds since the one I had 4 weeks into starting MJ. I was fast-tracked for an ultra-sound which revealed I had a "perfectly normal post-meno womb". I'm not on HRT so I've not had that to juggle with. I'm keeping fingers crossed that it's over and done with now.