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[Diamonds and pearls 53]

Hello I am a newbie but it doesn't feel like it as I have been a long time lurker! Decided to come out of the woodwork as I had a particular query which I have already posted..then thought that I had better say Hi. Having been happily on conti hrt for 4 years i have now had to come off it for the second time whilst some bleeding issues are being explored.Needless to say the old meno symptoms have returned with a vengeance and I am feeling pretty miserable..as well as anxious about what could be the cause of my problem.Anyway,looking forward to support and advice on here..and any words of wisdom ladies.. please send then my way! 

Diamonds and Pearls x

[Kathleen]

Hello Diamonds and pearls.
Just wanted to say welcome to the forum and I hope you find the answers you are looking for.
Take care.
K.

[Dancinggirl]

Hi and Welcome D&P 53
We need a bit more info.  Are you getting a scan to investigate things.
Maybe you need a different HRT?  What one were you taking?
There are some ladies posting on this site who are really clued up and I'm sure with more info they will be able to offer advice.
DG x

[Diamonds and pearls 53]

Hi Dancinggirl and thankyou for the welcome :)I have posted in Personal Experiences and already received some support and advice from the very knowledgeable Hurdity and also from Andius who made some good suggestions.I am awaiting a referral for a hysteroscopy and biopsy but as my bleeding has now stopped (10 days after stopping my conti hrt on my GP'S orders) I think this may be the reason for the bleeding.I really hope I will be allowed to stay on hrt-I fear not as I have been taking it for 5 years now but will endeavour too as it has suited me so well.   

[Dancinggirl]

Maybe you need to try a different HRT.  Which one were you taking?
I'm 57 and though I am taking a break from HRT very soon to see how things are, if my meno symptoms are bad I will push to stay on HRT but maybe lower the dosage.
I am gradually reducing my HRT before coming off completely - did you go cold turkey?
DG x

[Diamonds and pearls 53]

I was on Indivina low dose conti ( Img/2.5mg.} Have had 3 bleeding episodes since January, had a smear, swabs, a trans vaginal scan twice and the last time  the consultant had a good look at the cervix too..womb lining thin, 2.9 mm, which was pronounced v good and everything else normal. Yes, in Jan I came off for 6 wks  and couldn't wait to start taking it again after the all clear.Last time I just reduced it and this time I went cold turkey on doctors orders..2 wks later I am starting to feel all the usual horrible side effects of the lack of hormones  ..if all is well with you I would stay on it as long as you can! Which hrt do you take and how long have you been on it?

[Dancinggirl]

I've used Oestrogel through most of my time on HRT. I'm 57 and, apart from a break from HRT because of Breast cancer scares 9 years ago, have been on HRT most of the last twenty years! Oestrogel allows you can adjust the amount according to need, which means you can have the minimum amount to keep symptoms at bay. I used to have progesterone monthly to have a withdrawal bleed but I've had a Mirena coil for the last 4 and half years which has been quite good. 
I've got to have the Mirena out soon ( coming to the end of it's life) - this is why I'm reducing my Oestrogel to have a break from HRT.  If I want to continue HRT because symptoms are bad, I may do Oestrogel, but use half the amount I have been using, & do Hurdity's regime - she uses Utrogestan, which is bio-identical progesterone, and take it for 7-10 days every 6-7 weeks to give a withdrawal bleed.
I know many women have problems with bleeding on conti HRT and whilst having a regular bleed is not ideal it is probably better to have a planned bleed every 6 weeks than constant spotting and bleeding.  If your womb lining was thin then that is good.
Good luck  DG x

[Diamonds and pearls 53]

 Dancinggirl I like the sound of the Oestragel, and may consider it in conjunction with the Utrogeston, if I can convince my GP to let me continue with hrt .I wouldn't mind a withdrawal bleed every few months-a small price to pay! However,as I am 60 now-the dreaded 'danger age' for hrt and have been on it for 5years- I may have a battle on my hands to persuade my GP in that direction.I hope you are not suffering too much whilst you are reducing yours ,you never know,you may be ok, everyone reacts differently.Good luck to you too..I will post an update after I have had the hysteroscopy..not looking forward to it I must admit..x   

[andius]

The estrogel sounds like it would be good to keep your levels steady as you are apply twice daily, right?
I don't think you can control the dose and levels as well with patches.

With patches, the levels go up when you change and slowly go down, then go up again when you change, etc.

I've read that some women keep old patch on for a half-day or so when changing to try to keep the levels more even.

Andius

[Diamonds and pearls 53]

 Andius I am not sure to be honest..I have only ever taken hrt in pill form -for the first year a sequential one,Premique,and then for the past 4 years a low dose conti hrt ( Indivina) I hadn't even considered OestrogeL and have had very little advice from my G.P(s) who seemed pretty uninformed. However it seems that it is a regime that more and more ladies on here favour as it is more natural..hope my doc will consider it!   

[Dancinggirl]

Oestrogel is used once a day.  You can take from 1 to 4 pumps per day - there would be no advantages of using it twice a day. I have always applied it to my inner thighs each morning and have never used more than 2 pumps per day.
I am down to about two thirds of a pump per day at the moment - I am reducing the dose as I'm coming off everything for a review of where I am in terms of symptoms at the moment - scary!!! I'm not getting any flushes yet so I'm realising I was probably on too much Oestrogel and if I continue using it I may try to stick to one pump per day.
Hope that helps/DG x

[Diamonds and pearls 53]

Thanks Dancinggirl..and what about the progesterone part of the regime,I know you said you had a mirena but I don't want that..on here Utrogeston has been mentioned as one of the most natural..is that in tablet form ? and how often does that have to be taken?

[Dancinggirl]

Diamonds and Pearls53 - i assume you are post meno so you will have different options with progesterone.  Hurdity is the expert on this but with Utrogestan( this is the bio-identical progesterone) you can take it in a small dose almost continually or opt for a longer cyclical regime - e.g 10-12 days every 6 weeks.  Do a search on utrogestan on this site - there are some very good threads. The other thing with Utrogestan is you can use it vaginally which can be a preferable way of using it - doesn't upset the stomach or go through liver.
Once I have had my Mirena out and if I feel I still need some HRT, I will be trying the Ustrogestan.
DG x

[Hurdity]

Hi there diamonds and pearls - I think I welcomed you on your other thread.

re patches or gel - it's a personal thing really. I would say patches give the most consistent dose although long term gel users will have got the hang of making sure the area it is spread over is the same. Levels of estradiol on patches only decline very gradually over the 3-4 days but there could be a slight dip on the changeover - although levels of estradiol take quite a few hours to return to base levels and by that time the new patch will have kicked in. I prefer it because I wouldn't want the faff of remembering every day, and I don;t have to worry about pumps and spreading. You just stick it on and you're away. Some don't like the zebra look though - but doesn't bother me in the slightest!

re your lining, which is very thin. Too much progesterone ( especially the synthetic progestogens) can actually thin the lining too much and cuase ulceration and bleeding - but i presume this has been ruled out through the scans? I'm not sure whether this would be visible but it I imagine it would be with a hysteroscopy.

Re persuading your GP - if there is nothing wrong then you will need to assure him/her that you have looked into it and you understand the risks equal the benefits between 60 and 70 and you know plenty of women who have chosen to stay on it - if that's what you want to do - and print off relevant stuff if necessary. It is and should be, your decision and if the doc says no then try a different one or ask for a referral - or e-mail Dr Currie. Having said that it is difficult to argue with a doctor though!

Hurdity x

[Diamonds and pearls 53]

Dancinggirl, thankyou for that info..I feel that although I have been taking hrt for 5 years I still have much to learn about it.Yes I am about 3 years post meno so if I was going to go down the Utrogestan route I guess I would have to decide whether conti or cyclically would be best..and then how to administer it,orally or vaginally..decisions,decisions!..Same with the oestrogen part..gel or patch? How to choose!..I have been reading the threads on Utrogeston and it does seem to be a popular choice,with different options available so at least that allows for some flexibility. And all this of course if my GP agrees after I have had the Hysteroscopy..sigh!