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[Sarah2]

This is just really another way of asking about my painful bleeds!

Is anyone having sequential HRT, long cycle? If so how much bleeding do you have?

I never had heavy periods- ever- in the peri meno they just fizzled out and got lighter.

I think I must have had low oestrogen levels throughout my 40s because I was diagnosed with osteopenia at 47 and had bladder frequency/pain for years .

My bleeds now last for about 4-5 days with days 1-2 being heavy-ish - by that I mean when I sit on the loo the blood flows out - sorry for tmi. But I don't have flooding , then the bleeding slows down quite quickly after 2 days and days 3-5 are lighter.

At the moment the only way I can see to reduce the bleeding is to have shorter cycles perhaps, try reducing the eostrogel, or take more progesterone.  I'll discuss with my dr and I know he'll advise, but wanted to try to get some benchmark of what happens to other women!

[Taz2]

I wasn't on long cycle but on ordinary sequi HRT my periods only lasted around five days. Days 2 and 3 were reasonably heavy but I thought that was normal as that's what used to happen with my "proper" periods although they lasted seven days.  I found the first three months on any new sequi HRT led to more painful periods but then they got easier.

Taz x

[Sarah2]

Thanks!

That's interesting.

I'm going to suggest I try the Utrogestan for one more cycle,( have now taken it for 3 cycles) maybe a shorter cycle, and if I still have a lot of pain will possibly go back to Norethisterone. My dr did give me the option of a reduced dose of 1mg for 10 days on that instead of the 5mgs I've taken before.

I'm a bit fed up this month because I've had no real problems at all with my HRT other than some occasional spotting which has always been investigated, but at 58 I can't be doing with heavy or painful bleeds brought on by HRT.

[Taz2]

I wonder why you are on a sequential HRT at aged 58 Sarah? Usually you would be on a continuous one by now. Sorry if I've missed the reason in a previous post.

Taz x

[Sarah2]

It's my consultant's recommendation because looking at the research papers available it would appear ( possibly) that it's the amount of progestins you take that is linked to breast cancer- women on  oestrogen only HRT have lower rates of b cancer - some research shows lower than women not on HRT at all.  He has always recommended keeping progestins to the absolute minimum. There is also some research which suggests that having a cycle 'sloughs off' breast cells that could otherwise continue to grow and may become dodgy. If you take combined/continuous HRT then you are taking 2 hormones daily. None of this is yet proven beyond any doubt I must add, but it's something to consider.

[Taz2]

That's really interesting. I'm not sure whether it is better then to have a "hit" of progestins for the second half of the month or to have a reduced dose throughout the month. I did read an article somewhere on the internet that said scientists had discovered that different types of progestins have a different effect re breast cancer and that two types had been found to actually prevent some tumours. There is so much information out there that it's difficult to know what to believe. One day all will be much clearer I am sure and hopefully the next generation of women will have a more informed idea of just what effect HRT can have.

Taz x

[Sarah2]

I did ask him whether it was how much or how often ( ie a small amount daily or a bit more for less time) and he said it was the total amount.
The paper I read showed that ( in vitro) breast cells sloughed off with cyclical HRT ( in the same way that the endometrium does)  but not with continuous.
There was a research paper out a few years back which studied French women on HRT and they all take Utrogestan which appears safer. My consultant also told me that he knows a breast specialist who is very happy about Utrogestan re. breast health so the possibility is that it's the synthetic HRT which may be worse.
I wouldn't like to post this and have anyone take it as Gospel because we don't know enough yet, but it's always worth thinking about.

[Sarah2]

Thanks StellaJ. Did you have period pain with your bleeding, I wonder?
I'm currently on an 8 week cycle after a few years on a 10-12 week cycle - he suggested dropping to a 6 week cycle but we compromised- but I think I will try every 6 weeks. He'd rather keep the progesterone down even if it means regular-ish scans to check it all. The doses don't work out the same between every day and half the month because he advises Norethisterone 1mg for 10 days on a long 8 week cycle ( which is less than on a short cycle and much less than daily) or Utrogestan for 10 days on a long cycle.

[Sarah2]

Interesting.

Am not aware of your history- but assume from what you have said that you have now come off HRT?

[Sarah2]

My consultant is good- voted as one of top 250 consultants in the country by other GPs and consultants.
Menopause and infertility are his specialisms.

How are you doing now off HRT?

[Sarah2]

I'm on 1.5mgs a day- that's 2 pumps of gel- but I do experiment with reducing and last month have managed to use less than 2 pumps which has brought it down to about 1mg for at least half the cycle. I have in the past managed to reduce it by half for an entire long cycle,which would be less than 1mg (but then the poor sleep patterns came back) and the bleed was hardly any different at all.

[Hurdity]

Hi

I've never had bleeding on HRT that compares with my previous menstrual cycles.

When I was on Cyclogest as progesterone, on 11 day 4 weekly cycle (400 mg pessaries) I stopped getting a bleed at all.

I am now on Utrogestan vaginally - was every 8 weeks but reduced to 6 because I supposedly had a thickened lining although this was dubious due to timing of scan, and now I am going between 6 and 8 depending on what I'm doing. I get migraines sometimes on progesterone and especially sometimes with alcohol so time it depending on whether I am away on holiday/away so as not to spoil the fun!

My bleeds on 6-8 weeks are always light eg at its heaviest a super-plus tampon can last most of the daytime, and then change once evening and night - if that's any indication. Also only mild cramping.

My reason for being on a cycle is not to do with research or cancer risks, but because I find progesterone affects me as it build up in the system - generally get more tired, foggy-headed and headachey as well as bloating and neck pains when sleeping sometimes -  which gets to a peak by the time I've been on it (vaginally admittedly) for 12 dyas. When l've got it out of my system after a few days I feel normal again and awake!

Hurdity x

[Sarah2]

200mgs for 10-12 days.