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[sonka]

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[honeybun]

Yes I had this after nearly two years on sequi. I was over 50 when my GP changed me onto a conti.I thought this was later in the meno journey so I asked Dr Currie and she said it was just fine.
I continued to have sporting for a few months and then things settled down and I am just fine now.


Honeyb
x

[oldsheep]

is there any way you can have an internal scan to check the womb lining thickness?
I started bleeding too often/much when on 200mg Utrogestan. Turned out it was too big a dose and was causing shedding. 100mg stopped it. However it did thin the lining quite well!

[Cassie]

I get so confused Old Sheep, always understood that the higher the progesterone the less chance of breakthrough bleeding, I was breaking through on 100mg so my Dr upped me to 200mg lol...

Or maybe you were not talking about breakthrough bleeding? I can understand that the regular bleed would be heavier as the dosage is higher but my understanding is that one needs a higher progesterone to stabilise the lining and when you stop taking it, then only are you supposed to bleed when the levels drop...? Maybe Hurdity can help here, brain is fazzled!

[Hurdity]

The more oestrogen you have the thicker the lining becomes and therefore the more progesterone is needed to shed the lining - on cyclical HRT. On conti HRT the same applies - the higher dose of oestrogen you have the higher dose of progestogen is needed to prevent the lining from building up.

If you are post-meno, sometimes on conti HRT there is still bleeding/spotting so a higher dose of progesterone is given to prevent this. On conti patches this is more difficult as there is only one dose available, which is why separate oestrogen and progesterone enables more fine tuning of the right dose for you.

 Progesterone works (when given continuously) by preventing the lining from thickening in the first place - but if this is insufficient then the lining will thicken and might shed erratically - even on a conti - or not at all (which is undesirable).

Bleeding can be cause by several factors - here is an explanation (DUB = Dysfunctional Uterine Bleeding):

The cause of DUB is usually related to one of three hormonal-imbalance conditions: estrogen breakthrough bleeding, estrogen withdrawal bleeding and progesterone breakthrough bleeding.1 Estrogen breakthrough bleeding occurs when excess estrogen stimulates the endometrium to proliferate in an undifferentiated manner. With insufficient progesterone to provide structural support, portions of the endometrial lining slough at irregular intervals. The usual progesterone-guided vasoconstriction and platelet plugging do not take place, often resulting in profuse bleeding.

Estrogen withdrawal bleeding results from a sudden decrease in estrogen levels, such as occurs following bilateral oophorectomy, cessation of exogenous estrogen therapy or just before ovulation in the normal menstrual cycle. Estrogen withdrawal bleeding is usually self-limited and tends not to recur if estrogen levels remain low.

Progesterone breakthrough bleeding occurs when the progesterone-to-estrogen ratio is high, such as occurs with progesterone-only contraceptive methods. The endometrium becomes atrophic and ulcerated because of a lack of estrogen and is prone to frequent, irregular bleeding.

http://www.aafp.org/afp/1999/1001/p1371.html

I hope this is helpful

Hurdity x

[zelda]

I too had a lot of breakthrough bleeding and and several scans etc but everything was o.k, it was just a hormone imbalance and my natural hormones breaking through, its very normal.

[Sarah2]

sonka- I think that at your age it's more likely that you are still producing your own hormones and that is what is causing the bleeding.

Are you menopausal or have you had blood tests which show it?

You may be finding that your own cycle is coming back now and then and overriding the HRT regime.