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[Cheshirejill]

I'm new to this post as I'm getting desperate for advice and doctor isn't at all helpful!

I have been put on HRT since having hot flushes keeping me awake all night and vaginal dryness. I have always had regular and heavy periods, which in the past 10 years have got worse, lasting for up to 8 days and three days each month when I dare not venture out because of flooding, despite using both tampons and nighttime pads..

I saw my doctor this month to say that I am still having flushes at night causing sleep disturbance and was fed up with the periods (I'm 57 next month and keep wondering when it will stop!) She said I won't stop periods whilst on HRT (which I need for the other symptoms) so has suggested I come off HRT to see if my periods stop. I have just had a period last week so it will be 3 weeks before I will see if any changes happen, but I'm concerned about the hot flushes and dryness returning.
Is there any HRT that doesn't give a period?

[Limpy]

Yep - Evorel Conti patches, think there may be another conti one femoston (sp?) but not sure.

Perhaps try menu on left for more info?

Sorry to be so brief but got to dash

Welcome to the forum BTW 

[sweatybet]

Hi cheshirejill

You will see from the information below that you can ask for bleed free HRT. This is from the green menu 'HRT preparations' post meno on the left.

WHY & WHEN TO CONSIDER CONTINUOUS COMBINED THERAPY

Why?

No physiological reason for menstrual bleeds if can be avoided.
Most women prefer a no-period option.
Cheaper for patient - one prescription charge instead of the two for sequential combined therapy.
Thought to be less risk of endometrial hyperplasia (thickening of the womb lining) in long term with continuous combined compared to sequential therapy.
When?

Patient known to be post-menopausal at whatever age, ideally by having at least one year of amenorrhoea (no periods).
If sequential therapy started while still having periods, wait till age 54 years. At 54 years 80% of women will have cessation of ovarian function and are likely to settle on continuous combined (period-free) therapy.
Change from sequential to continuous combined by finishing current sequential pack and start new therapy at the end of the expected bleed.

Take this info to the GP along with a suggestion of which HRT you want to try and see if they will change it for you. If not ask for a referral to a Consultant.

Good luck SB

[Hurdity]

Hi Cheshirejill from me too.

Sorry to hear about your symptoms and ongoing heavy periods, and I presume you have only just been put on HRT so still having natural periods at age 57?

Firslty you are on the extreme end of the age to still be having natural periods (well someone has to be) but I say this just to make sure your doc has checked you out for possible fibroids or similar which might be causing the heavy bleeding - although these tend to shrink after menopause?

My view as a non-medic would be:

First get your womb lining checked out. Then if there is nothing amiss but your periods are still heavy then maybe ask for a Mirena coil - which releases continuous progestogen to keep the lining thin and will often stop the bleeding after 6-9 months.

Your doc is right that you have been put on a cyclical HRT (ie to give a bleed) - because your periods have not stopped for a year. Women who haven't had a period for 12 months ( or reach age 54 having been on cyclical HRT for a while) are put onto conti HRT, as most women are assumed to be post meno-pausal by then. A proportion - like you - continue after that.

If you have a Mirena coil, you will then be able to add oestrogen (which will stop the flushes and sweats).

Make sure that even if you stop HRT you use a vaginal oestrogen (listed here: http://www.menopausematters.co.uk/local.php) to help with the dryness.

How long is the doc suggesting you stop HRT anyway - if you've only just gone on it you really don't want to wait a whole year to see if they've stopped?!

Hope this helps

In haste!

Hurdity x

[Dancinggirl]

Hi and welcome Cheshirejill
You obviously went on HRT whilst still peri meno so had to have a sequential HRT which gives withdrawal bleeds. You don't tell us which HRT you take?
Limpy is right, you could probably change to a continuous HRT which would mean the bleeds would stop completely (you get some bleeding fro the first few weeks or even months) - At 57 you are probably well in to post meno.  The GP may want you to have a break from HRT for a couple of months to then do a blood test to check oestrogen and FSH levels to confirm you are post meno.
An alternative that may suit you would be to have a Mirena fitted and then you could use oestrogen in weather gel or patch form which means you can adjust the amount of oestrogen you use to control symptoms.
Do read up all the info under the headings to the left of this screen to get really clued up.  DG x
PS Hurdity has got in before me with some great advice - she is very knowledgeable.
Get back to us with more questions .

[sweatybet]

Cheshirejill I reiterate at 56 you could have gone on to period free HRT at 54, regardless of whether you were still having periods. 

SB

[Cheshirejill]

Thank you all for your very helpful advice. To fill in the blanks.. I went on hrt 2yrs ago (femoston 1/10). My doctor advised me to come off slowly, I.e. One pill every three days and see her again in 6 weeks. I have had my fibroids checked about 10yrs ago, they were large but not big enough for consultant to worry he prescribed some tablets to make the blood clot more which I had to take before a period. I don't take it anymore as it clots anyway and I'm rubbish at remembering to take tablets!
As my husband has had a vasectomy after my emergency caesarean and elective caesarean births I don't think the coil will have any benefit for me
I was advised by a rather brutal private gynagologist about 3yrs ago to just 'whip it all out - you don't need it' - my husband was alarmed at her attitude and we decided to hang on to see if my periods would stop but sadly they are not.
My friend who is 4 yrs younger than me went onto hrt around the same time as me and just has one 'bleed' day a month lucky  girl!
 

[Dancinggirl]

Hi cheshirejil
If I were you I would definitely change to a continuous HRT - Femoston comes in a conti form.
Don't rule out having a Mirena fitted - it isn't just for contraceptive use - it is often given to women with heavy bleeding through peri and into post meno.  I had one fitted post meno because I didn't get on with any of the other conti HRT options.  The breakthrough bleeding reduced very quickly and by 3-5 months had stopped completely.  I used Oestrogel (around 2 pumps per day) to give me the oestrogen I needed to control my flushes etc.
Good luck  DG x

[Hurdity]

Hi again Cheshirejill

I agree with Dancinggirl: as you started cyclical HRT 2 years ago at age 54 (presumably) - which was the right method if you were still having periods even though you were around 54 - then you should be able to go onto conti HRT now. (I started HRT at this age but as it was only 5 months since previous period I wasn't post-meno so was put onto cyclical HRT ie with a bleed. My bleeds were never heavy though).

However I am surprised that you are getting heavy bleeds on Femoston 1/10 which is a weak dose especially if you are post-meno.

I would urge you to go to your doc and ask for a referral,  to check your fibroids cheked by a gynae - regardless of whether or not you stop HRT.  if they were large 10 years ago then they could easily have grown in that time, as oestrogen promotes their growth. If you want HRT for symptom control, but it affects the fibroids then you will need to discuss your options with a specialist.

It is possible to take HRT with fibroids with a Mirena coil - here's what it says in the A-Z of health conditions ( (blue menu on left)


Fibroids   
    Fibroids are benign smooth muscle tumours of the uterine (womb) wall and are dependant on estrogen. They tend to shrink after the menopause but shrinkage may not occur, or they may even increase in size with HRT use. Increase is thought to occur in 25% of HRT users and mainly occurs in the first six months of therapy. There is some evidence that transdermal (patch or gel) but not tablet HRT nor tibolone may promote fibroid growth. [ref 24] Fibroid size can be monitored by regular examinations and sometimes by ultrasound scans. There is some evidence that the use of the progestogen releasing intra-uterine system, Mirena may cause fibroids to reduce in size. Mirena is often used in the perimenopause by women who have heavy periods and/or require contraception and can provide the progestogen part of their HRT.

Hope this helps

Hurdity x

[Cheshirejill]

This is my first time using a forum for advice and I am so impressed with the kindness and wisdom of the  advisors on this web site!
Thank you, I was going round in circles and I should have come here first. I will certainly be speaking to my doctor with a bit more knowledge now, and hopefully I will get sorted out. I will keep you posted! X