Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Chi chi]

I was on 3 pumps of oestrogel and after speaking with Prof Studd as I thought I wS maybe having too much oestrogel and it was overloading me, he told me to up it to 4 and to also increase my testim back to 1 tube a week instead of a fortnight so I did. The day after I had increased to 4 I felt even more anxious and jittery so I decided I would reduce down to 2, I've been on 2 now since Friday. Well this morning I have started bleeding and since yesterday I have the most painful back ache, thought it was from sanding my stairs??
I still haven't taken any Utrogestan since 1 september but I am going to try it vaginally starting on 1 November.

Why am I bleeding? Is it because I've reduced my oestrogel?

Thanks in advance 

[Hurdity]

Hi Estelle

I presume you are bleeding at the "wrong" time in your cycle?

There are a number of reasons for abnormal bleeding which need specialist help to diagnose - but some of the common ones are oestrogen withdrawal bleeding (reduction in oestrogen), progesterone breakthrough bleeding (too much progesterone compared to oestrogen) and oestrogen breakthrough bleeding (too much oestrogen compared to progesterone).

Here is some info I found:

"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."

DUB = dysfunctional uterine bleeding
http://www.aafp.org/afp/1999/1001/p1371.html

In your case it sounds as though it could be either reduction in oestrogen, or too much oestrogen without progesterone ( especially as you haven't had any since September).

Also when women become peri-menopaisal and are on HRT the cycle is artificially maintained by the added hormones, but underlying it your own cycle may be doing its own thing with all the internal fluctuations of your own hormones - so this can also cause abnormal bleeding. Still not sure if you are peri-menopausal??

Good luck with the Utrogestan!

Hurdity x

[Chi chi]

Thanks Hurdity,
This is the thing, I don't know if I'm peri or not? I don't know what my cycle is? Isn't it being controlled by all the hrt??
After reading your reply, I think your right, it's got to be either the reduction in oestrogel or because I haven't had any progesterone for a while.
So do I just carry on and see what happens and start the Utrogestan as planned in November?

Thanks again 

[Hurdity]

Hi Estelle

I'm not your gynae nor do I have medical training so I can't actually tell you what you should do. There should be a system in place for you to be able to e-mail/phone your specialist to dicuss this - but as you are not following his prescription ie you are reducing the oestrogel, this might be tricky.

However, personally I would always follow the course of progestogen prescribed - because the dose relates to the extra oestrogen you are having, and the amount of prog needed to oppose a given amount of oestrogen is dose dependent. The thing is it cannot do you any harm to continue with it, but you could have further problems if you didn't take it.

I think I've said before but I can't remember - I thought you were put onto oestrogen because of hormone responsive depression and this was happening in your normal cycle, ie that you had low oestrogen anyway that wasn't necessarily to do with menopause? I wasn't sure whether you first sought help with Prof Studd because you were getting peri-menopausal symptoms ie your periods had become a bit irregular and you had other menopausal symptoms as well?

Hurdity x

[Chi chi]

Well I originally saw Studd to see if my depression, anxiety, loss of libido, aches and pains etc were a hormonal problem. AD's haven't worked so this was my next step really.
He discovered my estrogen was on the lower side of normal and my testosterone was very low along with low Vit D, also oestioporatic in one of my hips.
I'd been on the mini pill (and mirena prior) to seeing him so wasn't having periods.

I realise you can't diagnose but am always interested in hearing your views as you are a wealth of information 

Thanks again

[Cassie]

Estelle this is exactly what happened to me on the Oestrogel...2 reasons for it. By tampering with the oestrogel dosage, you have induced a bleed. I cannot even forget it for one night and I bleed and secondly you need to take Utrogestan more regularly. I was breakthrough bleeding like this as Hurdity says one needs to get the balance. I tried all sorts of regimes in order to avoid taking the Utrogestan regularly and it just resulted in bleeding when one shouldnt, most annoying. 3 pumps is quite heavy for no Utrogestan, may I ask why you are not taking it regularly was this his suggestion? I would start the Utrogestan now as that will curb the bleeding and then try to take it on a monthly cycle, I use 100mg for 12 days a month and get a regular bleed. Did he scan your uterus to see how thick the lining was? 2 pumps should be ok, that is the standard dosage..good luck and let us know how you get on...

[Chi chi]

Hi Cassie,
I was supposed to take the Utrogestan every month for seven days, my first round was back in sep, a couple of days into starting it my mood seemed to drop quite drastically (hasn't really improved since)! And I was very wary of having to go through that every month  I'd initially been doing really really well before starting the Utrogestan. Studd said I was prog intolorant and that's the reason why I felt bad on it and said to skip October and try again (vaginally) in November.
I don't really know if I am prog intolorant? I have lots of low prog symptoms and wondered if I was actually becoming estrogen dominant??
Prof Studd has said I should consider having a hysterectomy, I'm not against it as I have 2 daughters and don't plan any more but would like to be 100% sure that I would be doing it for the right reasons? I.e. Prog intolorant 

[Cassie]

Its quite a drastic step but yes I guess if the Utro isnt agreeing with one.. I def found that taking it every other month and not regularly caused breakthrough bleeding in my case and also only taking 100mg for 7 days a mth didnt work either, touch wood, the 12 days per month seems to be doing the trick, am seeing my gynae next week for scan so will see what the uterus is looking like on that dosage...