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[Briony]

Just wondered if anyone is under 50,  still  having periods,  and taking HRT continuously? Is it true you can take 100mcg for 26 days to avoid the progesterone dip some people get with it when taken cyclically?

I can never understand why GPs wont prescribe continuous HRT for younger ladies, yet are happy to prescribe the combined pill (back to back even).

Would be interested to hear your experiences.
 
Thanks, B

[dazned]

As far as I'm aware you only get prescribed continuous hrt when you are period free for 12 months or 54 years over ,according the hrt leaflets. 

[Poppyflower]

Hi Briony,

I have just had my specialist appointment and asked that very same question. I was informed that it is an option I could consider even though I am perimenopause, however bleeding would be very erratic. I have decided to stick it out with my patch for now, 75 estradot and not take any progesterone as I am having a bleed that is a normal amount every 23-25 days. I have made the agreement with my specialist that if a bleed does not happen I will take my prometrium. She is not sure if my bleed is from ovulating or not, and wants me to use ovulation test kit for 2 months to see if I get a LH surge which would tell if you are ovulating and therefore are in need of progesterone or not. Also am considering going back to birth control as do not know how long I can take the mental symptoms of this perimenopause journey. Can not stand having the mental symptoms and personally if they could be gone would gladly switch for erratic bleeding or hot flushes/sweats!!!!!

[HappenstanceMarmite]

Yes I too would like to know why back to back birth control to avoid bleeds is ok, but not with HRT.

[Hurdity]

Briony

You can take 100 mcg Utrogestan for 25 days out of 28. This is classed as continuous combined but actually it isn't because of the 3 day break. This would enable a bleed to happen if lining had built up, and also if you are still peri-menopausal. I expect if you are still peri and have a storng cycle you would maybe also get break-through bleeding at other times. I am sure there are women on here who do this (jedigirl maybe?) as it may also prevent such a heavy bleed?

Poppyflower - it is not advisable to take oestrogen without additional progesterone - especially a 75 mcg dose - is this what your gynae has advised and are you in UK? This can lead to build-up of the endometrium. In your case, if you are considering it and are still young, it would perhaps be better to go back to birth control and there is a bio-identical one called Qlaira (contains estradiol and synthetic progestogen).

Hurdity x

[honeybun]

I started conti HRT at about 52 due to breakthrough bleeding on sequi. It took about 6 months to settle as I had a bit of spotting on and off during that time.

I have no idea where I was with regards to being period free for a year but I checked with Dr Currie and she said it was perfectly safe to use a conti under 54.


Honeyb
x

[Briony]

Thanks - really appreciate this. Am going to print it off and show GP next time I go.

Have been feeling fantastic on Qlaira for 7 months and now suddenly seem to have gone backwards - severe headaches, crashing fatigue and last night, so much sweat my OH thought I'd peed the bed.  It's day 16 of 28 so it's not even like it's the pill free phase. Now feeling really down - though not sure if that's hormonal or simply the thought of going back to where I was before          Interestingly, had first ever 'blip' during the two pill free days last month too - headache and tears. Never happened before.

Any higher dose of pill worries me as I am such a high risk already. Loved taking Utrogestan but suffered badly when I stopped taking it, hence reason, if I go back to HRT,  I would love to take a lower dose for longer like Hurdity mentions. I would love to know what dose of patch (or gel) is equivalent to 2mg of estrogen in Qlaira? I was on 50mcg patches which didnt really help - always feel best when on the 3mg pills.

[jedigirl]

Hi Briony
I am 45, perimenopause and I take 100mg Utrogestan for 25 out of 28 days. I also use two pumps Estragel. I was having awful dips in my cycle when on two weeks oestrogen only, then two weeks combined. I was suffering weeks of nausea and anxiety attacks to the point where I couldn't eat for days and my weight fell drastically.
I find this way gives me a steadier level of hormones and mostly feel much better. As Hurdity said I do get some break through bleeding but it is light. I'm not saying it has solved all my problems but is the best regime I've found so far for me. I was at a menopause clinic two months ago and the consultant was happy for me to stay on this.
Hurdity you actually made me bawl remembering me! You're amazing to retain such details.
Good luck Briony, I will happily answer any questions I can xxx

[Briony]

V grateful to you all, especially Hurdity and Jedigirl!
 Will print this out and take this with me. Jedigirl, do you know roughly what pill or patch 2 pumps equates to? I take 2mg of estrogen daily in pill form and wouldn't want to be on a dose less  than this. I want to go to doc well armed as whenever I am in there I seem to forget everything! x

[jedigirl]

Hi Briony,
My Oestrogel states each metered dose (1 pump) contains 0.75mg of estradiol. I'm not sure if the doses match up though as the topical route may deliver a more efficient absorbency than a pill. Maybe Hurdity can advise?
x

[Hurdity]

Hi there



You're right jedigirl the doses don't match up - the amount of estradiol in the gel is the total amount in that dose but not the same as the amount delivered into the system. Patches will have a total amount on them but they are labelled according to the amount delivered ie 25 mcg per day etc. The actual patch contains way more than this!  Remember 1 mg = 1000 mcg so 0.75 mg = 750 mcg.

The info on this site gives low medium and high doses which is a very rough guide to equivalence. However there is great variability between individuals in how they respond to the each delivery method but in general transdermal (patches especially I understand) will give a more consistent dose. If 50 mcg was not doing it for you Briony then I would suggest trying 75 mcg at this point if you are thinking of going back to patches, and if after a few months this doesn't work then increase to 100 mcg with the support of your doc/gynae!

There is also some info on the link here but the products are American (although there are UK equivalents) http://portal.mah.harvard.edu/cms/content/B7ACBE692D3340DD9CD308883BC9750B/C8FBA664C44E4E9797A5069E4A8FF7F4.pdf  The introduction says "Blood levels of hormones are less variable for topical products than for oral products in individual patients, although there's still a lot of variability in general between patients."

Hurdity x

[GypsyRoseLee]

So sorry you're feeling rough at the moment. Just when you think you have reached a safe haven (hormonally) it bites you on the ass.

I don't know either, why it's fine (even advised) to take the Pill continuously to control mood swings and PMS. Yet you aren't advised to take HRT continuously even though it's weaker than HRT.

My GP actually recommended I took my packs of the Pill back to back, with no break.

[Briony]

Thanks again to you all. I have made an apt to see doc, but in two minds about what to do - have had two blips but neither lasted more than a few days. Maybe too high expectations?

[Nina]

I am 43 and take utro 25 days. One month I forgot the break and just continued! Also use 3 pumps oestrogel. I have had one break through bleed in 6 months. I had erratic bleeding pre hrt. Just off to bed sorry for short reply!

Oh and changed to conti because had too many ups and downs on sequi, am much more stable now. On patient.co.uk it states that if you've been on hrt for a year then you can move to conti despite being under 50.

I'll be back tomorrow nighty night

[jedigirl]

Hi all,
I feel i should add to this thread this morning as I am considering my options re the 1-25 day Utrogestan. When I started in March it was to steady the rollercoaster of hormones as I seemed to be suffering badly every time I came off progesterone.
After attending a menopause clinic two months ago I was asked to chart my bleeds and they're all over the place since starting this regime. I was still having periods before so I think my own cycle is still battling underneath. I've just started another bleed after just finishing 11 days ago. I don't know if this is my hormones or the HRT causing the erratic bleeding. I'm not feeling that great either, better than before I went on HRt but not right.My doctor didn't seem overly concerned except to test my iron levels.
I am back at menopause clinic on Wednesday next week so will be seeking advise. Last time she advised me to up my Utrogestan to 200mg but I only tried it for two nights and felt hideous. 
Just wanted to add this as not many others seem to be on this regime so wanted to add my experience.
jedigirl x