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[Dediva Ann]

Hello again ladies

I am on my first pack of Elleste Duet 1mg.  I felt fabulous on the Oestrogen only pills but as soon as I started the combined Progesterone / Oestrogen green pills everything changed. SO MANY horrible side effects - especially gastric!  I know I need to persevere for three months to give it a fair trial and I intend to do so but I have a more immediate query if you might be able to help.  I have been bleeding non stop since I started the Progesterone ten days ago (never ever had such a long bleed before. Ugh!) My partner is home for one night only in three whole months on Thursday.  I was hoping I'd be Oestrogen fabulous and period free but it's not looking good since I don't start on Oestrogen only again until Thursday. I know it's not advisable to do so but would it really do me any harm if I skipped my last two green pills and pretended Tuesday was Thursday?! (i.e. start back on white pills tomorrow?) And if I did this, is there any hope it would help the bleeding to stop in time for Thursday night?! Thank you. Slightly desperate Dediva 

[Dediva Ann]

Thanks so much for replying StellaJane   I didn't know that you normally bled after taking the progesterone - I must be atypical I guess.  I did speak to my GP yesterday and he said I must persevere with it and he couldn't authorise skipping two doses.  So I have been umming and ahhing about it - but actually last night after I posted this I started bleeding so heavily, like I never have in my life and felt sooooo drained and crazy suicidal.  I have a psychiatric history so it may not be related to the progesterone at all but these feelings came out of the blue and were really quite terrifying so this morning I decided that even if it doesn't stop the bleeding I just can't take the risk of taking another green tablet.  My GP is insistent that I do three months of this but I am not prepared to put myself through this anymore.  It may be that they then refuse me HRT which makes me feel pretty bleak.   i am so grateful to you for replying xx

[Clovie]

Your doctor sounds inhumnan!!!!!!

I too reacted similarly to you, mood wise, when I was first given synthetic progesterone. I was in such a state my hubby phoned the GP and she phoned me back within half hour. I explained how bad I felt after only 5 tablets and she told me to just STOP them immediately.

If I was you I'd stop them (that's just what I'd do though!) as you know yourself if you feel the prog is affecting your moods, probably moreso if you have had psychiatric issues. After my experience above I went on to try long cycle HRT (3 months of oestrogen and then the prog) I was only 48 so common sense tells me to go 3 months without prog is seen as OK, so leaving 2 tablets out ought to be no problem. Unfortunately this also contained synthetic prog so was also intolerable. I was then given Utrogestan.

I'd see another doctor and ask to try utrogestan for your prog element of HRT.  Utrogestan works much better for some of us ladies who are prog intolerant as it is bio-identical. It's not perfect - but it's better, I find.

Also, I always bleed before I finish my prog course. Always have. I was told it isn't a problem and likely because I have my own hormones still kicking about in there.

Good luck!

[Lizab]

I would probably umm and shhh over it and still take the pills, because I'm crazy about following the rules. But, I think it would be fine to skip. Here's my reasoning: you have only been on one pack. That's not a huge amount time for estrogen to build up and cause any harm. Plus, if you're already bleeding well, the progesterone (whether your own or fem the hrt) has already done it's job and you're shedding the lining.
Now, for my experience: I'm on a different progesterone, but my first time on it I bled at least a week and I know I woke one morning absolutely soaked. I thought there's no way I can stay on it if it makes heavy bleeds like that. I hadn't had a period in a few months then, so that may have been part of it. Several months into it and my bleeds are no longer heavy. Also, my first 3 months I bled before I finished the progesterone. I also had to use heat and ibuprofen I was cramping so badly in my lower back.
This last month is the first time I didn't start bleeding until I stopped the progesterone. I had no cramping and my bleed was reasonable. I had made a change increasing my estrogen dosage. I don't know if that is the reason my period held off or if my body has adjusted.
So take that for what it's worth. I think you could probably jump ahead to the estrogen only for now and then see how it goes next month.

[Taz2]

It's worth giving it a go although it is usually stopping the progesterone which starts the bleed so I don't know where you stand if you are already bleeding and them stop the progesterone.

Taz x 

[Hurdity]

Hi there - as has been said when and if you start and stop bleeding when on HRT and peri-menopausal is anyone's guess. However I would suggest the opposite. Progestogens are normally given to control bleeding - so normally I would carry on taking them - for the normal length of time. If you are peri then the lining could have built up quite a bit anyway if you have had longer cycles at all, so the progestogen is just helping to shed what may be quite a thick lining? Women often bleed heavily when first starting HRT especially if peri-menopausal for this reason. Eventually in later cycles it should calm down (if the progestogen is sufficent). Whether or not you continue with the tabs - you may still be bleeding and in this short timescale even if you took extra norethisterone (which is sometimes given to control heavy bleeding) you may well still be bleeding. To me that would be the only way to stop the bleeding - go to the doc and ask for a high dose of norethisterone - but they may not give it to you, it is unlikely to work that quickly, and the progestogen may make you feel rough anyway - and especially if it is causing your mental symptoms. Sorry if that sounds garbled! Might I suggest other ways to - er - enjoy his visit if you can...... 

Hurdity x

[Dediva Ann]

You are such a lovely lot    Thanks for all your replies.  Brief update:  So I did break the rules (I am like you Lizab so it was a big deal) and stopped the progesterone two days earlier than I am supposed and so started the second month of oestrogen only today.  The heavy bleeding continues (but has been helped a bit with tranexamic acid) but the completely crazy suicidal symptoms I was experiencing 24/7 ago have thankfully abated.  I felt like I had been completely derailed yesterday and it was incredibly scary and not something I ever want to repeat. My BP also went sky high (I have been checking it daily) but has come back down to my normal now.  My GP is lovely Clovie but I think he may be out of his depth on this (he usually has a huge willingness to think outside the box on most matters but perhaps menopause is not really his area) and is also governed by expense and the CCG's guideline.   I am going to try and see the lady GP in the hope she will have some more sympathy and flexibility on HRT options.  I am only 48 Clovie and what you did sounds ideal. Three months of oestrogen only would be heaven!  Of course it may not work for me but I am going to mention your experience when I see the lady GP and definitely ask for utrogestan.  I am pleased to hear your bleeding etc eventually settled on your progesterone Lizab.  I was willing to tolerate the days of diarrhoea, stomach cramps, painful breasts, boils etc etc, even the heavy bleed... but not that extreme dangerous swing in my mood.   I am peri and this is all a steep learning curve for me Hurdity and Taz2. Your explanation makes a lot of sense given that prior to starting HRT I was having longer cycles and thus why I have been bleeding so heavily. 


So Thursday's activities are now in the hands of the gods!!


Bottom line is I know I really can't take anymore of the norethisterone which is in the Elleste Duet. 

[Dediva Ann]

Just a brief update: I managed to speak to the lady GP on the phone today and she completely understood that trying to continue with the northisterone was intolerable for me and so has switched me to Femoston.  Everything crossed this will be the HRT for me 

[Hurdity]

Good luck with that Dediva Ann! What dose have you been given?

Hurdity x

[Dediva Ann]

Thanks Hurdity I've not collected the prescription yet but the GP said it would be 1mg of oestradial. She didn't say what the progesterone would be.  Do you or other ladies have any experience of Femoston? The GP said all oral progesterones are synthetic? X

[Dediva Ann]

PS. Apparently there are supply issues with the one she ideally wanted to try me on.