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[oleva]

am posting because am really desperate for advice.  A year ago I started with the estradot patch 75 micrograms and taking two ultrogestan 100 capsules from day 1 - 12 of the month.  My consultant says this should have produced a chemical bleed on day 11 or 12 of the month.  Instead what's happened is that I have started having very very heavy periods that are now starting on day 28 or 29 of the month.  I have always had very heavy periods but these are terrible.  It is really difficult to leave the house bleeding like this.

To add to the misery I am due to go on holiday to Greece in the next few weeks with my son.  I have no idea what to do as my periods are likely to start while I am over there.  the last time I saw my consultant she said to just not take the ultrogestan tablets and I wouldn't have a period so at least Greece would be ok.  However since I saw her my periods are now starting before I take the ultrogestan each month so this wouldn't have any effect.

I know there is probably not much anyone can say to help but I wondered if anyone out there has experienced anything similar and has any advice at all.  Why is my body not responding to the Ultrogestan?  any advice would be appreciated.  I am so fed up with this.

[Dancinggirl]

Hi and welcome oleva
What you are describing is actually quite common when using Utrogstan for the progesterone - it isn't as stable as the synthetic progesterones and many of us get problematic bleeding.  The licensed dose for Utrogestan is actually 200mg for 12 days each month but some of us find this higher dose can give more side effects. 
I would definitely get back to the gynae or your GP about this bleeding as you should probably have a scan to check your womb lining - unlikely to be anything sinister but useful to know whether the lining is shedding properly or not.

You also don't tell us how old you are or at what stage you are in your menopause? What meno symptoms are you trying to control? If you are peri meno then your own hormones may well be effecting things.

If you want the bleeding to stop then you could try stopping all the HRT for about 4 weeks to see what happens, take this break after using Utrogestan for the 12 days then don't use the patches or Utro after that  - bleeding should stop after about 7 days and this might clear out the lining.  I would seek advice from the gynae about what to do next. It could be worth starting again after a 4 week break but use 200mg Utro for 12 days each month as your are using a high dose of oestrogen and this might prevent bleeding.

75mcg patch is actually quite a high dose and 100mg of Utrogestan is a low dose so may not be enough to ensure your womb lining sheds properly and this would cause the bleeding.  If you are peri meno then your own cycle could be over riding everything.
You may do better on Provera(medroxyprogesterone) or maybe consider having a Mirena fitted as this will usually stop and control all bleeding.
I have had problems using Utrogestan so really understand your problems - I am certainly no expert so my suggestions are based on my experience. Dg xxx

[oleva]

thank you so much for your reply.  i am just so fed up as the bleeding is frightening and I have no idea how I will cope in Greece.  I am 57 and unbelievably had not stopped my periods when I went on HRT.  I was still having regular periods but they were now every three months but like clockwork.   I was having terrible problems with flushing and sweating, nothing like any of my friends.  I had no sleep at all for two years.  I was determined not to take HRT but had to give in.  At first my doctor put me on only the patches and no ultrogestan.  These made me bleed one week on and one week off.  However, the bleeding was light but it was a nuisance.  I was then referred to the consultant who put me on a higher dose of oestragen as my flushes were still around.  I am taking two ultrogestan tablets each night when I take them which bring my dose up to 200 mg a day.  I'm just to worried as the holiday in Greece is a walking/snorkelling holiday and I have no idea how to do this when bleeding very badly.  They have done a scan of my womb and thankfully nothing is wrong.  It's just so nice to here that somebody else had similar problems. 
I hadn't thought of just stopping the HRT for a month.  Although I would have awful hot flushes at least hopefully I would be able to go to greece.
Thank so much for your reply.

[Dancinggirl]

oleva - it sounds to me as though your own hormones are still kicking in as well!!!!
You could have fibroids or polyps which would cause heavy bleeding - did they not do a scan to see what was going on?
A Mirena would definitely be a good option for you - I would see your GP and ask if one can be fitted as it would settle the bleeding gradually over a few weeks and you can use as much oestrogen as you like without the erratic and heavy bleeding.  Here is the link on this site that tells you about the Mirena - the info is at the bottom of the page.
DG x

[oleva]

thanks for your reply.  yes, you are probably right I think my own hormones are kicking in as well.  I don't have fibroids or polyps as the scan they did showed everything is ok.  have just made an emergency appointment with the doctor tonight so hopefully she will have something useful to say.  thanks once again

[Hurdity]

Hi oleva

I just looked back at your earlier posts and see you were put on oestrogen only patches for a while which caused more bleeding and then you were put on utrogestan. You also said you had a thickened lining. Do you know how thick it was and were you given any treatment for it?

If you weren't and it was thickened then it is likely that it is partly being shed from when you took oestrogen only - depending how long you took it for without progesterone. Also if you were still having periods at 57 as Dancinggirl says you will still have some hormonal activity which can cause unpredictable bleeding.

How do you feel on the progesterone? One possibility is to take 200 mg every day for a while rather than oestrogen only - because if your lining is thick it could equally break away spontaneously in the absence of progesterone, if it is still thickened? However it may also lead to withdrawal bleeding as it acts on the womb lining.

I also think a Mirena might be a good idea although if you are happy on utrogestan then why not carry on. As Dancinggirl says this dose is higher than the standard 50 mcg dose so maybe more problematic to give a predictable bleed as well?

Hurdity x

[oleva]

thank you for replying and taking the trouble to look at my earlier post.  everyone who replied really cheered me up then.  it turned out I didn't have a thickening of the lining of the womb.  the radiologist didn't know what she was talking about and was told off.  when I first went on the patches I was on a lower dose of oestrogen - 50 instead of 75.  I was bleeding every other week but it was light bleeding.  I was then put on the progesterone and the oestrogen put up to 75 which is when the very heavy bleeding started.  I have now just seen my doctor as cannot see the consultant till next week.  I said that somebody on this forum had suggested lower dose patches and she agreed!  she said if I stop dead then it is likely I will bleed anyway.  so am now back on 50 patches instead of 75.  she said that during the next week I could cut a bit off the patch so I get even less oestrogen.  I cannot believe how much trouble I have had on this.  If my hot flushes had not been so bad I would never have gone on it.  I just hope things get better.  Thank you all so much for your replies, at least I don't feel so on my own with it.