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[Dreamaway]

Hello forum, this is my first post and I would be so grateful for any help/suggestions anyone may have for me.  I am 61, been taking HRT for 8/9 years now.  Have tried to come off a couple of times (slowly) but always menopausal symptoms return and I eventually give up through loss of sleep, pain (it helps me with joint pains) and as I have low phosphate levels I feel it gives my bones some help!  A few years ago my dr switched me to Elleste Duet Conti which I was very happy on but being mindful of my age I had successfully reduced the dosage to 1mg each night and had been on that dosage for a couple of years.  Approx eighteen months ago I started to bleed and have basically been bleeding continually ever since. I have been referred to the local gynaecologist twice and have had two procedures, the last was definitely a Hysteroscopy, not sure what the first one was, but on both occasions biopsies were taken and polyps removed. Nothing sinister at all.  On my first visit the gynaecologist told me to keep taking HRT if I wanted to - he felt quality of life outweighed the dangers.  So I have continued but am still bleeding, even though I returned to the original dose of 2mg.  The gynae suggested the Mirena coil but I am not keen to go down this route and I have been offered no alternative or advice - in fact my doctor doesn't seem interested at all.  There seems to be nobody at my surgery who has any knowledge of hrt and no clinic in the area I can ask for a referral to.  Does anyone have a similar experience or any advice for me?  I am seeing my doctor this week and any insights from anyone here would be really helpful.
Many thanks for reading this. 

[Dreamaway]

Hi Stellajane, thanks for your reply and yes, constant bleeding is pretty awful - I suppose knowing that its nothing sinister causing it helps and I'm pretty sure its hormonal - just a matter of getting the hrt right I think??  I will talk to my doctor again this week - the least she can do is test my iron levels which I would think would be a little depleted by now!  I will keep you posted and thanks again for your reply.

[dazned]

Hi I think that 2mg is on the high side probably causing a build up which in turn could be causing all the bleeding. If it were me I would be looking to reduce my estrogen intake at that age.

[CLKD]

 

[Dreamaway]

Hi all and thank you for your insights and advice. Broke my 2mg tablet in half last night and will continue to do this until I figure out what to do - didn't realise this could actually be the cause.   StellaJane how do you take the separate progesterone - is that tablet form?  I think thats what the Mirena coil administers but I really don't fancy having a coil fitted and would much rather take it in tablet form.  And does your doctor prescribe the oestrogel or is that something you get yourself?   

[Hurdity]

Hi Dreamaway from me too.

Has the gynae suggested why the polyps are recurring or growing and isn't there a concern that they are re-growing if you are still bleeding? I don't know anything about them though!

If it isn't the recurring polyps causing the bleeding then as the others have said the progesterone/oestrogen balance is wrong and you cannot adjust it with combi HRT preparations - you need to take separate oestrogen and progestogens.

I agree with Stelljane a transdermal preparation is advised for older women like us (yes I am in my 60's too). I also have a long cycle HRT - usually every two months but sometimes a bit shorter if convenient. Also as she says if you have a cycle you get a predictable bleed. Some women shudder at the thought of bleeding in your 60's but you have to go with the best option for you overall - given all your symptoms and long term health benefits or implications.

All the oestrogen only preparations are here:

Transdermal ones are oestrogen patches or estrogel (scroll down).
http://www.menopausematters.co.uk/treatafter.php

...and the progestogens are here.
http://www.menopausematters.co.uk/to_progestogens.php

There are only two types - Provera a synthetic one and Utrogestan - which is taken orally but can sometimes be used vaginally if the side effects are problematic.

Many women swear by the Mirena. I wouldn't mind having something like that - the only reason I don't is because I only use bio-identical HRT and Mirena contains a synthetic progestogen - but it works well.

Once you have researched what you want to try then you should print off the info from this site and the links to take to your doctor if they haven't heard of them - they are all licensed and available on the NHS and they should prescribe it if you give valid reasons eg your age, wanting transdermal HRT, wanting separate oestrogen and progestogen so you can control bleeding etc

Have you checked whether there is a clinic in "Specialists" ( blue tabs at the very top of the page) - it is your right to be referred if they can't help you. I would have though most women should find there is one within 60 miles (well mine is a bit more than that and a couple of counties away but I've never asked for a referral!)?

Hope this helps and good luck

Hurdity x