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[PollyH]

Hi All

I haven't posted for a while - I have the busiest year ever helping bring up my grandson.

Here goes - I'm 51 post menopause and have been on and off HRT for 10 years. I am progesterone intolerant and have exhausted all options and have had a difficult time with it all. I came off HRT last September as I was so ill on and off with the progestogens and ended up taking VR at work last November. I was lucky this came up as my daughter was due a baby the same month and I was worried that I wouldn't be able to cope with work because she moved to Leicester - nearly three hours drive away - so it meant I could concentrate on her. All went well and Teddie was born 17th November. I travelled to and from Leicester - she stayed at Xmas for two weeks and struggled on without HRT.
She then had to move in with us at the end of Feb as her house was a building site and ended up staying until August this year. I was blessed seeing my grandson and my plan for having mirena coil went on hold.

I eventually had the mirena coil fitted together with 2 pumps of estrogel at the end July and lasted 6
weeks and had to have it removed. I was advised to go down to 1 pump for two weeks and then to come off the gel. I did have a bleed two days after the coil was removed and lasted for three days quite heavy. Then my daughter rang to say a wall was being knocked down and could she come home for two weeks. So I had to stay on 1 pump as I wanted to be able to cope. My daughter went home and I started to feel not right like I needed a bleed so decided to take Utrogestan vaginally but only managed two as I felt so ill and had terrible thoughts. So stopped it but NO BLEED. So feel messed up now - and have been on the estrogel for six weeks. I saw the specialist Tuesday this week and told him about the utrogestan. He said I can come off the estrogel and he was 99% sure I woul have a bleed. Is this right ? I didn't bleed with two utrogestan which I normally do so how will I without any.

Any advice would be appreciated - we also talked about hysterectomy but he's not too keen as can cause other problems. He wants to scan me as well so waiting for an appointment so sick of this meno as many many of you are.

Kind regards
PollyH

[Hurdity]

Oh dear PollyH - so sorry to hear about all your problems with bleeding and HRT - but congratulations on your grandson - that must have been lovely for you

Yes it does sound confusing. Two days is not enough progesterone to cause a proper bleed and ensure that it is shed unless you still have progesterone of your own. It is good that you are being offered a scan - you will want to see how thick the lining as as you have had a variety of treatments. Whether or not you get a bleed when you stop estrogel I would have thought would be hard to predict. That type of bleeding would be called "Oestrogen withdrawal bleeding" and would indicate your lining had thickened - as I understand it, and only the correct dose of progesterone for the right length of time will ensure that all the lining comes away after it is withdrawn.

I am very surprised that you would have a proper bleed after only 2 utrogestan per month - but perhaps you are not quite post-menopause and were still ovulating?

I'm sorry I can't give you any advice except would it be possible to take HRT on a longer cycle, and stick to one pump? eg take utrogestan every 6-8 weeks? If you look at Stellajane's current thread on utrogestan I posted about what I've done to minimise systemic effects through vaginal use - plumping up with vagifem beforehand ie increased dose, and then building up the progesterone slowly - 100 mg then 200 mg and then reducing. It may be a one-off but seemed to work this month.

By the way why have you been asked to come off the Estrogel - is this before you have a scan? You may well experience a resumption of menopause symptoms though....

Hurdity x

[Dancinggirl]

PollyH - I know it sounds strange but when I stopped oestrogen, I still got a week of bleeding even though I hadn't done the Utrogestan.  Not sure why!!!  I would just stop the oestrogel and see what happens. If you don't get a proper bleed then you may need to get the womb lining scanned to be on the safe side. DG x

[Mary G]

PollyH, congratulations on becoming a grandmother!

It sounds as though you are like me i.e. you should really have a hysterectomy but struggle on in the hope of progesterone substitute. 

I only became intolerant to synthetic progesterone and Utrogestan post menopause, I didn't have problems pre-menopause and had a Mirena coil for quite a few years but as soon as my own hormone levels dropped, my body decided to reject all forms of artificial progesterone including the Mirena coil which I eventually had removed.

It's a difficult one.  If you can't tolerate artificial progesterone there is not much you can do about it other than severely limit its use.  Will your gynaecologist allow you to simply stop using the gel every 6 weeks (for example) have a bleed (which should happen each time you stop the gel) and then start the gel again once the bleed stops?  You would have to have regular scans but I did read about this method being used in very extreme cases while a hysterectomy is being considered. 

I had a proper bleed one month after only taking just 1 x 100mg Utrogestan capsule vaginally.  After just one capsule, I had a migraine and thought "sod this for a game of soldiers" and ditched out and I had a normal period 6 days later.  Same has happened with 2,3,4,5 & 6 100mg capsules - yes, I've had to ditch out due to migraines many times but regular scans have shown a 2mm lining measurement.  Obviously this will not be the same for everyone but it does show how some women can get away with less Utrogestan and if you are one of them, perhaps your gynaecologist will work with you and let you take the barest minimum?  It has to be worth a try.

[PollyH]

Thank you all so much for your replies.

You have all given me some different options.

I am going to stop estrogel tonight as I have to do something as I can't stay on HRT because I am too ill on the progestogen. I need to get back to work. My only worry is if I stop and I don't get a bleed what do I do then. Will I still have the same symptoms ie. Feel like I need a bleed but then it will be too late to take utrogestan because I will have stopped the Estrogel.

Just hope I get a bleed. Then I'll think again.

I'll keep you posted.

Thanks again so much

PollyH
Xx

[Dancinggirl]

If you don't get a bleed then you need to have a scan which your gynae has already suggested anyway.
Once you stop the Oestrogel I suspect you will start to feel better within a week.  Sometimes taking a break is the best option or you never know whether it's the HRT causing the problem or something else. DG x

[PollyH]

Hi all

Day 2 of no estrogel - felt ok yesterday   surprisingly but today I'm soooo tired- can't be bothered with anything - had a few backache pains but don't really feel like I'm gonna have a bleed yet or is it too early? Feel like. I could just go bak to bed.

I have to wait until 16th November for ultrasound scan - what if I don't have a bleed and my lining has built up how will  i shed it without being on any progestogen. Have a feeling this won't work. My lining seems to build up quickly but how do you know what thickness it should for each person to feel ok. I think mine needs to be less than 3mm.

Should I go bak on estrogel until my scan on 16th November even though I know I will have to take some form of progestogen to shed the lining at some point.

Maybe it's not good to come of estrogel if you think the lining needs shedding . Hope it all makes sense to somebody .

PollyH xxx

PollyH

[Dancinggirl]

PollyH - it's too early to tell whether you will get a bleed or not - don't start using oestrogel again.  The whole point of the scan is to look at the womb lining and they will advice you after that.  Mid November will be perfect for the scan - if you get a proper bleed in the mean time then great but if you don't then the scan may throw some light on what is going on.  It's quite normal to get some fatigue etc. after stopping the Oestrogel and if you were to continue with the Oestrogel you would just build the lining up more.  Stay positive. 
Utrogestan is clearly not good for you so a break from HRT generally is probably good.  If you do decide to try HRt again then maybe consider a Mirena or a different progesterone e.g. Provera.  DG x

[Mary G]

PollyH, when I had my Mirena coil removed and when I stopped taking Angeliq, it took 6 days for my period to arrive.  I still had some residual oestrogen in my system on both occasions and had another period 4 weeks later without taking any hormones but then they stopped completely. 

So I would leave it, wait for the period and then have the scan as arranged.  Am I right in thinking that you have now exhausted all possibilities progesterone wise and you literally can't take any full stop? 

 

[PollyH]

H all

Thank you so much for all your replies. Sorry I didn't get back sooner as I had to go to Leicester again last Tuesday till Friday night. It is day 9 since stopping estrogel - NO BLEED - even though the specialist said he was 99% sure that I would. I knew this would happen. I am very up and down, weepy, period like back pain on and off  - bit depressed and de-motivated. I do feel like I need a bleed. My ultrasound scan is on 15th November.

What will he do if my lining has built up - will he advise me to,take utrogestan to shed it. Wish it was all sorted. I know I'm gonna have to have a bleed I can feel it. Shall I take utrogestan now - can u have it on its own.

I should have followed my instincts - cus last year wen I came off it seemed much better - and I think its because I had a bleed and then stopped the estrogel. Hope somebody can understand what I am trying to say.

Any thoughts woul be really appreciated - also felt bit shaky this morning.


Kind regards
PollyH xxx

[CLKD]

  ……… bet Teddie grows every day!

Maybe make a list of symptoms to the appt.?  Jot down what you would like to deal with first and discuss how to combat those symptoms?

Let us know how you get on!

[PollyH]

Hi and thank you again for your replies - I hear what your saying Stellajane about the utrogestan - what about if I try Provera - I woke this morning at 5am with terrible pain in back and womb so my body is trying but needs a little push for it the bleed to happen. Don't think I can cope like this for two weeks - I've got my grandsons 1st birthday 19th November and my daughter is coming home for it to stay with us and I'm doing the party for family and close friends of hers. At this moment I feel like I will not be able to cope.

I am seeing the GP on Wednesday don't know whether to ask him for something for me to bleed - seems more complicated now I'm off estrogel. I have tried all progestogens but can't remember whether I've tried Provera.

Thank you all again
PollyH xxxx

[Hurdity]

If you want to have finished the course of progestogens and to have had a bleed before 19th November (or even 15th) you would need to get on with it. The thing is you don't want a scan half-way through the progestogen course - and it would be best to take the dose for at least 10 days. In that case it would be best to have a scan immediately following the bleed, so we're talking about at least 17 days before a bleed might finish (10 days prog + 2 to wait for bleed + 5 for bleed). Otherwise you might as well wait as others have said and see what the lining is doing in the absence of prog. The other alternative is to take a course of prog and delay the scan for a week if you can. The pain also may well be the sign that a bleed is going to start....

Hurdity x

[PollyH]

Thanks Hurdity for your reply - I see what you mean about the scan and timescales. It's the dreaded utrogestan that scares me and didn't know whether to try  Provera or see if I can get a cancellation to see the specialist this week. What is confusing me is the fact that I am not on estrogel (10 days now) and if I leave it and wait for the scan and then a follow up appointment which will probably be two weeks after then it's gonna be six weeks off estrogel - and if the scan has a womb lining build up can take progesterone without estrogen having been off for six weeks.

Altogether I have had six weeks of 1 pump of estrogel and in my beginning post I tried utrogestan but only managed two ( after four weeks of estrogel - but it didn't shed like it normally does). Hope I'm not confusing everyone - I can only explain how I feel just wish I could bleed  and I would feel better -  don't even want to go out today.

So sorry to moan
Kind regards
PollyH xxx

[Dancinggirl]

PollyH - I'm not sure why you are so worried about being without the Oestrogel??  If you are not using oestrogen then the womb lining won't build up further unless you are peri meno and still producing oestrogen yourself. I also wouldn't worry about using Utrogstan again - this clearly doesn't suit you so an alternative needs to be tried.  In the mean time, I know you feel as though you need a bleed but not having a bleed right now is not important.  Just write down all your concerns and questions so when you see your gynae or doctor you can discuss your options and the best way forward in a positive way.  I feel you very over anxious right now - so don't over think everything, try to relax - take some pain killers for the cramps if need be. ARe the flushes and night sweats bad right now? When you have had the scan then the whole situation can be reassessed.  If HRT is really not going to work for you then you may need to look at other options.  DG x