Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Alypoole]

I have been on Ellesse Duet since April 2016. I feel better on it and my libido has returned. However I had to go to the GP as I have recently had a period. I have had a little spotting in the past. The Gp immediately said I should stop taking it. I said that perhaps the dosage needed to be altered. She knew very little and had not heard of menopause clinics! Is this my only option? I really would prefer to remain on it. She changed my prescription to Kliovance for 3 months to see "how it goes"

[Dancinggirl]

Hi Alypoole and welcome to MM
How old are you?  When did your natural periods stop?
If you are on a continuous HRT (so taking progesterone all the time) then some erratic bleeding can happen and this may be because your womb lining is building up too much.  Some spotting and bleeding in the first 6 months on any conti HRT is quite normal but after 9 moths you shouldn't have had a bleed.
It sounds as though your GP is clueless - no surprise there .  She should have sent you for a scan of your womb lining to see if this has built up - so I'd pop back to ask for this if the bleeding doesn't settle. The new HRT may suit better and give you what you need - so give this the 3 months. There are meno clinics - depending on where you live -  or you can ask to be referred to a gynae for specialist advice.
One of the best HRT options, if you don't want to have any bleeding, is to have a Mirena fitted and you can then use as little or as much oestrogen as you need as patch, pills or Oestrogel to control your meno symptoms.  Have a look under treatments at the top of this page and browse around the site to get clued up. DG x

[Alypoole]

I knew I should have given more information! My natural periods stopped at 54. I am now 64. I went on to HRT after a friend told me that you could! My main reason - if I'm honest- is the returned libido. Life just seemed to return to normal in that respect. This is something that doctors seem to overlook, and usually assume it's for hot flushes. I'm getting a little concerned now and don't feel there is any real help in my surgery. Perhaps I should see another doctor - there are at least 12- and not limit to the female ones.
Thanks for your reply.

[Dancinggirl]

Alypoole - As a general rule it is not advisable to go onto HRT for the first time when one is so post meno and certainly not in your 60s.  The risks of HRT are increased if started so late and to expect the body to adjust to the hormones is really asking too much.  HRT is really best introduced either in peri meno or shortly after periods have stopped and then once we hit 60, either reduce dosage or have really good monitoring from then on.
Libido is a difficult thing to help - it's not just about the hormones.
See how things go - do read up all the info on this site and decide who you want to proceed after that. Your poor womb may not like being stimulated when it's been dormant for so long and possibly rebelling.   I am 60 and, though I have used HRT for many years, I had to stop HRT 6 months ago due to problematic bleeding and spotting  -  I think my womb just didn't like the HRT hormones any more. Using HRT is about the benefits versus the side effects and risks. 
I have found I can keep the libido going without HRT by relaxation and having more ‘me' time - hubby makes me feel sexy which really helps. DG x
 

[Alypoole]

Reduce the HRT gradually then?

[Alypoole]

But surely there are women who continue to take HRT all their lives. You are lucky you were able to maintain your libido, mine completely disappeared along with any responses however patient my husband was.

[Dancinggirl]

Don't stop the HRT if you don't want to yet without advice about whether to continue or not. If you do want to stop you don't have to reduce slowly, you can simply stop if you want.
Yes, some women take HRT well into their 80s, however they started HRT either before or just after their natural menopause - so between 45-54.  It is not considered safe to start HRT some years into post meno - I think there are many reasons. If you have not had any real problems so far, then you may well be fine to continue with HRT but the erratic bleeding may well be to do with starting HRT so far into post meno. Many women choose to use a sequential HRT and put up with monthly bleeds or have a Mirena that will protect the womb lining more efficiently.
I am nearly 61 and I took a break from HRT for a year when I was 57 - when I went back onto HRt after this year I think my womb simply couldn't cope with being ‘woken up' again and gave me cramps and erratic bleeding and spotting all the time.  Your bleeding may settle and if you are feeling really good on this HRT then it could be fine to continue. It is generally advised that women over 60 should use HRT trans dermal ( so not in pill form) so some specialist advice would be a good idea and into our 60s we need to be monitored more closely with regular womb scans etc. but this would probably only be available privately.
Perhaps ask your GP surgery if there is a menopause clinic in your area for you to visit or ask if you can have a referral to a gynae.  If you can afford it, then some advice privately from a gynae specialising in menopause could be a good idea.  DG x

[Hurdity]

Hi Alypoole

  from me too.

I do agree with Dancinggirl and I am very surprised that you were given tablet HRT for the first time at 64, 10 years after the menopause!! The medical profession now say that there is a "Window of Opportunity" whereby to minimise cardiovascular risk, women should start HRT below 60 or within 10 years ( ideally 5 ) of menopause. Also it is recommended if women do start HRT over 60 that transdermal methods should be used and starting with a very low dose. Those who are already using tablet HRT at age 60 are less at risk if they continue post 60 but care should also be taken.

I presume you were given Elleste Duet conti ie a no bleed HRT if you have only just now started bleeding? If so this is a high dose! Your GP sounds ignorant and if I may say, somewhat irresponsible.

I would definitely ask for a referral to a specialist clinic - at your age  and time since menopause this is imperative. You might have to travel/wait but you should definitley have a scan. I would also want to check my cardio-vascular health - not sure how this is done and have cholesterol levels measured.

Your risks are of course lower if you are generally healthy ie not overweight, eat good healthy diet - lots of fresh ingredients, don't smoke, drink little alcohol, take lots of exercise, minimal stress.

The HRT most used in post-menopause for libido is Livial - but this is also not recommended over 60.

Please seek specialist help - you owe it to yourself, and your GP owes it to you too

Hurdity x

[Alypoole]

Oh Lord I feel really worried now. I have had HRT in the past but not for a while until I started again. I was never once told I shouldn't do this because of my age....... and I do feel better on it! I will look for a private gynaecologist tomorrow as I am yet to find a GP who knows ANYTHING in my health centre.

[Hurdity]

Hi Alypoole

We didn't mean to alarm you - but it's as well to be advised properly and to minimise risk at your age. However if you say you have tried HRT since your periods stopped at 54 then that could put a different perspective on things. How long did you take it for and what did you take.

It is the possible damage to arteries in the years following menopause which can cause a problem if HRT is then started much later - hence the window of opportunity. There is some information here: http://www.menopausematters.co.uk/newsitem.php?recordID=140/HRT-and-cardiovascular-prevention

Here in terms of starting HRT over 60:
http://www.menopausematters.co.uk/newsitem.php?recordID=145/BMS-Council-Consensus-Statement-on-HRT

Shame on your GP practice as all the information is readily available in basic form on this website and anything significant is always published in the national media - so General Practitioner or not - GPs should be prompted to at least look up anything medical that makes the news!! And they will have their own guidelines and updates too.....

Do let us know the outcome please

Hurdity x