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[Janet123]

Hello, I am having problems at the moment with constant bleeding whilst on a continuous combined HRT. I had successfully had a Mirena coil (originally fitted to prevent return of Fibroids) with Progynova 2mg added when I started going thru the menopause, about 10yrs ago. I have had this regime for a number of yrs, the last (3rd) coil was fitted late 2011. I thought it had 'run out' as I was getting night sweats and intermittent bleeding. Went to GP who referred me for a scan. Two of three scans were done, the third to check womb lining couldnt be performed because coil in situ. The scans were fine. In Dec I had coil removed and stopped taking Progynova.
At Xmas I started Kliofem as the replacement HRT. I have taken it for approx 7weeks. Had sore breasts for a week or so they have settled. However, I have been bleeding constantly for nearly 4 weeks. Night sweats are worse. Feeling very miserable. Digestion problems. Feeling muddled. Migraine/Dizziness. Lower back pain.  Went back to GP a couple of days ago, saw a different GP to the one who prescribed the Kliofem. Explained the problems. She is referring me to Gynaecologist and told me to stop the HRT.
I am wondering if the Kliofem is a close substitute for what I was on? I had asked for as close a match as possible as it worked for me. Also not sure if I should have stopped just like that, I did ask and she said it was ok to.
Your thoughts appreciated, thank you

[ancient runner]

No useful thoughts except that sounds really miserable and that stopping the HRT cold like that might make you feel rubbish for a bit. Have you got a date for the gynae appointment?
I think there's detailed info on different types of HRT in the pull down menus at the top and you might find equivalences there. It's possible that you're reacting to the progesterone in the Kliovance - it may be different/bigger dose than what was in your Mirena. I believe there are types which cause fewer reactions, and those are in Femoston and the gel (can't remember the name) which quite a few people use on here.
Best of luck - an expert will be along soon I'm sure but didn't want to leave you there!

[Hurdity]

Hi Janet123

It sounds to me like the progestogen in the Kliofem is insufficient to keep your womb lining thin?  The Mirena does tend to stop bleeding in many case pre-menopause but maybe not always and there can be breakthrough bleeding if you have anovulatory cycles? I'm not sure? Also you can have bleeding form the Mirena if the lining becomes over thinned although if you were taking oestrogen as well,  I would have thought that this would be unlikely?

Some women seem to get worse sweats and flushes when on continuous combined HRT due to the effect of the progestogen so maybe this is the cause? Less progestogen is absorbed systemically from the Mirena whereas you are taking it orally with Kliofem.

Are you able to have another coil fitted once your investigations have been completed to check on the womb lining? That way, if all is normal then you could perhaps change to a transdermal HRT (patch or gel) at this point so you would get a more consistent dose of oestrogen and eliminate the sweats and flushes once more?

Hurdity x

[Janet123]

Thank you both for takng the tme to read a reply.

Subject to no other problems found I will opt to have another Mirena fitted along with either tablet or as you suggest patch/gel equivalent. I think it is all a bit hit and miss. Hopefully my appt will be through in next 2 weeks so not too long. I will update this post when I have agreed the new approach, for information.
Have a lovely weekend