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Author Topic: Switched to cyclical - bleed questions  (Read 2295 times)

hoping4best

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Switched to cyclical - bleed questions
« on: July 09, 2017, 12:27:56 PM »

I just switched to cyclical after a few years on continuous where I bled horribly every 1-3 weeks because both oral utrogestan/prometrium and vaginal Crinone progesterone gel made my endometrium thin (per ultrasounds), but unstable and constantly shedding.

I'm on a estradiol patch and I just switched to taking progesterone 12 days every 2-3 months (my choice as to when I trigger a bleed).

I did okay on the progesterone (some crankiness and tiredness), and I stopped it about 5 days ago. How long after stopping it should I expect to bleed? And if I don't get a bleed, is that something I should be concerned about?
« Last Edit: July 09, 2017, 01:06:31 PM by hoping4best »
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dazned

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Re: Switched to cyclical - bleed questions
« Reply #1 on: July 09, 2017, 01:14:12 PM »

Hi ,you will only get a bleed if there is any lining build up to shed. So not bleeding is not big deal per se. What dose of oestrogen are you using ? As you are on a long cycle it would be prudent to get 6monthly scans to check the lining is indeed being kept thin.
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hoping4best

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Re: Switched to cyclical - bleed questions
« Reply #2 on: July 09, 2017, 02:05:12 PM »

I'm on 75mcg plus a little extra cut patch (but just below 100mcg, as the 100mcg gives me sore breasts but the highest patch I can tolerate seems to really help my VA). I last got a scan 2 months ago and had no buildup, and that's when I switched to cyclical. My endocrinologist will be doing scans--another one in September. So maybe I won't worry? (Hahaha.)

I was about to get a consult for a hysterectomy and removal of my one remaining non-functional "failed" ovary due to the endless bleeding and awful cramps I had on continuous. The cyclical has been a revelation. No cramps or spotting or anything. So I delayed my hyster consult and would love it if this works out and I can cancel it! Fingers crossed. Also found 12 days of Crinone vaginal progesterone gel quite tolerable. After 4 years of quite awful HRT struggle since sudden onset meno, I feel hope for the first time.

Thank you!
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dazned

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Re: Switched to cyclical - bleed questions
« Reply #3 on: July 09, 2017, 02:42:29 PM »

Fingers crossed for you. Possibly you've cracked it now ,hurrah.😀
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hoping4best

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Re: Switched to cyclical - bleed questions
« Reply #4 on: July 14, 2017, 12:05:30 AM »

I did get a bleed! A week after I stopped the Crinone. Am in it now, with cramps and insomnia, just like my period used to be, but worse! Fun!

Quick question dazned: when you say "6 monthly scans", is the recommendation for long-cycle cyclical that I get a scan every month for 6 months? Or one scan every 6 months? I live far from my endocrinologist, but I expect I'll be able to get a scan about every 3-4 months for a while.
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Hurdity

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Re: Switched to cyclical - bleed questions
« Reply #5 on: July 14, 2017, 04:08:42 PM »

Hi there hopingforbest

I would have thought an annual scan should be sufficient - especially as you've had one recently and are having another one soon.

Interesting that it took a week for your bleed to come eg I have a 7-8 week cycle and had my last utrogestan (100mg) on Weds and have started bleeding already today (Friday) - ie about 14 hours after the missed dose last night. How we all vary - hence the need for caution when it comes to prog doses and cycles and not to self medicate that many of us are urging until you know how your uterus behaves on different regimes under medical supervision.

Hurdity x
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weathergirl

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Re: Switched to cyclical - bleed questions
« Reply #6 on: July 14, 2017, 06:29:52 PM »

I don't bleed at all after my 10 day (every 4 weeks) cycle.  Maybe a tiny bit of brownish pink spotting. I think what dazned said makes sense.  A bleed happens when there's actually some lining to shed.  So much of this is estradiol-dose dependent and how much of that estradiol your body is absorbing and using to build a sheddable lining.   Hurdity, earlier in my HRT days I used to bleed the way you describe - within less than 24 hrs after last progesterone dose.  But that stopped when I dropped down to a lower patch.  I agree with Hurdity that an annual scan should suffice, no?  I suppose it is whatever your doctor has recommended based on your agreed-upon regimen.   Hope you have found a method that works for you in terms of frequency of progesterone use - if I could get the Crinone covered by insurance, I'd definitely try it!
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hoping4best

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Re: Switched to cyclical - bleed questions
« Reply #7 on: July 15, 2017, 01:31:00 AM »

Thanks Hurdity & weathergirl!

I think the initial more frequent scans are just to check to see if the change up is working. My reproductive endocrinologist does ultrasounds in his office and they are quick. I'm 42, so my patch is almost 0.1mcg, plus now an estring.

This Crinone every other month or so is the lowest dose progesterone I've been on. I was on 100mg/day of oral micronized progesterone, then 200mg/day for a while! That was way too much.

Eventually I was still bleeding most of the time when I was on 8% Crinone twice per week, with no endometrium build up. Hence this change.

It can be so hard to get this right! I hope I'm getting closer after 4 years of awful!
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hoping4best

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Re: Switched to cyclical - bleed questions
« Reply #8 on: July 23, 2017, 02:06:04 AM »

Hi Shortie,

I do find I am a bit less symptomatic on Crinone. It's 8%, and I take it every 2-3 months for 12 consecutive days. (Prior to that I had been using it 2x/week when I was on continuous.)

It's a gel that seems to stay up pretty well. I don't find what comes out to be particularly unpleasant or troublesome. I actually find the extra moisture helpful with my VA.

Hopefully that helps, but feel free to ask me more questions!
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Hurdity

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Re: Switched to cyclical - bleed questions
« Reply #9 on: July 23, 2017, 07:36:13 PM »

Correct me if I'm wrong but I don't think the 4% is available any more and hasn't been for some time. I think many women were hoping it would be a choice for endometrial protection because I think the 8% - again licensed for fertility - could well produce more undesirable side effects than a lower dose and perhaps does not need to be so concentrated for the prog part of hRT as opposed to fertility which does? I think there was some preliminary research on it - a few years back I read something about it and trials showing it did work to protect the uterus.

Hurdity x
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