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[Tindia]

Hello all, Ive been on Utrogestan and estrogel for about 16 months. Ive had no bleed for around 8 months. Using one pump of estrogel daily and 9-12 days of utro as a pessary (i have to have a days break mid prog phase as it makes me anxious and gives me insomnia and having a night off helps)
Im 49 and happy to not have a bleed but if im only taking it to ensure a shedding of my lining then im wondering why Im bothering. The very young nurse at my hrt check said not to worry about the lack of a bleed as its my own hormones still acting. I didnt have a bleed on the mirena coil so in some ways this is the same result but no one ever talked about the dangers of womb cancer at that stage but its a major concern for hrt prescribers.
Just doesnt seem right considering why we are told to take a combi hrt. Any advice appreciated.

[Keepgoing]

Sorry I can't help I always have a bleed when I take it but my periods were still regular when I went on hrt...maybe make appt with doc and discuss with them xx

[Hurdity]

Hi Tindia

It is abnormal bleeding that is more of a problem than lack of a bleed. On this website it states that 15 % of women approx do not bleed on sequi HRT (as you are taking). This also happened to me in the later stages of monthly sequential HRT. I was on 50 mcg patch and 11 x Cyclogest (progesterone) pessaries x 400 mg  per 28 days ( before utrogestan was available). On the basis of this I was able to lengthen my cycle - with the approval of my doc so that now I take progesterone every 6-8 weeks and get a short bleed. Depending on your symptoms and how well you feel - the other alternative is to increase the oestrogen dose but maintain the cycle as now - and then you may well get a small bleed?

The reason you do need to continue to take it, is that all the while you are taking the progesterone you are also stopping the womb lining building up - it just means that there isn't enough to shed.

The dangers of womb cancer is when oestrogen alone is taken without progestogen for long periods, or at insuffucient doses - but the warning signs should usually occur well before cancer  ie the lining thickens and then sheds sporadically as abnormal bleeding. At this point medical investigation would reveal a thickened lining - and this would be investigated and treated. There are several stages of changes that occur before cancer develops and usually unscheduled bleeding reveals nothing amiss.

However if you are concerned then do consult your doc - but I doubt they would carry out any investigation for lack of bleeding - rather - the opposite.

Try not to worry!

Hurdity x

[Tindia]

Thank you, thats kind of what the nurse said so I will carry on the regime as in all other ways its been fine. X