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[Lynnmignon]

I am menopausal - and haven't had a natural period for more than two years - I am 51.  The only side effects of the menopause have been horrendous night sweats and I persevered for a year using lots of different natural methods but none of them worked.  I then went to the doctor back in April this year and said I need 'proper drugs' so I could get a decent nights sleep!  So, she put on Evorel patches which I started on 28th April which didn't work as I had persistent bleeding although it fixed the nights sweats inside two weeks!   I returned in August and she increased my dose to a tablet form Elleste Conti which I started on 20th August.  It is now mid October and I am getting increased cramp pains (which wake me in the night) - along with dark brownish bleeding which is more irritating than worrying.  To be sure the original bleeding wasn't anything more serious I was given a womb scrape and it all came back fine so we know its the HRT that was the original cause of the bleeding.  I have an appointment again at the end of the month by which time I will have been taking this particular HRT for 10 weeks.  In the meantime the doctor has told me to take paracetamol/nurofen to help manage the cramps - which does work but I it is merely masking the problem. I am minded to just stop the whole HRT thing and suffer the night sweats again as this simply cannot be right.  Has anyone had this sort of problem and is it fixable?  I haven't had children or any gynae issues. HELP!

[Taz2]

Hi Lynnmignon 

Lots of women do suffer from bleeding when on a continuous HRT and it may be worth your while asking your doctor to prescribe a sequential HRT instead. This will give you a (usually) short withdrawal bleed once a month which is more manageable than constant breakthrough bleeding. If you do stay with a conti HRT you may find that the bleeding stops after the first six months as it can take that long to settle.

If night sweats are your only menopause symptom then some women do get a good result from being prescribed a blood pressure medication to combat the flushes and sweats - friends of mine have done well on this with no sweating at all.

Someone else will be along soon with their advice.

Taz  x

[Dancinggirl]

  lynnmgnon

Erratic bleeding is common with any continuous HRT.  As Taz2 has suggested,, you may find it's better to have a sepquetial HRt and simply have a rearguard monthly bleed which is predictable and over time should give very light bleeds with less pain.  Why not try Femoston 1.10
Dg x

[Lynnmignon]

Thank you to both of you for replying.  Helpful info. As I sit here I have bad cramps again so just taken some paracetamol before heading to bed so the pain does not wake me up.  I am seriously considering stopping the HRT and will talk to the doctor about this next week.  In addition to this cramping and bleeding side effect, my breasts are sore and my partner says i am a'nightmare' to live with!  I have become very short tempered and for someone who never used to suffer from mood swings etc I really feel most peculiar!

[Dancinggirl]

Lynnmignon - I'm afraid what you are experiencing is typical with continuous HRT.  This is why many choose to use a sequential HRT and put up with a monthly bleed - less progesterone used and therefore fewer side effects. Sore breasts do tend to settle as the body adjust to the hormones. DG x

[Lynnmignon]

Thank you Dancinggirl - good to know its 'typical' - I decided this morning to stop the HRT I am on - I had another 'painful' night and was woken up at 1am with severe cramping etc.  I am due a conversation next week with the doctor, but frankly the symptoms from the treatment at the moment is worse than the original symptoms so I am just going to see what i can do to alleviate the night sweats - assuming they come back!

[Hurdity]

Hi Lynnmignon

  from me too. I agree with Taz and Dancinggirl - your best solution is to try a sequential HRT type. This is the problem with starting HRT post-menopause. Most women are given continuous combined from the start - get side effects - either the bleeding, the cramping or the synthetic progestogen - and give up. You have plenty more options!!

Did you say the Evorel patches worked apart from the bleeding? Then why on earth did doc change your HRT to a tablet and increase the dose? If that dose suited your symptoms then Evorel sequi would be the one to try next. You might still get cramping but only once a month and once your body had acclimatised you may find your bleeds dry up even on sequential HRT (as mine did on a monthly cycle). Please don't give up - you are so young - but of course you want to feel better on HRT than off it. Might take a few attempts but really is worth it - because as well as symptom improvement, you will also get the benefit of bone and cardio-vascular protection for a few years.

There is also Femsevon sequi , as well as oestrogen patches ( or gel) with separate progesterone, or even a Mirena coil....

Hurdity x

[Lynnmignon]

Thanks Hurdity - apparently the way to reduce the bleeding is to increase the dose and the doctor (who specialises in gynae thing) suggested this HRT instead of the patches.  The bleeding on the patches was pretty much all the time.  Although this oral pill was ok for the first few weeks it has become steadily worse and the cramping and bleeding are worse than ever.  I stopped it on Tuesday this week after being woken up almost nightly with pain and bleeding. ( I know this is not the recommended way to come of HRT but I simply couldn't tolerate it)   This will now be day 4 without HRT of any sort.  The bleeding and cramping is as bad if not worse last night, I don't know if this is from the residual HRT or whether its become worse because I have stopped.  As usual I can't get hold of a doctor until next week to discuss so if anyone can tell me if this is to be expected that would be great.  How long does it take for HRT to get out the system?

[Dancinggirl]

Lynnmignon - this cramping is one the side effects I got with HRT in post meno - along with erratic bleeding - this is why I have given up on HRT. Whilst higher doses of progesterone may settle the bleeding a cramps it can bring more low mood and PMT type symptoms.
The only non bleed regime that worked for me OK, was having a Mirena fitted and then using oestrogen as gel or patch.  After the first few weeks, the bleeding stopped and I seldom got cramps. The first few weeks can be a bit tough, while the body adjusts, but you do then get 4 years of relatively trouble free HRT benefits.  The Mirena delivers the progesterone more directly to where it is needed with less absorbed systemically - hence fewer side effects.  Some women find they can't even tolerate the Mirena as they are so sensitive to any progesterone but the Mirena is a favourite with many gynaes because it can settle erratic bleeding and even shrink fibroids and polyps.  DG x

[Lynnmignon]

Thanks Dancing girl - I am afraid I can't tolerate a coil - I tried that method as a contraception in my early 40's and it irritated my womb - this solution was a no go and I had to have it removed.  I am hoping this current pain and bleeding will abate in the next few days with having stopped all hormonal activity  - I will deal with the consequences of the night sweats which is all I was suffering with before if they come back.  I generally don't have PMT or mood swings until I tried HRT which sent my body haywire in all sorts of ways - I really just don't think its suitable for me - I know people have to try different things and it all seems a bit hit or miss but I think I was having a relatively easy menopause (just night sweats) - and although it was bad, I think I can learn to tolerate that relative to this constant bleeding and pain!

[dahliagirl]

Ibuprofen usually works better than paracetamol for period type cramping pains. 

It is something to do with the chemicals it is broken down into and prostaglandins that I don't understand The chemist tried to explain it to me.  I know that I had terrible pains in my early 20s when asprin went out of fashion and I started using paracetamol so it ties in with my experience.

Ibuprofen can also reduce some of the bleeding, especially the bright red sort where it is bleeding from the womb, rather than discharged lining.

Hope that helps.

[Lynnmignon]

Thanks Dahliagirl - yes nurofen is much better for period related stuff - I have to be careful though as it can cause stomach problems, ulcers etc if you take too many (I had this some years ago as this was my 'go to' painkiller - but you can take it with paracetamol (so my doc said)!  Just hope the cramps stop soon, as having them during the day too and its not conducive to having a good day!

[dahliagirl]

Something with codeine in is also helpful - my daughter has nurophen plus when things are bad.  It relaxes the muscles a bit.  Good at bedtime.  Bad for constipation though. 

My strategy was to always take something at first hint, then you don't need as much.

There is always the wheat bag as well 

[CLKD]

I could take a bottle of Paracetamol and it wouldn't touch my pain levels.  Nurofen however I find useful.  A Pharmacist will give advice on what to take for various symptoms, some are designed to reduce pain, others to reduce temperature/aches and pains of 'flu.  Might be worth while asking?  If I get pain I take something immediately otherwise I get sick to my stomach.

As for HRT it isn't the magic cure for some ladies.  Trial and Error can be so tiring  . 

[dahliagirl]

Actually, I found I had nasty cramps with Elleste duet - along with very dark sticky brown 'blood' - norithisterone is very effective as a progestogen - cleans you out.  I was better with Femeston although I think I have more bleeding with it on the whole.