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[Leesh]

Hi everyone.

I went to see my GP for some advice on HRT with regards bone health, as I have arthritis in my spine and wanted to ask if I should take HRT to stop it getting worse. I am 48, and in perimenopause.

When I went to see her I hadn't had a period for 3 months, and my symptoms weren't too bad at all - it was just to talk about bone health. Anyway, she persuaded me to try HRT anyway, as I suffer from insomnia, and put me on patches - everel 50, and then evorel conti for the 2nd 2 weeks.

Anyhoo...after 4 days I was spotting and had gained 2lbs. I've spent the past few months losing weight and have lost 26lb so far, so I know it wasn't coincidence, as I was sticking to my diet plan 100%.

I stopped using the patch after those 4 days, as my symptoms weren't bad and it wasn't worth the risk with weight gain.

Oh Lord...that was 3 weeks ago and I have been bleeding ever since. Heavy bleeding with HUGE clots, and today, after 3 weeks, I flooded while out shopping.

Is this normal? I know hormones mess with your body but it's starting to worry me. There are no appointments available with my GP until mid Dec at the earliest.

Has anyone else started and stopped like that? I'd be interested to hear others' stories.

[CLKD]

Awful not 2 be able to visit your GP!  Can you access the appt. system via an e-mail system, there are often appts available at our Surgery.  Maybe see if you can get an appt. with your Practice Nurse, does your Surgery have Nurse Practitioners?  If not, ring and ask for a GP to ring you back 'to discuss'?  There are medications that can ease heavy bleeding.

Browse round here. Make notes.

[Hurdity]

Hi Leesh

Emergency appointment are usually available at short notice and in your position due to the heavy bleeding and clots then this is not a routine appointment - so do ask to be seen earlier if you can?

Having said that - you say you started bleeding 4 days after starting the Evorel 50 mcg - is this right? The bleeding then is most likely just a coincidence. It cannot make you bleed this heavily so quickly and it is likely that this would have happened anyway. What happens in peri-menopause is that in some cycles you don't ovulate but your eggs start to develop and then get absorbed. While they are developing they produce oestrogen which thickens your womb lining and in the absence of ovulation no progesterone is produced. If this happens for a couple of cycles the lining gets thicker and eventually when you do ovulate the bleeding can be very heavy. Sometimes the womb lining gets so thick it comes away even in the absence of ovulation - such is in peri-menopause.

What will happen while you're on HRT is that eventually the over-thickened lining will shed and then you should settle into having a withdrawal bleed every 4 weeks just as with your natural periods - although your own hormones can come into play quite a lot during peri-menopause.

There is an interesting article here which might be helpful to you:
https://www.menopausematters.co.uk/magazine/pdf/Article%20-%20Perils%20of%20the%20Perimenopause.pdf

Sometimes weight fluctuates throughout the menstrual cycle anyway so in the light of your period starting very soon afterwards could this have been the cause of the apparent weight gain? It may well be temporary and it is really not necessary to gain weight on HRT - provided you continue with your weight limitation diet. Sometimes oestrogen can cause temporary bloating - but this should also settle. Ditto some of the progestogens. I have pretty much only ever used  transdermal oestrogen and "natural" (body-identical) progesterone - on a cyclical basis and have managed to lose weight since peri-menopause. Struggling a bit now but nothing to do with HRT which I have been taking for 10 years.

There is info on bleeding problems and treatments also on this website ( top tabs/pale green banner):
https://www.menopausematters.co.uk/heavyperiods.php
https://www.menopausematters.co.uk/periodtreatments.php
https://www.menopausematters.co.uk/hrtandperiods.php

Hope this helps

Hurdity x

[Taz2]

Hi Leesh

I agree with Hurdity that taking HRT for four days wouldn't have led to a period such as this. I think it is more likely that as you haven't had a period for three months then you are now having a heavy period which is very common during peri menopause. Although clots can feel very horrible when you pass them my GP explained that this is a good sign as it means your clotting mechanism is working well. How many pads/tampons are you having to use a day/night?

Obviously if you feel that things are getting worse then you should call your surgery again and ask for an earlier appointment. My longest period lasted over eight weeks unfortunately and was considered part of being perimenopausal.

Taz x 

[CLKD]

8 weeks Taz is far too long.  Can lead to anaemia and I for 1, would not have tolerated such a long bleed.  It would have intereferred too much with my work load!  It was bad enough having large clots passed every time I moved and that was when I was taking The Pill  . 

It's too much of a co-incidence that a bleed as described begins so close to starting HRT.  Do ring your Surgery tomorrow and push for advice!

[Taz2]

It wasn't too long for me though. No anaemia. Took enough pads etc into work. Old towel on car seat just in case and a hot water bottle for cramps together with nurofen. Was also driving a round trip of 300 miles two days a week to care for parents on the two days I didn't work.

I think that the fact this lady
hadn't had a period for three months but had begun to experience some spotting before beginning HRT does point to the possibility that a period was already on the way.

Taz 

[CLKD]

How R U this morning Leesh?

[Leesh]

Hi all, I'm so sorry I haven't replied sooner, I completely forgot I had posted on here!

So, my period lasted for a whopping 32 days, heavy for 30 of those days. It finally stopped on Tuesday, and I decided to give the patch another try as someone suggested that it was probably a coincidence. I put a new patch on last night and lo and behold...I am bleeding again! After 32 days of bleeding I have had 3 days off and now, having stuck another patch on, here I go again!

I gave it the benefit of the doubt, but there's no way this is coincidence.

In all this time I have not been able to get a doctor's appointment, but I did manage to get a cancellation for next week, so I will be seeing the GP then.

Somebody said I had had spotting before starting the patch the first time - I hadn't, I had had no bleeding for 3 months.

Feeling very fed up at the moment, I can't go another flippin' 32 days of heavy bleeding!

[Leesh]

Hello again all

I managed to get in to see my GP, and she has taken me off the HRT - for whatever reason it seems I can't tolerate it and she agreed that the prolonged heavy bleeding was not acceptable. As I am still having periods, albeit erratic, I am still producing oestrogen so there is no worry about bone health, and it's not classed as early menopause (or won't be when it's complete) as I am 49 in a few weeks so a pretty normal age.

So, I'm kind of stuck with the hot flushes, the insomnia, and the crippling period pain and breast tenderness. She did suggest anti-depressants for the hot flushes, but it took me ten years to come off one due to withdrawal being so bad, and I'm not willing to go back on them, so I'll now start looking into natural treatments.

[Hurdity]

Have you thought of having a Mirena coil fitted Leesh? This would eventually sort out the heavy bleeding and then you could add oestrogen only as a patch as you were using, which would eliminate your flushes. Your doctor should not be suggesting anti-depressants because these will not sort out your heavy bleeding even if they did work on flushes, and natural treatments will not sort out heavy bleeding ( and probably not flushes) either! She should surely be working with you to sort out the bleeding (unless she gave you treatment for this?) and flushes, by helping you to find out an HRT treatment that works for you!

The other alternative is to try the pill ( not the mini pill as this only contains a progestogen - so will sort out the bleeding but not the flushes) - there are a couple which provide replacement oestrogen of the same ( bio-identcial) type as in HRT ie estradiol. These pills are called QLAIRA  and ZOELY - but can only be taken up to approx 50 - but might be good initially as they will regulate your cycle, stem the bleeding and should also eliminate your flushes.

There really is no need to suffer either the bleeding or the flushes, nor resort to weak "natural" treatments - although lifestyle measures such as weight loss, exercise, reducing alcohol can help to a point.

Hurdity x

[Leesh]

Hi Hurdity

No, the coil wasn't mentioned, and nothing was prescribed. I am now bleeding again, started period yesterday and am flooding through super plus tampons AND night time towels, and have the worst cramping I've experienced since I was a teenager.

I don't really want to go on the pill, it never really suited me and always made me feel sick, which is why I chose the patch this time.

I don't drink alcohol, but I am on a diet (lost 27lb so far). I can't exercise much as I have spinal arthritis, which makes it incredibly painful, although I do try (and I make sure I get out for a walk at least once a day as I work from home).

I'm not sure what to do next. I just looked at my doctor's online booking system and there is nothing available until at least the 2nd week in January!

[Hurdity]

Hi again Leesh

If your doctor agrees that heavy bleeding like you are experencing is not acceptable, then surely she should have suggested something to help you!

As I mentioned yesterday the Mirena coil will help the bleeding and then eventually you will be able to take oestrogen when you get flushes and sweats - or as soon as the bleeding is under control. Another alternative is tranexamic acid. Do read those links about bleeding at the bottom of my post in October and think about what you want to do. For instance in one of the links it mentions that the doc could arrange a scan to check for fibroids which sometimes cause heavy bleeding.

As for the January appointment - phone up and ask for one in the same week on an on the day one in the circumstances. Those long term online ones are for routine matters that can wait. I would suggest this can't and your treatment from your doc yesterday does not sound satisfactory in terms of dicsussing options to help re the bleeding.

I take what you say about the pill - but the two I mentioned are not like the CCP types with strong synthetic oestrogens in them as I pointed out - but patches are recommended for those who suffer nausea with tablets.

Hope this helps - and please get more help from the doc - there really is no need to suffer.

Hurdity x