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[Blue Kingfisher]

Hello everyone,

This is a Noddy question but I'm on oestrogel & utrogestan & as a result my periods are like clockwork. I'm 50 years old next month & it's occurred to me that I have no idea if my HRT will effect the timing of when I hit the menopause stage.

Let me explain what I mean.....I'm peri-menopausal now because I'm having my periods & I belive you aren't technically classed as menopausal until you've had no bleeds for 12 months. So my question is, will I just one day stop having my periods even though I'm on HRT & that will be that? I'm not sure what the ‘transition' period looks like from péri to meno so have no idea what to look out for so I know that stage is coming.....

Does HRT even prolong the péri stage?

I hope this question makes sense, feel a bit silly asking but I just don't know what to expect!

Thank you everyone 

[Annie0710]

I've not had periods for years (hysterectomy when I was a lot younger) but my understanding is if you are taking progesterone with a break you will continue to have ‘periods' even after post menopause, the progesterone forces the bleed

Also, no hrt can prolong peri or speed it up, once your eggs are gone, they're gone, it's just you won't notice whist on hrt.  I've had to rely on blood tests to tell me where I was in meno but to be honest it's irrelevant, just carry on as you are if you're feeling ok x

[Taz2]

Good advice from Annie. The only way you can really tell if your natural periods have stopped is to come off HRT for a while and see if you do then have a period. Obviously this is a bit difficult to consider doing especially if you are feeling well on HRT.

Most doctors want you to be at least 53 before changing you to a continuous HRT which, after the first six months, shouldn't cause any bleeding although some women do still continue to bleed and so return to sequi HRT.

Taz x 

[sheila99]

Does your body give you any indication? I'm in peri & can tell if I'm having a 'normal' cycle or a HRT induced one.

[luna66]

I was technically in menopause (hadn't had a period for a year) before I started HRT at the age of 51. I take Estrogel (three pumps) and Utrogestan 100 for 10 days a month, as well as a small blob of Testim daily.

After being on HRT for about three months my period returned. Bummer, to be honest, but I feel so much better on HRT so it's something I live with.

What this tells me is that if you're taking HRT your periods may well not stop, so you won't necessarily know if you're in menopause unless you come off it for a year and don't have a period. Maybe there are other ways of testing, like having hormone tests, but not sure how the HRT will interact with those tests.

x

[luna66]

Hi Stellajane

Yes, I'm aware that it's a 'period' and not a period, and that the womb lining had to build up a little before the first bleed. I wasn't taking utrogestan during that first three month phase either.

Thanks 'though for clarifying.

x

[Blue Kingfisher]

OMG....so I'm not aware of anything about this at all!

The realisation that I will be having a period, whether natural or HRT induced is extremely worrying to me! Bleeding itself isn't a real issue, this is just inconvenience. What does cause me immense problems is the whole hormonal roller coaster, otherwise know as my ‘cycle'.

I struggle on days 1-6 of my cycle (day 1 being first day of bleed) & then things are really bad day 10-15 of my cycle. I feel nauseas & exhausted on days 10-15 & holding down my job let alone organsising the family & running the house is a problem!

I studpidly thought I would be on HRT, one day my periods would stop & I could either stay on HRT....I was assuming oestrogen only so I didn't bleed - don't ask me why or how I've built this rationale!.... Or ease of HRT, I would no longer have a cycle & things would even out. None of this up & down stuff with progesterone & oestrogen across the month. I was picturing a flatter graph!

Now then, I felt extremely bad before I was out on oestrogel (my oestrogen came up as less than 19 & my gynaecologist said it needs to be minimum of 500 to feel good). So, aside from worrying about the fact I have to apply 6 pumps daily (because I suffer from poor absorption - this gets me close to 500) & any associated increased cancer risk with this.......I would also be terrified about coming off oestrogen & not being able to get out of bed again!

These HRT induced ‘periods', do they carry all the natural cycle symptoms such as cramps, period pain, mood changes, hormonal rollercoaster activity that affects your energy, well being etc?

So there are 70,80 year old women out there still having ‘periods'? I had no idea! I am totally ignorant!

[Taz2]

Hi Kingfisher. If you are post meno when you begin HRT you are put on a 'continuous' regime where you have progesterone throughout the month. This can give you bleeding on and off for up to six months but then, usually, settles down and you become bleed-free. If you are not post meno when you begin HRT you are put into a sequi regime which gives a regular withdrawal bleed to keep the womb lining thin and so prevent endometrial cancer. Then at around aged 54 it is considered ok to be swapped to a continuous regime. Some women (like me) find bleeding on this regime continues past the first six months and so revert to the sequential regime as at least the bleeds are predictable.

As for whether you still get the same symptoms as with a normal period I found the first three months were painful and heavy but then they settled down to lasting around five days, light and not painful. The PMT type symptoms can be a problem for some women while taking progesterone but you can try other types.

Hope this helps.

Taz x 

[Hurdity]

Just to add that I am 65 and still have a withdrawal bleed but I wonder how many women in 70's and 80's still do - doubtful? Of the women who continue to take HRT until this age I suspect most will have had hysterectomies so obviating the need for progesterone, and the remainder will be using some form of low dose continuous combined HRT.

At this moment I am wondering quite how long I can go on like this but do not want to take continuous progesterone that Taz refers to, but don't quite know what else to do!

Hopefully you will stabilise soon....

Hurdity x

[Blue Kingfisher]

So I take it I'm currently on what is called a Sequi Regime is that right? I take progesterone for 7 days at the beginning of each month & then have a withdrawal bleed/natural period a couple of days after stopping progesterone.

Taz2 that's very helpful to know about the average age of 54 to try the continuous regime of both pg & oestrogen every day....is your plan to try this again at some stage to see if things are ready to settle down I.e. you stop bleeding?

Is there anyway I can find out what stage I'm at with regards to the menopause? Or does the gynaecologist know this from my usual hormone blood test results?

Hurdity, I'm interested to know, if you don't mind, why you don't wish to take continuous progesterone & prefer the sequi regime?

Thank you everyone who has responded, this is incredibly helpful!!! Much appreciated!! :-)

[Taz2]

Sorry, I should have mentioned that I had a hysterectomy a few years ago due to prolapse so I no longer need progesterone and am on oestrogen only HRT (Evorel). I would have tried again though with the continuous regime to see if the bleeding problem had resolved.

Taz x

[Hurdity]

Hi again Blue Kingfisher - no secret - I'm always talking about it! I don't like the effect of continuous progesterone along with quite a few on here....it is sedating, makes me feel fatigued after a while, bloats me up to some extent ( boobs mainly), sometimes gives me headache and sometimes migraine, and nearly always makes me foggy-headed the longer I take it. However I cope with it for 12 days per 6-8 weeks.

You are on a very low dose of progesterone - but if you are still very much early peri-menopause you will be producing your own progesterone when you ovulate so your womb lining is more likely to be OK. However when you get to menopause then that dose may well be insufficient (partly depending on your dose of oestrogen though).

You won't know you have reached menopause unless you stop all HRT for 12 months. FSH tests are unreliable indicators.

Hurdity x