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[Debster55]

Hi ladies - love this forum and often look at it.

I started HRT in March - at 54 and Post menopause with aching joints - hands and hip, brain fog, poor quality sleep, anxiety, VA (prescribed Vagifem) low mood etc.......    eventually settled with Femoston Conti 1/5 daily with Everol 50 patch - for vascular symptoms   
Fed up now with sore boobs but mostly with irregular bleeding which can last upto 2 weeks sometimes - ranging from red to brown.      I have given it six months (as i read everywhere) but I'm thinking this isn't working.   Hair loss has also increased.

Gynae said Femoston Conti 1/5 would be sufficient for endo. protection but am wondering if the dose is right?

Or, could it be the polyp that the nurse spotted when I last had my smear test in 2017, altho. gynae didnt seem bothered about this when prescribing HRT.
Wondered if it would help if reduced 50 patch to 25?  but dont fancy the return of the symptoms.   

After being on the pill Cerezette in my 40s for 10 years or so and not having any periods, I dont fancy going back to it.

My doc doesnt want me to be on HRT long term and whilst he was good enough to prescribe for me, as I originally saw a private gynae, he admits he doesnt have good knowledge on HRT and doesnt want me to use long-term.

Looking at the forum, should I ask to be referred to my local meno clinic for scan. to check?     I think I have answered my own question but any comments would be appreciated.  Feeling this just isnt worth it.
 

[Dotty]

Hi it could be that you are not getting enough progesterone in the Femoston Conti and the extra oestrogen is causing the bleeding.

You might be better on Oetrogel with Utrogestan or a 75 patch with Utrogestan. x

[onion relish]

I can't help, sorry, as my knowledge about HRT seems on par with my GPs - zero!

What I can do is hopefully lend a bit of support by saying you're not alone. I'm on a different regime but just posted with a similar complaint.

I think it's about time all GPs and many gynaes NEED to get trained so they can at least get to a similar standard that many of the other ladies on here are about HRT.

I'm sure you'll get some helpful replies from those ladies soon.

Good luck.

[Natatters]

A bit late to this post but I had a similar experience. Had no bleeds for  18 months. Started indivinia combined hrt. Took for 18 months with no bleeding  then moved onto ustrogen and evorel patches. Bleeding started almost straight away and built up over a 6 mth period to the point I was having a heavy painful bleed every 7-10 days. Changed to provera then  norethisterone. Bleeding carried on to a lesser extent but still getting bad cramps . Advised by meno dr to have a scan before we change the regime.  Scan found 3 fibroids and adenomyosis.  Just considering what to do now. So yes, think it is a good idea for you to get a scan a then you can discount anything physical causing the bleeding. If your gp by his own admission doesn't know much about it, def worth seeing a specialist if you can, although expect they are all v busy at the moment. It is a pain isn't it trying to get the balance right!

[Hurdity]

Hi Debster55 - I agree with Dotty. I am surprised that you have been prescribed this combo because it is very much off-licence (though I know some health authorities suggest addtional oestrogen can be added to some HRT combos.). Femoston 1/5 is designed as a combi product and as such is balanced on average re the oestrogen and prgoesterone doses. Some bleeding can however be expected in the first 6 months of any continuous combined HRT. However the addition of extra oestrogen and especially a medium dose patch is upsetting the balance in favour of oestrogen so the bleeding is almost certainly due to the lining building up and breaking away - and the polyp could make this worse maybe?

I would definitely ask for referral for a scan  - not from a menopause clinic but through your GP - because you are still bleeding after almost 6 months and you are in an unlicensed combo. I get that your GP is not happy with this. However your phrase "whilst he was good enough to prescribe for me" sounds like you are grateful for this - when it is actually your right to be prescribed HRT for menopausal symptoms if you have no medical contra-indication.

Please go back to your GP and tell him you feel your bleeding could be abnormal and request referral for a scan in the normal way as Natatters also suggests. Do ask for a referral to a menopause clinic anyway to review your HRT - I feel your private gynae should not have prescribed this and left you to it. If women take unlicensed combinations and their doc (GP) has insufficient knowledge then really this does need regular monitoring which the NHS doc may not agree to if unlicensed.

Dotty's made some good suggestions. Have a think and see what you might like to try. I know the appeal of Femoston is because of the Dydrogesterone (the progestogen)  unfortunately not available on its own, but the oestrogen/progesterone balance must still be right to prevent endometrial thickening.

Let us know how you get on!

Hurdity x

[Debster55]

Thank you everyone for your helpful advice.    Doc has referred me for a scan to check all is OK.   He also said come off the Everol Patch and continue with the Femoston Conti 1/5.   Touch wood, no bleeding.  Awaiting appointment for scan and will let you know how I get on.
thank you again.
Debster55