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[LizzieL]

Hi

My menopause started when I was 52 and I struggled on with the symptoms for 7 years hoping they would subside, but they only got worse! So aged 59, I swerved my GP and went straight to a menopause  specialist.

I started on oestrogen patches but after 6 months of increasing the patch strength it was clear from blood tests that I had poor absorption, as my hormone levels remained stubbornly low. I then switched to 2 pumps of Oestrogel with the odd 3 pump application and after 3 months my hormone levels are now satisfactory. 

Alongside the oestrogen, as I have my womb, I started taking 100mg of Utrogestan orally, but did not tolerate this well, so for the past 3 months, on the consultants advise, I halved the dose, taking 100mg every other day.  During the last 3 months I have had a couple of periods and occasional spotting, which I understand is normal. However last weekend I had a very heavy, in fact I would say horrendous bleed, with several large clots. I eventually had to control it by taking Tranexamic acid and the bleeding stopped.

Last Tuesday I also had a meeting with my consultant who advised that this type of bleed should not be a recurrent feature, but suggested taking the Utrogestan 100mg every other day vaginally, as well as prescribing Androfeme, which I have done. However last night another very heavy bleed started, with large clots and again I have had to control it with Tranexamic.

Has anyone else experienced similar?  Should I just stick to the new regime and give my body time to settle?  Any advice would be welcomed. Thanks.

Liz

[LizzieL]

Thanks Stellajane. I think the 100mg Utrogestan orally was probably not enough. Just going to stick to the new regime - 100grm vaginally and 2 pumps of the Oestrogel - and fingers crossed it will all settle down. If not, then I think a scan is a good idea.

[Honeybean]

LizzieL

Hi there, I don't have any pearls of wisdom to share with you unfortunately, but the same thing is happening to me too. I am on day 3 of a very heavy period, having to dash the loo every hour to change tampons (sorry for TMI). I am beginning to feel very weak and tired. I suspect I'm a bit anemic. I too am on a very low dose of Utrogestan because I cannot tolerate progesterone either. I take 100mg from days 1-25 and then have a 3 day break for a bleed and then start the 25 day cycle. This is not actually working very well and the bleed comes when it wants. This is the first time its been this heavy. I am on 4 pumps of the Estrogel per day. I am assuming I am having too much estrogen or not enough progesterone.  I will probably ring the doctors today, and Im sure they will alter my dosages which Im kind of dreading because the progesterone side affects are not great. I will let you know how I get on. 

[Hurdity]

Hi LizzieL

 

The problem with these off-licence regimes prescribed by (?private) consultants is that they are much less than the licensed dose and therefore may well be insufficient to protect the endometrium and lead to bleeding (this can also be caused by eg fibroids or polypds which may grow in the presence of oestrogen and insufficient progestogen). The licesned regime for utrogestan is 100 mg every day orally (or Days 1-25) although off licence this can be used vaginally. There is a small study ( maybe 2?) which shows that for low/medium doses of oestrogen there was sufficient protection to the endometrium when 100 mg utrogestan was used vaginally every other day, and some consultants and even the recommendations in some scientific reviews are suggesting this is fine. Caution is always important and especially with higher doses of oestrogen. Incidentally there should be no need to measure oestrogen levels to test for absoprtion but go by how you are feeling.

Someone else on here - look at the thread started by Jeepers probably still on the first page - is having the same problem and was taking utrogestan every other day orally with a medium/high dose of oestrogen gel. This really is not recommended by anyone and any doc who is advocating this except for very low doses of oestrogen is doing this very much off-licence and agaianst any recommendations as far as I understand it.

Hurdity x

[Hurdity]

LizzieL

Hi there, I don't have any pearls of wisdom to share with you unfortunately, but the same thing is happening to me too. I am on day 3 of a very heavy period, having to dash the loo every hour to change tampons (sorry for TMI). I am beginning to feel very weak and tired. I suspect I'm a bit anemic. I too am on a very low dose of Utrogestan because I cannot tolerate progesterone either. I take 100mg from days 1-25 and then have a 3 day break for a bleed and then start the 25 day cycle. This is not actually working very well and the bleed comes when it wants. This is the first time its been this heavy. I am on 4 pumps of the Estrogel per day. I am assuming I am having too much estrogen or not enough progesterone.  I will probably ring the doctors today, and Im sure they will alter my dosages which Im kind of dreading because the progesterone side affects are not great. I will let you know how I get on. 

Hi LizzieL - yes this is the most likely reason - because you are on a high dose of oestrogel the utrogestan dose sounds like it is insufficient especially if taken orally. However if you are still peri-menopausal then your own cycle may be coming into play and if that is the case you would be better taking the progesterone on a proper cycle.

Hurdity x