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[GypsyRoseLee]

After my breast cancer diagnosis 6 weeks ago I have slowly titrated down from 4 pumps to 1.5. So far I've had no side effects which has stunned me, to be honest. I was so ridiculously sensitive to any hormone fluctuation and had previously suffered dreadful peri anxiety and depression to the point of being suicidal.

Anyway, I have just finished my last 7 day course of Utrogestan (probably my last ever one) and have barely had any withdrawal bleed at all. Just a few brown smears on the loo roll with tiny bit of red.

I'm wondering if my much lower dose of oestrogel this last month has made my withdrawal bleed virtually non existent? And that my own cycle has now completely stopped?

[rolercoasterhell]

Please keep us posted GLR,

I think if you do well without so much oestrogen (or none at all if that is a possibility???) it would help a lot of people feel more positive about the future.

I so hope that you continue to feel stable.

X

[Kathleen]

Hello GypsyRoseLee

I assume your Utrogestan dosage has remained the same while you were reducing the gel. With much less gel but
the usual amount of progesterone a light bleed would seem about right. Not that  I'm an expert in any way mind you.  Hopefully finishing with Utrogestan will be just as easy for you.

Take care.

K.

[CLKD]

   PHEW !  ?

[Mary G]

GRL, it sounds like you are now post menopause meaning you can be symptom free on a much lower oestrogen dose.  You may well find you can easily stop using oestrogen altogether.

I found out by accident when I changed my HRT regime and halved my oestrogen dose.   I'm now on a long term maintenance regime to keep everything well oiled!  I have been post menopause for years but if I had tried to reduce the dose too soon, I would have been sweating buckets.

[Jari]

Good news GRL. I too had much less symptoms when I came off hrt and they just keep getting less and less!

 

[Hurdity]

Hi GypsyRoseLee, so pleased to hear you are feeling OK so far despite a reduction in oestrogen, and especially after your worrying diagnosis of breast cancer, making this an enforced reduction. As you suggest, this much smaller amount of oestrogen is presumably not causing your womb lining to thicken.

In the late stages of 28 days sequi HRT ( progesterone for 11 days Cyclogest per 28 day cycle in my late 50's) on medium dose oestrogen ( 50 mcg patch) I never got any bleed, so this gave an indication of how my womb lining would behave on a longer cycle ( presumably I could also have tried a shorter duration but I am a bit wary of the 7 day regime so prefer to increase the cycle!). It's quite common to bleed minimally on low doses of oestrogen provided the progesterone dose is adequate which sounds like it is for you.

Yes it sounds like your cycle is not happening at the moment - but that's not to say it won't. For example you could be late peri-menopause and still get the odd ovulation, but sounds like certainly not regularly.

All the best

Hurdity x

[warwick01]

Hi Ladies

Once you get into post menopause do you require more or less oestrogel?? a little confused some Doctors say we need more, some say we need less.

Wxx

[Tc]

Hiya GRL.  Realy realy good news that lowering  hasnt caused the hormonal upheaval you anticipated. I know what a frightening prospect that was for you.as it would be for most of us.   

I know you had no choice in stopping and that it's not certain you are post meno yet,  but the question you raise is I think well worth exploring.

So i hope you dont mind  me adding some thoughts of my own.

One can't be much more "post" than the line in the sand of surgical meno. (Same as one can't be  "a little bit pregnant ). So  I had always assumed my needs won't  change from immediately post surgery from then on in.
 
I sometimes dip into an online  surgical menopause site (not the highly visible one you might be thinking of  which I consider to be an awful site) . The info pages look at this question and offer an opinion on it.

I  should say how they explain hormone needs post meno   in order for this to make sense and I'm paraphrasing.

They say that how much E we need to replace will depend on  how well each individual body is able to compensate for the significant  loss of ovarian E (that occurs in both natural post meno and surgical meno alike)  in order to meet our individual needs by way of  other sources. I.e  adrenal, fat  etc  and ovarian androgens which convert and contribute to circulating E . ( obvs this is lost in surgical meno so might make it harder to meet those needs).

Their  view is that as we age and put more years between us and our last period that the bodies hormonal needs may  indeed change.  I'm not knowledgeable enough to know how true that is or the science behind it, so that in itself seems very open to discussion.

But   if ,as they say,  those needs might change over time then the question of re evaluating dose arises.
 
 To that end  they profer  that it's a good idea to  re evaluate eastrogen needs every so often post meno as the years pass.   

I believe  some women find it obvious when a previously o.k  dose feels it has become too much after a while. And I've seen women talking about this.

 But what if you are happy and settled on a dose? . How are you to know you might be just as well served by a lower dose due to the fact that in the background your bodies requirements might have changed with time. 

. The only real  way to tell seems to be to lower the dose..and see.   They advise you can of course increase again  if it doesnt work out as symptom control is key. But for  those of us sensitive to fluctuation it might be a scary experiment. 

Sadly  I havent got there yet but i would imagine once you have achieved hard fought for stability,  it's hard to contemplate upsetting the applecart.

I'm not for one minute suggesting  that the site I mention are an authority on it. It's their take on it which I thought might be worth discussing here in response to your question GRL.

It seems to me it realy rests on the question of whether our bodies hormonal needs realy do change in time and with age, and if so how  significant is this as  I assume none of us, myself included want to be using a dose over and above what is effective for us as an individual and offers bone protection. 

 I wonder what your thoughts are ladies. ?

Much love GRL. Xxxx

[Wrensong]

Hi GRL, great news that so far you've had no side effects from reducing, which must be a big relief given your situation.  Very pleased for you & hope this continues to be the case as you reduce further .

On a fairly new-to-me regimen of 25mcg transdermal oestrogen with 7 days pcm low dose MPA (several years postmenopause) I've just gone 9 months without a bleed, having had my first negligible traces of one on withdrawal of prog in month 10.  A recent scan at the end of my 3 week oestrogen-only phase of the cycle showed a lining of only 1-2mm & no abnormality bar pre-existing fibroids.  So I'd concur that your light bleed is very likely the result of minimal lining build on the reduced oestrogel, but only time will tell whether you are now postmenopause.

If Tamoxifen is on the cards that could make it more difficult for you to know for sure, due to the amenorrhea that can result.

[Kathleen]

Hello ladies.

I'm intrigued by the idea that our oestrogen needs are reducing in the background as we become more and more post meno.

 I always assumed that HRT was 'feeding' our oestrogen receptors and whenever we lower the dose the receptors react to the decrease (and not in a good way lol). I can't understand how we can support these receptors on the one hand but expect them to adapt to lower levels at the same time.   I think Louise Newson has said that we don't need to fear that our symptoms will return when we lower our HRT because our bodies are changing in the background but I've never really understood how that works.

Nonetheless an interesting topic to ponder on ladies.

Wishing everyone well.

K.

[GypsyRoseLee]

Thank you for everyone's replies and glad you think it a subject worth exploring. I've been pondering all day. My periods suddenly got lighter about 7 years ago, which coincided with all the peri Hell starting. Then when I started on 4 pumps + 100mg x 7 days per month, my withdrawal bleeds were even lighter which surprised me. I had 2 private scans in 3 years which showed my lining was nice and thin.

When I queried my very light withdrawal bleeds with Prof Studd he just said that the Utrogestan was doing its job.

[dangermouse]

Out of interest, did you ever try the AD without the HRT? Just wondering if it was that alone which had made you feel better.

Or do you think the high dose oestrogen made the bigger difference by dampening your own hormone volatility?

I also got large breast cysts a few months before my periods stopped due to my own oestrogen surging so high. (I had to have biopsy but was ok). This may have been like the times when you felt hormones breaking through.

It definitely seems to be a pattern for many of us that it all goes crazy again just before it settles.