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[jasmine5]

Hi
I'm 62 and I'm currently on Evorel Conti patches, I've been on hrt for 9 years.  I've recently been trying to decide whether to come off the patches mainly because of the intermittent light bleeding which I've suffered since starting hrt.  Over the years I've had every test known to man and they always conclude it must be down to the hrt.  I've had yet another bleed now (just like a very light period) and just can't face another scan/examination, so I have been trying to decide whether to just stop and see what happens. 

I've tried to reduce the dose several times in the past but my symptoms always return within a few weeks (in particular night sweats, profuse sweating, insomnia and terrible joint pain).  Whenever I speak to my Gp for anything at all she always comments "you're 62 and still on hrt!, you should really be thinking about stopping now" which always starts me worrying.  Would it be ok to carry on with hrt at my age even though I'm getting light bleeds? Physically I feel fine but I worry a lot that I have been on it too long and I shouldn't be getting bleeds at my age.  Isn't quality of  life more important though?  I just don't know what to do and it's making me feel very down. 

[sheila99]

There is no age limit for hrt now so there's no need to stop if you're still getting some benefit from it. I don't know much about the bleeds but as it's a long standing problem which has been investigated I can't see why it should be a problem now.

[Cassie]

Silly GP, my gynae told me he has patients in their late 70s still on HRT.

[jasmine5]

Yes I know but each time the GP says I should come off it I worry that the bleeds might be doing me harm in some way.  Can someone please explain exactly why the bleed happens, is it because I have too much oestrogen which is causing the womb lining to build up and come away like a normal period and if thats the case should I reduce the hrt?  Also why Do the Gp's panic when you mention a bleed and start talking about cancer of the womb etc?  Sorry for so many questions but I'm quite an anxious person!

[sheila99]

If your lining builds up you're more at risk of cancer and bleeding can be a symptom though I think it's more likely to be spotting than something that looks like aperiod. Fibroids and vaginal atrophy can cause bleeding too. Perhaps ask for a scan to set your mind at rest? You can arrange it privately if your gp won't play ball. Do you get any period type changes? It's unlikely but some women don't reach meno til their 60s. Without investigation no one can tell you the cause.

[Kathleen]

Hello jasmine 5

I am 63 and understand your worry about the bleeding.  When I was on HRT the dose was usually 50mcg of oestrogen which didn't stop all my symptoms, even the flushing continued. However when I raised the dose to 75mcg I had some bleeding and needed a hysteroscopy. I also worried about possible progesterone intolerance  from Utrogestan so a year ago I came off HRT altogether.

Initially I didn't notice much difference and certainly didn't feel any worse.  However the last few months I have noticed increasing tearfulness and anxiety plus very low mood.  You make a good point about quality of life, my male GP tells me that it will all  settle down eventually but  he isn't the one dealing with it.

I also understand how being in a state of uncertainty can add to your worry. Every day I wonder what I could or should do to help myself and it has become exhausting.

As you may know some ladies here are on a long cycle and arrange private scans to check their womb lining. Perhaps they will along soon to advise you.

I'm sorry that I can't be of more help but I hope you find a solution soon.

Wishing you well.

K.

[jasmine5]

Yes before the bleed I get most of the period-type symptoms like breast pain, water retention etc. I've had every investigation under the sun including ultrasounds, hysteroscopy, biopsy etc but everything is normal so this should give me piece of mind should it?  I just want to get on with my life and not bother the Gp again but at the back of my mind I'm always worried and of course, having a bleed out of the blue is a bit of a shock and not pleasant either.  Would it be worth seeing a private doctor as I'm thinking he may try me on a different preparation, although I think I've tried most of them now!

[jasmine5]

Hi Kathleen
This is my fear that if I stop I will once again become depressed and anxious as I have been in the past.  I suppose what I want is some reassurance that I can carry on with the Hrt and also not worry about the bleeds when they happen, but I haven't come across a Gp yet that will give me this assurance!  I'm very interested to hear about the 'long cycle' as I haven't heard of this regime.

[Kathleen]

Hello again jasmine 5.

I think several ladies here are on a long cycle which means that they take oestrogen only for about six weeks then  progesterone for about a week which gives them a planned bleed and keeps their womb lining thin.

I don't do this myself and I'm no expert so I may have got that wrong. The best person to ask on MM is Hurdity as she has had success on this regime for a long time.

Can I ask what dose patches are you on and do they alleviate flushes as well as anxiety and depression?  When I tried them I was on a 50mcg patch but my flushes were still happening along with other symptoms which was so disappointing.

Wishing you well.

K.

[jasmine5]

That regime actually sounds very interesting, I would like to find out more about it if possible.  I've been on Evorel conti 50 for the last few years, Prior to this I was on Femseven but couldn't get hold of it any more, I don't know whether it was discontinued or not.  For me Evorel has been a bit hit and miss, it does alleviate my flushes and anxiety although I am on a small dose of Sertraline for my depression, unfortunately It also gives me bad acid reflux for which I need to take medication and of course the period-type symptoms and bleeding are also a worry, so it's not ideal. 

It's so disheartening when you can't find the right preparation isn't it?  I know as I think I've tried almost all in the last nine years!  Personally I think that the dose I'm on is a little high for me as I suffer badly with breast tenderness, I'd like to try something with a lower dose but I don't think there is a lower-dose patch.

x

[sheila99]

As you're getting period type symptoms I wonder if it's your own hormones? Even some experts think everyone is meno by 54 but I had no peri symptoms at all until I was 56 and at 59 I am still ovulating though less frequently. It might explain why the investigations found nothing wrong. You should use the standard dose of 200mg for 12 days if you use a long cycle,  most people seem to use a 6 week cycle (I do too but that's because I have a natural 6 week cycle).
Kathleen did you try increasing your oestrogen? Some people need more than 50mcg and it might be that you don't absorb well. Many meno symptoms can have other causes too but I don't think flushes can be anything other than oestrogen deficiency.

[CLKD]

If it works in the main: and you have been thoroughly investigated: stick with it?  Light bleeds could be a polyp which can be triggered by hormones [as mine was] or your ovaries working .......... do you keep a mood/symptom/food diary to chart progress?

Quality of Life is important.  Have you put the product name into the search box on the Forum? to see what pops up? make notes 

[Kathleen]

Hello Sheila99

 I tried 75 mcg of Evorel for a while but that caused a lot of bleeding and my GP told me to reduce again. I had a hysteroscopy and all was well thankfully .  I have also tried up to three pumps of Oestrogel  but again some bleeding so I reverted to two pumps. Throughout it all I have continued to have flushes, sometimes quite mild but flushes nevertheless and like you I believe low oestrogen is always the culprit.

Wishing you well.

K.