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[Masmeno]

Hi all - just wanted a view on continuous v cyclical Utrogestan regime and sleep quality.

I stared cyclical hrt in September 2020, at that point I had not had a period for 5 months. For 2 weeks of the month I took 2 x Utrogestan and it disrupted my sleep so much I felt like I was losing the plot.

I had one period in the October (a month after starting) and then that was it.

So 6 months later with still no monthly period on cyclical, in April 2021 I was moved onto a continuous regime of one Utrogestan a night.

And hallelujah one Utrogestan a night was the sweet spot and I slept for at least 7 hours a night every night.

But unfortunately then had either spotting or a light period nearly every month, sometimes twice a month from April to September.

Last month due to this bleeding my doc has asked me to go back to cyclical for 6 months as it looks like I am still peri. So for the last 2 months I have been back to 2 weeks on and 2 weeks off and also the return of 4/5 hours sleep every night.

So, long old story (sorry!) but I would like to go back to continuous as I would rather have the breakthrough bleeding than the lack of sleep.

I am going to ask my doc if this is ok to do on a call tomorrow, but was interested to hear if anyone else had experience of this back and forth and monthly bleeding on continuous?

Thanks!

[Hurdity]

Hi Masmeno

 

I have only ever taken conti HRT for a few months but this was on a low dose oestrogen and I had no bleeding - in fact have almsot never had any unscheduled bleeding since I've been taking HRT - for nearly 15 years. I don't like progesterone so I stay with a (long) cycle even in my late 60's, even though I also hate the bleed!

You haven't mentioned what dose of oestrogen you are taking? I am thinking you are possibly on a low dose patch in view of the lack of bleed on cyclical utrogestan? Are you taking the utro orally or vaginally?

One possibility if you think the dose of oestrogen suits you, is to move to a longer cycle if your doc is happy (though if a GP, they may not have sufficient confidence or knowledge to allow this - luckily mine is a gynae specialist so is happy for me to do so). So eg if you took the utrogestan every 6 weeks as I do, then you will have a 4 week period of time on oestrogen alone and reap the benefits. Also the licensed dose is 12 days per 28 day cycle so I take 2 x 100 mg utro capsules vaginally for 12 nights every 6 weeks. Yes I feel foggy-headed and excessivle sleep during this time and often have to get up in the night re bladder, but to me it's a small price to pay for feeling good for the other weeks!

However if you like the continuous progesterone then sounds like this wouldn't be ideal for you. The tricky thing with the unpredictable bleeding is that this is usually an indication that something is wrong so you would not then have the usual warning signs. So if the unscheduled bleeding did not stop after 6 months then this shows that the regime is not really recommended.

I would be interested to hear what your doc says.....

Sorry I can't really help with my experience of this.

Hurdity x

[Masmeno]

Hi Hurdity

Thank you for responding.
For oestrogen I am on 150mcg patches (1 x 100 and 1 x 50mcg.

Your comments re longer cycle are v interesting thanks for that. I will discuss my options with doc tomorrow (doc is from Louise Newson clinic so very well informed  )

I agree I really don’t want to have breakthrough bleeding if I can help it, but I am now at the stage where my cycle is so all over the place I am not sure what is what or even if it is a cycle!

My main gripe is the sleep - just struggling to cope with the reverting back to shocking sleep when I felt like I had it cracked.

Thanks though some useful info!

[Masmeno]

I had the call with the menopause doc this morning and as the 2 x 100mcg of Utrogestan interupts my sleep and the 1 x 100mcg does not, she has recommended a halfway approach.

Basically as I need 2000mcg of progesterone a month to protect the womb…rather than take it 2 x 100 mcg for 12 days, I should try 1 x 100mcg for 23 days (then have 5 day break) as that is the same amount and see how I go. As long as I have a light bleed each month that is ok.