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[Sfifties]

Hi everyone,
stupid question but if i have not had a period in now just over a year am i in post menopause ?

I am trying to make sense of all and please forgive me if i should already know the answer to some questions,read a lot here and starting to understand , but i was wondering since i am on a conti regime ( 2 pumps of oestrogel and utrogestan100 vaginally every other night) ,apart from the settling period that occurs in hrt i am approaching 3 months ,what causes  pms symptoms like cramps and period pains irritability ,sore breast ,bleeding and more ..in conti every few weeks ?


I thought that those symptoms would be more common on a sequi regime ( mostly used from women who still have natural periods)as then there would be a part were progesterone would not be taken and then u get a bleed and as many posts say some ladies have symptoms depending on which phase of that sequi cycle they are on and the progesterone might cause some pms like symptoms .
 When i was  younger and still had natural periods i was explained  that the cause of my bad pms were due to the fluctuations of the hormones in the natural menstrual cycle .

So now that i don’t have any natural periods and  on conti hrt therefore  i have “stabilised “ my hormones with a regular intake of oestrogen and progesterone and no flactuations  in progesterone as taken it regularly what is causing all this pms symptoms every few weeks ?

i was expecting some occasional bleed in first 3 -6 months but all the rest of symptoms …..
i hope i am making sense and trying to educate myself although still finding some of this not easy to understand .
Any comments ,  clarification very welcome .
thanks

[Dotty]

Hi were you a year without periods before you started HRT ?

[Sfifties]

Hi Dotty , i had been without periods for just under a year,  my periods had stopped at end of ‘20 beginning of 21i  remember  having a very faint brown spotting day in january then i had a blood test in February 21 .

My blood test showed
FHS :76.8
LH  35.6
My usual dr told me that i was in peri menopause and no treatment  was offered for low moods , lack of energy aches ,insomnia, no libido , dry skin and generally feeling not good.

In mid September i started having palpitations and night sweats and several hot flushes preceded by palpitations and i spoke to a female gp who is the one that has more experience in hrt and when she called me she said that she had looked at my feb blood tests and those values confirmed i had already gone through Menopause .

So i was able to start  hrt beginnings of November .
I have since then had another blood test that initially i found very confusing as the fhs and  lh level were much lower ( like i was in follicular and ovulating phase )but  then after hours of internet search I realised that hrt does lowers those hormones .
Any more thought on why as seemingly gone through menopause get pms ?
Thanks

[QueenofReds3]

Hi
I was told to take the utro every night as part of the Conti regime. I have been period free for four years. I think was period free around 18 months before they put me on Femosten Conti. I have not started the new regime yet as I am waiting for endocrine to see if they are compatible with my meds.
I think there are ladies on here that may give you more helpful advice but I am wondering if taking the prog every other night is causing the bleeding. Maybe contact GP to let them know of symptoms. X

[sheila99]

If it feels like a period it probably is. Blood tests are notoriously unreliable on peri. Although the nhs defines meno as one year without a bleed this is to err on the side of caution, some ladies do go longer than a year and then their periods return. Your gp is wrong on saying hrt is only for when you're meno, oestrogen deficiency starts in peri so you should be able to start hrt when you have symptoms. Once you're on hrt you usually can't tell if you're peri or meno.
If it doesn't feel like a period you should get it investigated to rule out other causes.

[Sfifties]

Thank you for your replies .
QueenofReds3 :i wanted to see how i got on with every other nights utro vaginally first( as suggested by various meno specialists) and after 3 months if bleeding still happens try 3 months every night to have a good picture of how i get on at the 6 months mark , but it’s not about the bleeding i am  concerned as i know it can happen at the beginning  but the other symptoms that make these bleeding episodes seem real mini periods .
 May i ask you why you decided to stop the Utrogestan and will start Femostan conti instead?

Sheila99:i understand that blood test can be up and down but my levels back in feb 21 were very much on the high levels and they seemed to suggest definitely a menopause status when those values are checked against charts .
Ì cannot help to think that given my age , i am 49, Gp should not prescribe a conti regime ( back then i didn’t have the knowledge or knew what sequi and conti was) as you said i could still be peri and initial signs of no periods for under a year and high levels of fhs and lh could have been misleading .

Had i been told to go on sequi i would have although how could i have known when to start  the progesterone since I couldn’t have followed a period pattern since no periods to guide ?

And if these bleeding episodes accompanied by all pms symptoms are periods  i am having  every few weeks they seem to be too close to each other and if that means i am still in peri , i am now in a big mess as continuing with conti is going to be full of issues rather than more regular bleeds .
On the other hand if  am post menopausal  i still haven’t got a clue of why so many pms symptoms?
I have just started and i am already overwhelmed by all of this , i have phone call booked but not sure i will be able to address everything…
I feel one need a medical degree to understand what goes on in the female body .

It ‘s one of those days where positive thinking it’s not in the cards.
I just was so “excited” about starting hrt and finding back my normal self …

Don’t know where to go from here , Gp ok but not as knowledgeable i was hoping .

[sheila99]

If you want to use a sequi regime you can use the same products, utro is 200mg x 12 days (according to the manufacturer, Louise newson think you can halve the dose  if used vaginally). Some who don't get on well with utro use a long cycle (6weeks) in meno, it won't do any harm to use a sequi regime in meno. It's difficult when your periods are erratic so really timing is best guess. Some people find using utro 25 out of 28 days works well in late peri as it allows a bleed if there's been a build up.

[QueenofReds3]

Hi Sfifties.
It is the other way round. Prescribed Femosten ,  but I had a bleed which turned out to be a polyp and stomach issues so I was put on Evorol Conti patch in 2020. Fast forward, anxiety , sleep problems , stomach cramps, irritability etc etc came back in Sept 21, spoke to GP who did some blood tests, thyroid, prolactin and suggested I try the Utro and Oestrogel as she thought I was not absorbing on the patches. But, after reading leaflet the HRT is not compatible with my meds for my prolactinoma so I have to either try something else or come off my meds which my consultant was suggesting I do anyway. I just wish to feel like I did before Sept, the patches were fine until then, the only thing was I had my booster back then! Felt awful for 2 weeks. Could it have caused this?..
Fingers crossed you will get it sorted soon. Keep us updated. X

[Sfifties]

Good morning Sheila99,
Thank you for your advice , very tempted to go on sequi but  really clueless on when to start progesterone, wouldn’t want to mess up cycle if there’s one any more .
looks like it’s going to go a longer process than i had imagined to get the right regime , seems a trial and error process…

QueenofReds3 : i feel like i need to be more patient with all as i see how your case is so much more complex with the diagnosis of prolactinoma that makes things more challenging and how so many of you here in this wonderful sharing platform have had struggles with hrt for long .
Re vaccin : i had my first two before starting hrt and the booster after , i had every time the same flu symptoms and aches for a few days , so unable to see if there’s a connection with hrt symptoms although i keep thinking that this vaccin was developed so quickly that we will find lots more in the future and all could be confirmed.
Was actually thinking about long term effects on teenagers as my daughter had hers( she’s 14 ) and heard a relative living in another country shocked that she did as she has heard of possible infertility issues …

My frustration with hrt comes mostly from the fact that after my endless reading and research i thought  that by starting with the “gold standard “in current treatment , the byoidentical hrt option ( oestrogel and utro) i was hoping everything would go much smoother…and not reverting to painful periods like and pms symptoms  and bleeding.

I hope you get sorted too and you are offered  something compatible with your diagnosis .
I am keeping a detailed diary so will have a better general picture in the coming weeks/ months .
Thank you for all your comments and replies they are very helpful in understanding more this complex stage .
Take care

[sheila99]

If you want to change to sequi I would stop utro and count that as day 1, take utro days 15-26. If your own cycle breaks through then start counting again with day 1 as the first day of your bleed. I'm very late peri and use a 6 week cycle but if you have a cycle of your own this is normally stronger than the hrt one.