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Author Topic: Cyclical HRT withdrawal bleed not in synch  (Read 1121 times)

ConfusedAboutHRT

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  • 51, peri, 75mg estrogel, mirena coil in situ
Cyclical HRT withdrawal bleed not in synch
« on: February 20, 2022, 09:50:43 AM »

Hi there. I’m perimenopausal and on HRT since August. Before starting my periods were quite irregular. Sometimes monthly, sometime 60-90 days. I started on cyclical 50mg patch and 100mg utrogestan days 1-25.  I had a withdrawal bleed each month approx 2-3 days later. In December i switched to taking the utrogestan vaginally. Having read that you need half the dose, I used it alternate days for the 25 days. I had a bleed 4 days later (14th December). A different gp freaked about me using the half dose and also didn’t like the 1-25 day regimen so switched me to a different regimen - taking 200mg days 15-28. I’m taking this vaginally. I had a bleed 4 days later (14th Jan). So far so good.  But gp told me to count day 1 as the day after I break in the utrogestan so that’s what I’ve been doing. So that effectively means two weeks on utrogestan and two weeks off. The problem is this month - After taking utro 25th Jan to 7th Feb (14 days worth) I didn’t bleed until 9 days later (16th Feb, 33 days after last period).  I don’t know whether to count 14 days from the bleed to try to synch (which would mean going without utro for 23 days) or 14 days from last taking utro (in which case starting 5 days after a bleed doesn’t suggest last 14 days of cycle). Maybe I’m over thinking all this - it’s only been one month blip.  Very worried about what to do.  Could it be that my own cycle is producing progestrone which is delaying the bleed?  I don’t think my gp knows much about any of this. When my bleed didn’t come after a week I called and he said he wasn’t worried and it’s probably just my body settling to regime change but to do a pregnancy test in case.  To be honest I’m so scared of getting it wrong, womb lining issues and everything else that I’m thinking of giving up. As I’m not sure my symptoms are getting better. I know I’m terribly anxious and there’s so much conflicting information that I’m just overwhelming. I’ve thought about just stopping but am afraid of withdrawal symptoms too. I’m really struggling. Please help. Thanks for reading.
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sheila99

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Re: Cyclical HRT withdrawal bleed not in synch
« Reply #1 on: February 20, 2022, 10:56:27 AM »

It's difficult in peri when your own cycles vary. Day 1 should be the first day of your bleed. If you're late peri and don't have much of a cycle of your own you can stick to dates but if you have your own strong cycle I find it best to adjust the hrt cycle to stay in step with my own. Not everyone can tell when they ovulate but if you can you can start utro a day or two later and you should bleed a couple of days after you stop. As long as you're having a proper bleed I don't think you need to be too concerned but if you're really worried you could arrange your own private scan in a few months to check all is OK.
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ConfusedAboutHRT

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Re: Cyclical HRT withdrawal bleed not in synch
« Reply #2 on: February 20, 2022, 02:34:46 PM »

Hi Sheila,
Thanks so much, I know you're one of a number of people on here who are active users and give sound and knowledgeable advice.  I truly appreciate your time.  It also saddens me that there's still so much unknown in the medical community that we have to look for answers elsewhere.  I've read many posts where the writer has been given entirely conflicting advice by difficiult medical people, or no advice at all (very common).  The whole thing is even more anxiety inducing, as if the perimenopausal anxiety wasn't already bad enough.  It's a great comfort to have this forum.  I think the feeling of being anxious is so lonely and not knowing where to turn.  This does help!
Best wishes, P
« Last Edit: February 21, 2022, 09:39:17 AM by ConfusedAboutHRT »
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sheila99

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Re: Cyclical HRT withdrawal bleed not in synch
« Reply #3 on: February 20, 2022, 07:16:34 PM »

Glad I could help. Anxiety and insomnia were my worst symptoms so I know how debilitating it can be, I hope you see some improvement soon. Incidentally you should be taking 200mg for 12 days, days 15-26 so you bleed again on day 1 (or not if your own cycle thinks otherwise  ::)) 0
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Vicky81

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Re: Cyclical HRT withdrawal bleed not in synch
« Reply #4 on: February 21, 2022, 10:57:00 AM »

Hi Sheila,

If you dont mind me asking which HRT got rid of your anxiety?

Vicky xx
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ConfusedAboutHRT

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Re: Cyclical HRT withdrawal bleed not in synch
« Reply #5 on: February 21, 2022, 08:07:42 PM »

Glad I could help. Anxiety and insomnia were my worst symptoms so I know how debilitating it can be, I hope you see some improvement soon. Incidentally you should be taking 200mg for 12 days, days 15-26 so you bleed again on day 1 (or not if your own cycle thinks otherwise  ::)) 0

Hi Sheila, Yes it makes sense to me to try to synch a bit, and like you say - only do 12 days (15-26, not 15-28 .  Actually my GP had prescribed 14-28, but I ignored the 14, as that would be 15 days taking it).  I spoke to my GP today.  She completely disagreed of course.  The usual.
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