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[Wannabewell]

Could anyone help, please.

My GP wants me to try continuous cycle.  I had had symptoms returning and am currently working up to 4 pumps of Oestrogel from 3.  I currently take Utrogestan 200mg days 15-26 but often I’ll bleed around three days before day 26.  Sometimes I don’t bleed and sometimes I’ve bled around three days after day 26.

I’ve tried to get in sync but it didn’t work.

Should I begin continuous if I’m still having bleeds? 

My HRT history (currently cycle 23):
Hadn’t bled for 8 consecutive months prior to starting 2 pumps Oestrogel and Utrogestan 200mg sequi.

Then symptoms started again so increased to three pumps Oestrogel.

Stayed on that for a good while then symptoms again so now working up to 4 pumps Oestrogel and to try continuous Utrogestan.

I’m thinking I may get breakthrough bleeding from my own cycle?

What do you think?  Would really appreciate some help.

[sheila99]

At this point in time you could do either but I'd suggest if you go for conti using 25/28 instead of every night as this allows a bleed if there's been a build up. Personally I'd stick to sequi for now if you bleed most months but I may be biased as I get fatigue on it. It shouldn't make any difference to your meno symptoms unless you have a reaction (good or bad) to utro.

[VanillaLover]

Hello Wanna

Sheila already replied to me in my posts as I have the exact same situation. My GP suggested I try continuous now.

I have decided to give the continuous a try for a few months. I don’t mind taking the utro so it makes no odds to me. Maybe the stability will help my hormonal migraines. Who knows.

Vanilla

[Wannabewell]

Thanks Sheila, that’s really helpful .. much more so than my GP.  I really appreciate it.  I’ll have a think but for this cycle I’m definitely sticking to the sequi.

Is there a time where I’d have to go in continuous even if I’m still getting breakthrough bleeding?

It confuses me how Utrogestan works to protect the uterus.  On continuous how does it protect if there is no bleeding?

[Wannabewell]

Hello Vanilla,

It’s a tricky situation isn’t it.  I really hope you do well on the continuous cycle .

Good luck 🤞

[VanillaLover]

Hi, no as far as I know there is no time you “have” to go continuous. It’s down to preference.

Progesterone changes the endometrium...oestrogen causes it to build until ovulation. Once ovulation happens, the corpus luteum (place left behind in the ovary where the egg was) secretes progesterone. This makes the thick endometrium change to become receptive to a pregnancy and it doesn’t build further.

So if you are taking progesterone continuously, it never builds up in the first place.

That’s my clumsy interpretation anyway!

[Wannabewell]

Hi Vanilla,

I’ve been looking through your posts and it’s been really helpful, I don’t feel as alone and confused by this situation now.

Thanks so much for your explanation and information, that’s really helpful.

I appreciate it, thank you.

[VanillaLover]

😀

[sheila99]

They prefer you to be on conti when you're meno, they told me there's a slightly higher risk of endometrial cancer on sequi (not sure there are any robust statistics though). I wanted to stay on sequi because I get fatigue on utro and they agreed to it. Most people prefer conti so they don't bleed but I'd rather have a bleed than fatigue.

[DottyD68]

Hi wannabewell,

I think I am in a similar situation to you regarding sequi vs conti decision.

Started sequi Oestrogel and Utrogestan (15-28) at age 53 whilst still have periods (of a kind). Was told that because of my age I should move to conti after 12 months of sequi. I did this at 54 but this also coincided with me just recovering from Covid and many of my menopausal symptoms returned very quickly. I contacted my surgery and another GP said I shouldnt have changed whilst recovering from covid, so I wasn't sure what had actually caused the reoccurance of symptoms (conti or covid). Was advised to return to sequi to let things settle.

4 months later when things had settled (as advised) I retried the conti regime of daily utrogestan and by end of week 3 I was in agony with a back in spasm, heavy/crampy legs (which was one of my initial menopause symptoms), fluid retention and my boobs were so large, sore and uncomfortable. This was similar to the first time I tried conti. I decided to stop the continuous utrogestan and within days I felt back to "normal". I had a big withdrawal bleed after 3-4 days which was actually a relief. 3.5 weeks later while now back on the sequi phase of utrogestan I have had a small breakthrough bleed before the end of my utrogestan phase which was happening whilst I was on sequi for the first year. I personally don't think I am ready for conti which I will discuss with my GP next month during my review.

I do take the GPs advice but I also believe we know our own bodies. Unfortunately for me I think I am "late" in menopausal terms (in that at 54 I am still having periods) but have been suffering with peri-menopausal symptoms for 8 years.

I'm not sure this helps but wanted you to know you are not alone in the sequi vs conti transition. Wishing you well x

[Wannabewell]

Hello Dotty,

Really sorry for the late reply.  I’ve had a terrible time lately with facial pain 

Thank you very much for telling me about your experience which does sound similar to my own.  The Covid recovery affecting you is interesting too.

I’m now on continuous (first cycle) and have not felt much different to usual but did have three days of spotting.  Today is day 26 and I’m not yet fully decided whether to stop Utrogestan for two or three days to see if I bleed or not.

It’s all very confusing.  Thank you for letting me know that I’m not alone with this, it does help. Wishing you well x

[DottyD68]

Hi Wannabewell,

Sorry to hear you haven't been feeling well.

Just thought I'd update you. I spoke to GP last week and told her about my 2nd abortive attempt at conti. She didn't see a problem about staying on sequi as she thinks I am still having natural periods despite my age (55 in July). However she did suggest I have a scan to see "where we are in terms of uterus lining". She is expecting everything to be ok but just wanted to check. I am happy with this but then did have a slight wobble as to what this could show. I did some more research on why the medics may prefer you to be on conti rather than sequi and exactly as Sheila99 says, it is because there is a slightly higher risk of uterine cancer especially if you have been on it for over 5 years. However I think regular scans keep a check on this.

I hope you get on well with conti X