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[Dsh14]

Hello,
I havent had a period for 6 yrs and in April last year started to get symptoms of GSM and vaginal atrophy. After a lot of GP visits I was put on 50mg Evorel patches and 100mg utrogestan orally. Im also on Vagifem every other day.  My symptoms didnt settle so my patches were increased to 75mg Evorel. Finally I was starting to feel ok down there but this week I have suddenly started with a period / bleeding.  I have had a scan and my uterus lining apparently did look thickened (according to the person doing the scan).  I am waiting for a follow up with my GP and gynacologist but has anyone else experienced this bleeding and please someone tell me it can be stopped as I just want to feel normal again!?

[Nas]

Hi
This happened to me.
4 months into starting patches, the bleeding began. Every 2/3 weeks, just like a period.

I had several scan and 2 hysteroscopies. All normal. No polyps, cysts, fibroids etc.

It was suggested I have a coil fitted, to allow me to continue to use Oestrogen. Reluctantly I agreed. 5 weeks on, I’m spotting rather than bleeding.


They might suggest you change your progesterone or double up on the utrogestan.

Fingers crossed it settles down for you.

[Dsh14]

Thanks for your reply. I have just been to the drs who says to reduce patches down to 50mg until I can see gynaecologist in 3 weeks time. However I’m worried if I do that I will get my original symptoms back. She said I may benefit from a  mirena coil to deliver the progesterone?  This HRT is such a minefield- is there anyone out there for who the original dosage was correct and they are ok? I’ve been trying to get this sorted for over a year now 😩

[joziel]

There are lots of people who are fine on 100mg of utrogestan. After all, that's what was used in the trials and research and why that is the standard dose which is given.

But women are individuals and it doesn't work for everyone.

Yes, the Mirena coil as Nas explained can stop the bleeding and then you would just need the estrogen by itself and wouldn't need other progesterone. If you don't want a coil, there are other options - you could double the utrogestan or you could even add in the desogestrel POP (I'm on that) for additional progesterone.

Reducing the patches for 3 weeks might see your original symptoms returning. I can't imagine that 3 weeks is going to make any difference once way or another, whether you continue or stop, in terms of the bleeding...

[Dsh14]

Ah ok , thanks , I’ve never heard of POP. I’ll look into that. Yes I agree, it’s taken me a year for my GSM symptoms to settle, I don’t want to risk them returning for the sake of 3  weeks !  I’m not keen on the idea of a coil but if that what it takes then I will have to go with it. Thanks for the help x

[joziel]

The POP is usually prescribed for women on HRT who also need contraception and don't want a coil. Because HRT doesn't offer contraception.

But it is also good for endo sufferers. I was on it for 9 years before starting HRT. When I started I tried to come off the POP but I got an endo flare-up after 5 weeks - so added the POP back in again alongside the HRT and all is okay again now. Obviously the more progesterone you take, the less likely bleeding is. I have been told to trial doubling my utrogestan instead of taking the POP and it's on my to-do list, but at the moment I am preoccupied with dealing with my estrogen-related side effects like heart palps and feeling throbby etc - I can't deal with an endo flare up as well, so I have de-prioritised that trial!!