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[KaraShannon]

Hi all

Some may remember that I mentioned being on continuous Estradiol 100 for 3 months, without progesterone because I had a reaction to it. 

One reason or another haven't got a doctor's appointment yet to sort out what progesterone to take.  I was on Evorel Sequi's norehisterone and did ok on that.  I know it's not enough with 100 estradiol but need to start something again while await doctor's appointment.  (the reaction was to utrogestan, not norehisterone)

Problem is it was suggested here to take the progesterone 14 days after my period.  That was on 5th.  So today I should start progesterone.  BUT yessterday I got all the bodily feelings of a period starting again, sleepiness, sense of well being, etc.  Today it looks like it's beginning, but it could just as equally disappear by tomorrow, I don't know. 

So wait 14 days from today, or start the progesterone today because it's 14 days since the last period.

Meanwhile I will contact doctor tomorrow, today I'm way too challenged by stuff     would appreciate your thoughts, I don't want to take progesterone and mess up my hormones if they are in the wrong phase.  Thanks

[KaraShannon]

I'm a bit pedantic.

Basically the question is, do I take progesterone today if my period appears to be starting?  (even though I'm 14 days after the last one)


 

[sheila99]

I would start it today but stop when your bleed arrives even if you haven't completed the course. That should get the hrt cycle in step with your own. When you say 14 days is that from the start of your bleed or the end of it? If it's from the start the timing is not far off right anyway.

[KaraShannon]

Thanks Sheila

it is from the start of the bleed last time, the 5th. 

Today there is spotting so I suppose I would say it's already begun, but who knows these days..............if it has, stay on the estradiol for another 14 days do you think?

[sheila99]

I would start counting again but from the first day of proper bleeding. I could spot (pale pink) for 5 days sometimes before I got a proper bleed.

[KaraShannon]

Thanks 

[KaraShannon]

Here's what I'm thinking, it's now roughly 14 days since the 'bleed.'  It was a little more than spotting but very scant.

But I've been around 4 months without progesterone, I'm getting a blood test soon but I think it's time I started the progesterone.  I don't feel like a bleed is due, so I think I'm going to at least put the evorel patch on (should be utrogestan but not ready for the reaction, based on experience)

Some progesterone is better than none I think, I usually feel loads better on the progesterone patches and I'm feeling not so good at the moment, as if retaining water.  I think progesterone helps with that so I'll give it a go today.

If anyone has any further thoughts about it I'm all ears I won't be changing the patch until afternoon.

[ATB]

I’m not an expert and you should discuss this with your GP ASAP, but my understanding is progesterone is very important and that it’s a little risky being 4 months without if taking estrogen. My specialist I see said not to worry too much if my period is not 28 days exactly, when I began I simple took it from the next day of bleeding- light or heavy- and then start on day 15 of that cycle no matter what. Thereafter 2 weeks out of every 4 I take Utrogestan ( you must take it for 12 days minimum for the progesterone ). I would suggest you start it on day 15, today? Regardless.

[joziel]

I agree with atb that it’s dangerous not to be taking progesterone. And when you do take it, it needs to be taken for the full scheduled time now.

If you are taking unopposed estrogen for months, you have been causing your lining to build up and get too thick - which is why you now have a bleed sooner than expected. It’s not a true period, it’s a breakthrough bleed due to your uterine lining having thickened too much without progesterone.

I don’t usually want to scare or worry people but you really should be concerned about taking unopposed estrogen. It predisposes you to uterine cancer and endometrial hyperplasia. This can happen quite quickly since in research their studies lasted a year usually. You’ve already been 3
Months without progesterone now…

Please don’t stop progesterone early to get it in sync with you own period -  because you need the full dose of it and because this isn’t a period. It is going to be your body getting rid of some of the build up which has now happened….

[sheila99]

I agree with atb that it’s dangerous not to be taking progesterone. And when you do take it, it needs to be taken for the full scheduled time now.


Please don’t stop progesterone early to get it in sync with you own period -  because you need the full dose of it and because this isn’t a period. It is going to be your body getting rid of some of the build up which has now happened….

Why? I agree with everything you say about the length of time without progesterone but once a proper bleed has started what is the progesterone going to do?
And I disagree with getting your own and the hrt cycle out of step. If it was OK out of step they'd tell you to start hrt at any time not to sync it with your own cycle.

[joziel]

sheila I think if someone has been regularly taking progesterone every month and has found it out of sync with their bleeding every time, then there's no harm in trying to get it to sync with their own body - they are getting enough, overall.

But if someone hasn't taken any progesterone for 3 entire months, the bleeding isn't anything to do with a period, especially if it is happening 2 weeks after the last bleed (a 'period' is what happens after successful ovulation, it doesn't just mean 'a bleed' and you won't have ovulated if you are bleeding 2 weeks later...). Instead the bleeding is because their lining has built up too much - which is the risk factor for endometrial/uterine cancer and is what progesterone prevents.

Progesterone thins the lining of the uterus, that is its function. Since there is now considerable build up, it's imperative that enough progesterone is taken to get rid of that extra build up and help the body to shed it - or it is a risk for uterine cancer. Taking progesterone for a few days and stopping again because you start to bleed, is not going to work - you need to keep taking it, so it can thin that lining.

But it is also a bit scandalous that someone has been in the position for this to happen and is unable to access medical help to get advice or more progesterone....

By the way, KaraShannon, if norethisterone works for you, the BMS have some info at the bottom of this pdf about using it for the progesterone: https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf 

"Norethisterone
5 mg for 12 days a month (cyclical) [given that no smaller (1-2 mg) dose stand-alone norethisterone preparations are available in the UK]
0.5-1 mg a day (continuous combined)
– Off license use of norethisterone in progestogen only contraceptive pills (e.g. Noriday 3 x tablets of 350
micrograms a day, will provide 1.05 mg of norethisterone) may be considered as an equivalent alternative."

Which means that officially you can use the Noriday POP x3 tablets daily (which is norethisterone) if you are really stuck, but you need to speak to a GP ASAP to get onto a progesterone.....

[KaraShannon]

Thanks for the replies, I will answer properly soon.  I've submitted an eConsult to the surgery today, so let's see what the advice is. 

I never meant for it to go on as long as it did but I have other health problems and fatigue and then a family bereavement, and then each time wanting to get the timing right and figuring that was important otherwise I'd put in a hormone that is at odds with my body.  I have had something of a cycle up until this month where I've had a very light period, so hopefully I've been producing some of my own progesterone, but agree it shouldn't have gone on this long.

[joziel]

That's good, let us know how it goes.

By the way, when you do start progesterone, you might bleed heavily and/or it might go on for longer than usual. Don't stop taking the progesterone - it is your body getting rid of all the extra build up...

[KaraShannon]

Taking progesterone for a few days and stopping again because you start to bleed, is not going to work - you need to keep taking it, so it can thin that lining.

But it is also a bit scandalous that someone has been in the position for this to happen and is unable to access medical help to get advice or more progesterone....

I haven't taken progesterone for a few days and then stopped because of starting to bleed....

Yes it's a bit annoying as I've mentioned this a couple of times to the surgery, told well lets have a blood test etc, but then that's weeks away etc, it's just a series of events

[KaraShannon]

By the way, when you do start progesterone, you might bleed heavily and/or it might go on for longer than usual. Don't stop taking the progesterone - it is your body getting rid of all the extra build up...

No I won't do that, I am waiting for it and expecting it, I even think some of my heart ectopics might be because of build up as before I went on hrt I had a lot of heart ectopics, then a really long period (6 weeks) and in that time not aware of my heart at all