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[ClaireB]

I’m just reaching out to see if anyone is having the same problem with HRT.
I can’t seem to find one that suits me and doesn’t cause bleeding every couple of weeks. Dr has done bloods, scans, has changed the dosage and type of HRT. I’ve used gel, patches and sprays over the last 18 months 😫
I’m constantly exhausted and my joints are really painful, I’m slowly losing the battle of the bulge and I’m only 43.
I’ve been struggling with the symptoms of exhaustion and body aches since my early 30’s and I just want to wake up and not feel tired and miserable 😭
Please tell me I’m not the only one struggling, I’m losing hope!

[CLKD]

Morning.  Peri-menopause are the years leading up to the last monthly period = menopause.  Peri can start 10 years+ with women noticing various aches and pains as well as periods waxing and waning. 

As oestrogen levels drop muscles may become lax = aches and pains as well as causing 'middle aged spread'.  Mine apron dropped so when I look down I look fatter without having put extra weight on.  When laying flat ;-). Have U taken an over the counter pain relief?

Some find that keeping a mood/food/symptom diary of use.  Some HRT regimes do cause a bleed for 3-4 months, your GP should have explained the ins and outs of what to expect.  He/she probably doesn't know much!

What does it say in the leaflet in the box with the HRT?   Did your GP do thyroid function and VitD tests? 

MayB over haul your diet and liquid intake.  Let us know how you get on.

[ClaireB]

Thank you for the information, I’ve been 8 yrs post menopause. Dr has done bloods for thyroid but not vitD, but I do take calcium and vitD supplements.
It was explained to me about the spotting in first few months whilst on HRT, I’m not spotting though, I’m having a full bleed every couple of weeks. With Duo-conti combined I was bleeding for 2 weeks straight and really heavy.
I’m having X-ray on knees, hips and back as some days I struggle to walk and a bone density scan to check for osteoporosis/ osteoarthritis as it runs in my family and I was misdiagnosed and not in HRT until recently.

[CLKD]

Hi! tnx for the clarification.

Good that you are getting X-rays so that you have a base line to work from.

Has your GP suggested a scan of the womb, is there a fibroid which may be aggravated by HRT.

[ClaireB]

Yep had a scan and nothing unusual found except thickening of the lining. But surely I shouldn’t be having this bleeding every couple of weeks??? Or am I just being silly and panicking about nothing?!?

[CLKD]

Anything unusual to us should be discussed with the appropriate medical advisor.  It may be your 'cycle' is being aggravated by any HRT tried, it is suggested that a regime should be stuck with for 3-4 months to get into a pattern.

Which HRT was prescribed?

[ClaireB]

I don’t have a “cycle” as the utrogestan I take is constant so I don’t have a break. I’m on Lenzetto spray atm

[joziel]

Claire - 4 things:

1) When you say you're on continuous utrogestan, is that just 100mg? Have you tried 200mg continuously? If not, ask your doctor if you can try that. (I'm currently on it because I have endo and we are seeing if it will suppress the endo okay.)

2.) If 200mg continuous utrogestan doesn't work for you, you could stay with 100mg and add in the desogestrel POP as well.

3) The other option is the Mirena coil, which should stop all bleeding - it can take up to 6 months to achieve that, but for most women bleeding stops totally. It provides the progesterone part of your HRT so then you would just need the estrogen/Lenzetto.

4) You could try sequential HRT for a while, as it seems that your body wants to bleed, even though you're menopausal. At least that way you would have a scheduled bleed and everyone would relax about it...

You say you've tried 'gels patches and sprays' to stop this, but those are all estrogen products. If you are having bleeding problems, it is the progesterone which usually needs to be adjusted, not the estrogen. Do you feel your doctor is experienced in dealing with HRT, early menopause etc etc?

If you are dealing with exhaustion, weight issues and body aches, you likely need more estrogen than you are currently getting. Lenzetto is quite a low dose estrogen because it's only licenced for 3 sprays (although some doctors prescribe more) and 3 sprays is only about 2 pumps of estrogen IIRC. Which is a 50mcg patch. Whereas someone with an early menopause would usually need at least 100mcg patch and often even more than that. But more estrogen without sorting out the progesterone side of things, is likely just to cause more bleeding - so you do need to figure that side of things out.

You might want to see a private menopause specialist GP. I see someone at Newson Health and they are good at working with things that are slightly challenging like this. It's not cheap but once you've found something that works, you can get them to write to your regular GP and tell them what to prescribe and they can then take over again...

[ClaireB]

Thank you Joziel, I’ve always been told that it’s the oestrogen that is causing the problem and no I don’t think my Dr is experienced in this field as they keep telling me to persist with it and they will up the dosage of oestrogen but nothing mention about progesterone.
I will ask them about the levels when I speak to them next.