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[Jan1234]

Ive posted so many times in here about the problems im getting with oestrogel and ultrogeston im nearly 6 months in now on this hrt and bleeding been my problem, i decided last month to give this my last try on it, anyhow i acually gone 6 weeks thus time without a bleed i thought things were acually settling i then come down with a tooth infection and was put on amoxicillin 500mg 3 days in and a periid have started only bleed in mornings and then stop does anyone know if antibiotics could effect the hrt to cause this or do i just accept that this is just not working for me im 58 and only had this problem since changjng to this hrt conti any thoughts please ive just had enough now thanks

[CLKD]

Is the bleeding cyclical?

How has the over all HRT regime eased the symptoms?

How were your periods prior to beginning HRT, it may be that your cycle is trying to over-ride the medication?

I had break through bleeding with Beconase nasal spray, I was on The Pill at the time.  Does it say in the leaf let in the box if there are any problems with other medications?

Let us know.

[Jan1234]

Im on conti been on hrt 8 years was on sequel till 2019 then put on kliofem cont and kept getting cervical polyps and was recommended by gp to go on oestrogel and ultrogeston as this was a safer option problems started since then i feel quite good except for the bleeding

[joziel]

Jan, please don't accept this isn't working for you (yet) because there are some more things to try.

You could try asking to double your utrogestan - assuming you are currently taking 100mg nightly, you could take 200mg nightly continuously. I'm doing this because I have endo and it helps suppress endo. (I'm 44yo and peri.) Ask your GP if you can increase your utrogestan like this.

Alternatively, you could try a Mirena coil - this contains a tiny amount of progestin which thins the lining of the uterus and after a few months tends to stop all bleeding for the vast majority of women. It acts as the progesterone for your HRT, so then you just need estrogen. There is no age limit to using a Mirena coil for as long as you can comfortably have one fitted and each one lasts 5 years.

Your GP might want to send you for a scan before you have the coil fitted, just to double check. It's normal to bleed when starting or changing HRT but you're coming up to 6 months now so a bit unusual not to bleed until now. (Unless it is caused by the ABs.) What does the fact sheet thing that comes with the ABs say? Are you taking them at the same time as the utrogestan and can you manage to have a few hours between them?

[Jan1234]

Hi joziel i really dont want a mirena and am being pressured by gp everytime i ring them thats why i dont want 2 contact them now, they upped me to 200mg ultrogeston back in april it stopoed the bleed but felt awful even though i take them vaginally  so was told to go back to 100mg then when away on my holiday in may was constantly bleeding 1st hol since covid i thought right lets try 200mg again to see if it stops i bled so heavy after trying 200mg that acually stopped my hrt till i got home aa it frightened me, i spoke to gp in june and she wont refer me back to gynecology as i seen them in feb and had a polyp removed she said i cant be referred until 6 months are up im at my end of my tether something dont feel right  i alao get alit if pain in my right side area of hip and was told by physio it was hormone related,  i acually cant  cope without hrt tryed beg of year and was a mess thats why ive perservered the bleed but cant do this no more now so i jjst dont know what to do next thanks for reply

[joziel]

Hi Jan - If you can't take 200mg utrogestan in an ongoing way without feeling progesterone side effects and if you don't want to consider the Mirena, there aren't a whole load of other options.

You could try a combined patch like Evorel Conti or Femseven Conti, which have a synthetic progestin in them that is different to utrogestan. But the estrogen in those patches is only 50mcg (2 pumps of gel) - if you need more than that, the combined patches wouldn't be appropriate really.

Why don't you want to consider the coil? I get that it is a personal choice and I also don't really want to consider it and luckily I'm doing okay with 200mg of utrogestan - but I most definitely would try the coil if it were the only option or the best option. If it comes down to stopping HRT or having the coil, it would be a no-brainer for me.

[Jan1234]

Joziel i want to go back on kliofem but to be honest my gp as actually scared me a bit about going back on synthetic types of hrt ive got 3 months supply still in date from last year but acually scared to take them as because all im hearimg is body identical safe synthetic not so safe im even considering going back on a sequel but at the moment i seem to be unsure of everything cauae i told my gp something dont feel right

[joziel]

If the Kliofem works for you then for sure, go back onto that I reckon. All things being equal and with nothing else to consider, then body identical is safer. But not everyone can do that.

The two issues with oral HRT are 1) oral estrogen, which increases the risk of clots - but if you are not high risk for clots anyway, that is not a huge consideration and 2) synthetic progestin - which is not great for many parts of your body, but I do think the ways it's not great are over-stated sometimes.

Really the Mirena would be ideal as then you could stay with transdermal estrogen, the bleeding would stop, and if you wanted to add some utrogestan in as well for the health benefits, you could. Why don't you want to try the Mirena?

There are some other women here who have it - Nas just got a Mirena recently - so they might be best placed to talk about it...

[Nas]

Mirena would stop the bleeding, as joziel said.
I had horrendous bleeding for months and months on the patch and utrogestan. Utrogestan just didn’t work. Like you, i was skeptical about having something inserted inside me, which I couldn’t readily ‘ stop’ or remove. However,  the bleeding got too much and without thinking too long and hard, i shot over to Liverpool women’s hospital and had a coil fitted.

Other than a bit of bloating and spotting at the beginning , you wouldn’t know it was there. No actual bleeding for 2 months now.

My Oestrogen isn’t quite right, but the coil is in situ, so am free to take whatever Oestrogen I can get my hands on 

The good thing is, I have the nurses number ( who fitted the coil) and she said at any time, it can come out.

It’s your choice entirely Jan1234, but sometimes, we need to try different options.

Go back on kliofem, if that suits you?
If synthetic was so dangerous , it wouldn’t be readily available to women.

[Ayesha]

If Kliofem was the cause of your polyps then its not advisable to go back on it, they are really something to be avoided as they can turn nasty. Also when you run out I can’t see the doctor prescribing more for you, at least a doctor shouldn’t.
If you rule out Kliofem then think again about your options, I wish you well and hope you find a solution that suits you!

[CLKD]

Were you 'referred back to your GP' after your Consultation in Feb.?  Without a follow-up appt.?  I consider that absolute Rubbish about not being able to refer within a certain time, if what if a patient had heart problems, thyroid function dis-order, asthma attacks  .......  . it's more likely that because each referral is charged to the GP Practice!

You could ring directly to the secretary of the Consultant who saw you and ask for advice .  A referral to a dedicated menopause clinic would be my suggestion though there are waiting lists.

[Jan1234]

Thanks all for your replies, i spoke with a  gp today i was  in luck today to be able to speak with the gp that had referred me to gynecology when i had polyps, she couldn't believe that im still having bleeding problems shes referred me back to gynecology she said at 58 i shouldnt be bleeding at all, we spoke about my options of hrt i  told her please dont pressure me for mirena i will think about it  and she was fine about that, i asked her about going on a sequel hrt so i know where i am with the bleeding she would not agree with that which shocked me she said at my age its not good to be having a bleed every month i was quite gob smacked acually as back last year she said to me that a sequel would be an option for me, so basically i carry on with what im on till  see gynecology so persvere bleeding again its never ending

[CLKD]

A Gynaecologist, unless working in a Menopause Clinic, may not know any more than your GP seems to.   .  There are some ladies who have regular periods into their late 50s/60s though they don't often appear on the Forum. 

I would ring to see why she thinks that you shouldn't be getting a regular bleed?  Ask if you can try the sequel for 6 months to see if it helps which would give you a base line.

[Ayesha]

She wants to get your bleeding sorted out before she can prescribe you anything. You are on the right path now being referred back to Gynaecology which can only be a good step forward!

[joziel]

Have you had bloods run to see if you are actually menopausal? Two high FSH readings, for eg?