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[Emm225]

I am on Estrodot..32,5 and utrogeston 100.  Been on it since March 2020... I was fine for a year or so, it saved my life tbh as had crippling anxiety, lowness and at least a hot sweat an hour if not more.
I was on 25 of estrodot at first for a year then symptoms started appearing again and upped the dose. 
Anyway, over the last year I started to spot...first it was perhaps once a month and over the last few months it has been every two weeks or so.  I also have the vagainal tablet which dissolves which I insert twice a week.  I am otherwise pretty fit, of normal weight and healthy.

i have had a hysteroscopy, several vaginal scans,..all clear... been examined by my GP but still they don't seem to know why I am getting the spotting.  The GP muttered about changing my HRT which to be frank I am a little scared to do as otherwise this has suited me ok...although I do wonder if my dose is high enough as once again I am hot hot hot at night but no hot flushes.  I haven't put on much belly weight with it , only a little and to be honest it's worth it for how much better I feel on it.

Anyone else had similar....I don't know what to do and the doctor ...when I get to speak to them over the phone which is hard at the practice I am at....lack of doctors....doesn't seem to know either and I feel like a malingerer.  Incidentally lately I have also had aching in my back and down my leg..coud be unrelated though but v annoying as I can't run and it hurts when I walk at times.

[Hurdity]

Hi Emm - if you've had investigations and all is clear then that must be a relief. Did you have a biopsy as well?

Also do you happen to know what the thickness of your womb lining was after the scans and the hysteroscopy?

Also not sure where you are in menopause? My thinking is that if you are post-menopausal and are feeling hot at night (which for me was the prelude to hot flushes and night sweats and in indication that my dose was too low), and there is nothing wrong with your womb lining, why not try an increase to 50 mcg which is the standard post-menopausal dose (as per the combi/conti patches) - though some women need more than this. It is also the minimum licensed dose to help protect against osteoporosis so depending on your age or risk factors you might want to think about this too?

Hurdity x

[Emm225]

Thank you for your reply and information....i am 57 and my womb lining, they said on the scan last Friday, is good and thin. I don't know how thin as I didn't think to ask.  I spoke to a doctor today but he was a locum and seemed a bit in the dark about meno and HRT so I've ended up booking with the doctor I thought I was going to speak to in the first place as she is the one who said perhaps we need to look at the HRT.  I did wonder about having the Mirena coil back in instead of taking the utrogeston orally.  I had the mirena originally to control bleeding...had it in for nigh on 20 years (not the same one!) and it was brilliant.  They took the last one out and told me they were going to leave it a bit to see where I was re meno (I was 55 ) ..then covid and lock down happened and I went onto HRT

[Dotty]

Hi you can take 200mg of Utrogestan daily or change to a synthetic progesterone called Provera or ,as you suggest, the Mirena.  That is the advice of the British Menopause Society for problem bleeding. x

[Emm225]

Thank you...doctor calling me on phone today ....taken this long to get an appointment....will mention what you've suggested

[Emm225]

So..doctor was helpful...to a point.  She has increased my HRT to 50 (Estrodot) and we discussed me going on the pill ( a firm NO from me as that is why I had the Mirena ..the pill doesn't agree with me whatever brand I try) and I mentioned having the Mirena again.  She was very surprised and said , "I've never heard of anyone your age having a Mirena"  However, she said she'd put me on the list. 

An appointment has come through for October 10th...a PHONE appointment! When I got through to the surgery to query this they said it was to "discuss having the mirena".. Since I had one (not the same one!) in for 20 years or so I'm not quite sure what there is to discuss?

I did have high hopes that the higher dose of oestrogen would work...but sadly today I have started spotting and have cramps.  I never bleed much but it's annoying...and worrying.

Not sure what to think/do.....

[Hurdity]

Hi Emm

Sounds like you may be better of with a Mirena as you say - and with a higher dose of oestrogen if you are still hot. The only thing to watch is that the dose of progestogen is high to start with so it can overthin the lining causing spotting but hopefully if you have upped the oestrogen you will be OK. How annoying that they want to discuss it with you if you know this is what you would like to go back to.

Be sure to have the information to hand that Mirena is licensed as the progestogen part of HRT - if necessary print off from this website: https://www.menopausematters.co.uk/to_progestogens.php (scroll down). British Menopause Society will also have some information but this website is very clear and straight foward. Doc can look it up in their book if necessary. Maybe ask to have the appt changed and get doc to agree on phone that you can have one fitted if this is what they do (they do phone consultations with doc in my area and can prescribe)?

Hope this helps and good luck

Hurdity x