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[Newtohrt2022]

 Hi,

Ive been prescribed HRT for anxiety, sweats, palpitations. I’ve been using oestrogel (1 pump) every night for a month. When I was started on HRT I had just started my period (I’m still having 23-26 day cycles naturally) so waited to start the utrogestan on day 16 and took it for 12 days. Everything was fine, no side effects other than a bit groggy in the mornings.
My period would have been due the day after finishing utrogestan but obviously things were a bit messed up. But OMG it arrived two days after finishing my 12 days of utrogestan and it’s the worst period I’ve ever had. Headache, severe cramps, flu like symptoms and really heavy bleeding to the point I had to stay off work. Lasted 48 hours and I’m finally feeling a bit more human again.
Is that normal? I presume it’s my body adjusting?

I was told to increase oestrogel to 2 pumps after two weeks ‘if needed’ but not sure if I need to not. I trialled it the night before I got these horrible side effects so now I don’t know if it’s just my body adjusting or because of the extra pump of oestrogel?? I’ve stuck to 1 pump last night and tonight to see if that helps.

I’m going to stick with it all but dreading the next cycle as it’ll be around Christmas 😖

[Hurdity]

Hi NewtoHRT2022

 

Sorry to hear about your heavy bleeding.

If you have been having regular periods every 23-26 days for some time and your cycle hasn't started lengthening then maybe you are not quite at the peri-menopause "proper" yet ( as defined by the medical profession) - even though you are getting some of the symptoms.

Women often do experience heavy bleeding at this point when sometimes high oestrogen is produced, but then it comes crashing down during the second part of the cycle, so the added oestrogen should cushion you from that fall to some extent. Also some cycles are anovulatory at this point - if you are actually peri-menopausal - which means you don't ovulate. In these situations you don't produce the extra progesterone as per normal cycles so the lining builds up. Then when you do ovulate (and produce your own progesterone) or take progesterone in the form of utrogestan - the lining is then shed and is heavier than usual because maybe it wasn't shed in the previous month?

I hope that explains a little what could be happening. There is a good article on peri-menopause on this website here:
https://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php

Also sometimes certain conditions can cause heavy bleeding - fibroids, polyps, endometriosis etc so if you are concerned then do consult your doctor.

In your position if you are feeling well, apart from the bleeding, then I would not increase the gel dose yet?

Another option is to have a Mirena coil fitted which will do for contraception (you didn't mention your age) as well as protecting the womb and will most definitely lessen the bleeding once it settles.

Re Christmas - if you want to try to lessen the amount of bleeding over Xmas then you could just continue to take the (I presume) 200 mg nightly dose of utrogestan and stop at the point when you don't mind the (possible) heavy bleed. Of course the utro will not suppress the cycle so if you ovulate then you are likely to bleed through taking the utro, but it may well not be quite as heavy as if you stopped the utro after 12 days.

The other thing also is that this first time - first cycle on HRT - as above you may have built up some lining to shed prior to taking HRT and from now on may not be quite so heavy? You can always take utrogestan for longer if you can bear it - ie exetnd from 12 days per cycle right up to 25 days as the licensing suggests.

Hope this helps and all the best

Hurdity x

[Newtohrt2022]

Thank you so much for your reply and great advice.
I feel totally fine again now, it was just two days that were horrendous so I’ll keep on with the one pump and take utrogestan for 12 days and see what happens. I’m considering the coil anyway as I hate taking tablets.