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[Emm225]

Since increasing my Oestrogen patch dose (estrodot) in September ..but not the utrogeston...on doctor's advice (symptoms had worsened again on lower dose and also kept having spotting...was all investigated ad all fine) ....I seem to be suffering from extreme bloating, particularly at certain times of the month.  I look pregnant with it (I am quite slim) and my stomach is hard and uncomfortable, and it wakes me in the night as it's so uncomfortable.

At first, in September, I put it down to constipation , which I can suffer from as I think I have a lazy bowel (sorry if I'm grossing you out!) In October it got bad again ...and I ended up going to the doctors about it..although typically when my appointment time arrived the bloat had gone down so I felt like a fraud.   However , the doctor took bloods etc and I was sent a bowel test kit, not heard anything so I presume all is fine.

BUT...the BLOAT CONTINUES :-(   ...I have looked pregnant this week and it's only just going down again.  I took photos (in case I ever manage to get into our doctors again for an appointment...very difficult here) I mentioned the HRT increase last time I went and the doctor summarily dismissed it and said she'd never heard of any links.

Can anyone help/has anyone else sufferred from this?

[Wrensong]

Hello Emm225, yes, oestrogen can cause/contribute to bloating in 2 ways so you are probably right to link yours with the recent dose increase.  Some women find it causes them to retain fluid (me included) & it's also increasingly being acknowledged in the medical literature that it's not only progesterone that can slow gut transit, but oestrogen, thereby contributing to any tendency to constipation.

With progesterone, the constipation link has long been thought to be due to its muscle relaxant effect inhibiting peristalsis, the resulting weaker contractions said to be less effective at propelling food through the digestive tract.

I think perhaps some women are more susceptible than others & I've had to reduce my oestrogen dose to enable me to manage these unfortunate side effects. 

Progesterone can have diuretic effects (very much so for me), perhaps offsetting any fluid retention from oestrogen, but potentially also adversely affecting stool form    Sorry if tmi but knowledge is power & all that!  Finding the right balance, as always with HRT is probably key.
Wx

[sheila99]

I would see your gp in case it isn't hrt related. If you had no bloating on the lower dose it's possible though perhaps unlikely to get such extreme bloating now. How much did you increase by? Alternatively try reducing/stopping for a couple of weeks and see if the bloating goes.

[Amazing grace]

Hrt can definitely cause bloating , I’ve been on it for 5 years and have bloating on and off but I recently increased my estrogel to 4 pumps and after 5 weeks the awful bloating started like you described I also looked pregnant I’m slim all over so it looked very obvious I went to my doctor also dismissed hrt being the cause I had blood tests and scans all normal I took it upon myself to decrease the dose and the bloating went away just to see if it was definitely the hrt I increased again and the bloating developed yet again after a few weeks of the higher dose , it also affects my bowels I use estrogen only so no progesterone to blame in my case x

[Emm225]

Thank you so much, informative and helpful...my GP hasn't been halpful really apart from doing tests.  I've also had another show today...it usually seems to tie in with the bloat as it were.

 I would say I'm probably post meno..difficult to tell as I haven't had a period for 20 years or so (on Mirena coil til the last one was removed 4 years ago ...and then it seemed to catapult me into physical meno...although looking back I'd had symptoms for a while..anxioety, UTIs etc)  I may try to reduce my dose...it was partly put up because I kept having shows as the GP seemed to think increasing my oestrogen dose would halp with that.  As I;ve had one today it seems pointless staying on a higher dose...I was on 37.5 and it was increased to 50....which apparently isn't very high at all.

[Wrensong]

As Sheila suggests, though probably nothing serious behind it, sensible to go back to your GP if it's persistent, especially if you're having unscheduled bleeding.  A pelvic scan might throw some light on the cause of both, if that hasn't been done already (I see you say the spotting was investigated & mention hysteroscopy on another thread, so imagine all checked out recently?)  I would definitely flag up that you've heard nothing about the FIT test (bowel).  My result earlier this year came through within a week as did OH's.
Wx

[Emm225]

thank you...yes I've had scans and a hysteroscopy (not keen on repeating THAT again!)  How do I go about going private ...I [phoned my GP, eventually got through, and I have a phone appointment in 3 weeks time.. and in the meantime I am still bleeding .  I'm 57 and feel this isn't right

[Wrensong]

How do I go about going private

If you want to consider a private consultation Emm225, have a google for private hospitals in your area & they should list their consultants, together with their special interests.  I'm not sure whether you're thinking Gynae or Gastroenterologist since you mentioned both bowel & gynae issues.  Either way, if they don't state fees or you need additional info as to who would be right for your concerns, waiting times etc (likely to be minimal) you can ring the hospital's admin/patient services section or the consultant's secretary to find out what you need to know, before booking.  Many accept self referrals these days, some may still ask for a GP referral.  If you are wanting a dedicated private menopause clinic rather than a general gynae or gastroenterologist, again you can put that into your search engine for the area you live in.

Alternatively, if you can face it, you could try your GP surgery again, stressing that you're worried.  At very least they should be able to tell you the outcome of the stool test if it was arranged through them & how to progress it if it was through the postal screening service.  Many of us do have probs with unscheduled spotting/bleeding & bloating on "no bleed" conti HRT regimens & it may well just be a question of tweaking yours, but if your instincts are that this needs further medical input I would go with those.
Wx

Later edit: I've assumed you're on continuous HRT, but rereading your original post you mention "certain times of the month" so are you in fact on sequential HRT but bleeding at odd times rather than just getting a withdrawal bleed after your progestogen phase?  Sorry if I've missed something, but the uncertainty over whether you may not be postmenopause also makes it harder to know what's going on, as you say.