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[Charlee]

Hi all,

I’m new to this forum.  I am on continuous Estrogen (gel) and Progesterone (pill) and approximately every 2 months I bleed for about 5 days.  Is this what is referred to as breakthrough bleeding? TIA!

[sheila99]

Yes. We're you meno (one year without a bleed) before you went on this regime. Progesterone (utrogeston?) is taken every day? How long have you been on it? Bleeding in the first 3-6 months of a new conti regime can be expected but any unexpected post menopausal bleeding should be investigated. If it's regularly every 2 months is it possible it's a period? If you're still peri you might be better on a sequi regime, you will at least know when to expect the bleed.

[Charlee]

Prior to taking the progesterone continuously, I was taking it 2 weeks on/ 2 weeks off (for about 4 months) but I wasn’t having a period during the off times so the doctor figured I had already gone through menopause and suggested I take it continuously.  I’ve been taking it continuously now for about 6 months. I’m not sure how to find out if I am in menopause without coming off the HRT and I really don’t want to do that.

[Hurdity]

Hi Charlee

 

You're right you won't know whether you have reached menopause yet except by stopping HRT.

A very rough guide as to where you are in menopause will be what your periods/cycle were doing in the months or couple of years leading up to starting HRT. If they were pretty regular then you may not be at menopause. If they were very few and far between like one every few months, then you may be.

Yes it is common practice to suggest a trial of conti HRT but usually after having been on HRT for a year and as sheila says - bleeding is common for the first 6 months of conti HRT.

I would go back to your GP and explain that you have been having 2 monthly bleeds and perhaps you will be sent for a scan just to check all OK, but I would agree with sheila that going back to cyclical HRT is probably the way to go. How old are you?

The other thing is you haven't given your doses. What dose of oestrogen and what dose/delivery method of utrogestan were you using (on cyclical regime) and what on continuous?

Hurdity x

[Charlee]

Thank you Hurdity and Sheila99 for your help!

I’m 47.  At 44 my periods increased in intensity and my estrogen levels were very high, after a while things settled down to normal again and at 46 my periods dropped to every 2-3 months at which point I went on HRT.  Interestingly, at 33 I attended a fertility clinic and was told based on my FSH levels I was perimenopausal at that time.

I use 2.5 grams of estrogen gel per day and 1 100mg progesterone tablet per day continuously.  When I was taking it 2 weeks on/off, I took 200 mg per day of progesterone and the estrogen stayed the same.  I also use a vagifem as needed. Do those amounts seem typical?

I think I will try going back to cyclical and see what happens.  It does feel like an actual period that I’m getting every 2 months as my breasts get tender and larger which happened during my normal cycle but perhaps that’s common with breakthrough bleeding too!