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Author Topic: Is it Estrogen or progesterone that causes bleed?  (Read 1219 times)

flossie fiddler

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Is it Estrogen or progesterone that causes bleed?
« on: January 08, 2023, 10:44:34 AM »

Went back on HRT back in August after 2.5 year break. Not had periods at all during the break). Was on Evorel Conti, but was getting a lot of bleeding (average 17 day cycle with constant pink discharge in between.

On 13th Dec I switched to Evorel 50 with Utrogestan 100 orally at night for 25 of 28 day cycle. The bleeding stopped within 3 days, and I’ve been totally clear but started with a bleed on day 22 of taking Utro. I’m now on my 3 day break, not due to start Utro again until Tuesday. The bleed has just about stopped now, and was 6 days.

I know it’s normal to get bleeds initially, but is it the estrogen or progesterone that triggers the bleed? I expected a bleed at some point, but thought it might be on the break from Utro.

If anyone has advice or experience of this please let me know. I have one more box of patches (was only prescribed 2 boxes initially when I changed from Conti to the current regime) so will be making an appointment in the next few weeks for another review.
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Taz2

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Re: Is it Estrogen or progesterone that causes bleed?
« Reply #1 on: January 11, 2023, 08:07:36 PM »

It's the withdrawal of progesterone which triggers a bleed usually. Your regime seems a bit different to others on here. I thought conti was 100 utrogestan continuously with no break. Sequi is 200 utrogestan I think for the last twelve days (maybe) of the month.

Irregular bleeding on conti is normal for the first six months. I had constant bleeding for the six months so gave up and swapped back to sequi.

Taz x
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flossie fiddler

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Re: Is it Estrogen or progesterone that causes bleed?
« Reply #2 on: January 21, 2023, 08:06:41 AM »

Thanks Taz,

My nurse told me that the 3 day break gives an opportunity for the lining of the womb to shed if it needs to. Im post memo so not sure why Im on that regime either. the last twice I was investigated it was noted that my womb lining is 5mm, but is normal for me. But that’s the thickness that triggers an investigation apparently.

If things don’t improve with the bleeding, I think my next option will be back onto Sequi. At least that way I’ll know when to expect a bleed.
 Incidentally, I was on Evorel Sequi for 6 years before I took a break, and the bleed always happened in week 4 of the cycle, whilst I was still on the 2 weeks of Conti patch.

I’ve just started another bleed. Thought it was coming because I was so ratty yesterday and had cramps. I’m due for another appointment with the nurse so will get that sorted out on Monday


It's the withdrawal of progesterone which triggers a bleed usually. Your regime seems a bit different to others on here. I thought conti was 100 utrogestan continuously with no break. Sequi is 200 utrogestan I think for the last twelve days (maybe) of the month.

Irregular bleeding on conti is normal for the first six months. I had constant bleeding for the six months so gave up and swapped back to sequi.

Taz x
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sheila99

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Re: Is it Estrogen or progesterone that causes bleed?
« Reply #3 on: January 21, 2023, 12:14:36 PM »

If you want to be bleed free a mirena is usually the best option to control problem bleeding.
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flossie fiddler

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Re: Is it Estrogen or progesterone that causes bleed?
« Reply #4 on: January 21, 2023, 12:57:18 PM »

To be honest I don’t mind having a bleed but if I’m going to have one I’d rather know when, so for me a sequential preparation might be a good option.

If you want to be bleed free a mirena is usually the best option to control problem bleeding.
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