Hi Cassie
Never fear - you're not alone! yes I am here, 70 and still bleeding
- ie cyclical HRT. I remember posting a similar thread about women in their 60's and bleeding! How time flies!!
There is no cut off date. The artificial cut-off date used to be post-menopause (or after a year of being on HRT or after age 54 when on cyclical HRT) but we're long past that. I can't remember how old you are but I know we've been chatting on here for some years.....
What is the alternative?
1 Give up HRT. I used to think when I got to 70 I would think about it but now I am here - NO WAY! As long as no medical reason means that I have to stop, then I'm not.
2 Have a hyserectomy - also out of the question. You can't just have surgery for no reason and discomfort with using progesterone would not be considered enough at our age I doubt.
3 Change progestogen. I've only ever used bio-identical products save for initial 3 months on evorel sequi 15 years ago and the occasional norethisterone cycle to clear my womb lining build-up. For me it has to be utrogestan with all its failings. The only exception I would make is if dydrogesterone was available on its own in UK and I would try that. As an aside does anyone know if it is available in Eire (as Duphaston or similar) because I think it is still available in some EU countries?
4 Take Utrogestan continuously. Like you Cassie this is a complete no-no. A don't want to end up like a fatigued brain-fogged migraine-ridden zombie. There is also the question mark of its association with breast cancer so taking it continuously for a long time into old age is untested and maybe taking unnecessary risks - not enough is known.
Which leaves what we are doing which is - taking it cyclically into our 70s and beyond. This is new territory and I'm not sure if anyone is studying it - I do hope they are!
How do I manage? Well unfortunately I did have some abnormal spotting and a thickened lining recrently though hysteroscopy and biopsy revealed nothing abnormal but I can't understand why this occurs because my bleeds are minimal. Maybe the utrogestan is not working as well as it used to. Maybe my uterus is not as responsive as it used to be? I have recently changed from 2 x 100 mg to 1 x 200 mg (the vaginal utrogestan) and I am hoping this might work better.
Becuase of the thickened lining I have reduced to 5-6 weeks, though post-scan/biopsy the consultant wanted me to take 200 mg for 14 days per 28 day cycle
. No way!
There we are.
And no, it is not recommended for anyone to use OTC progesterone cream for endometrial protection as part of HRT in case anyone is thinking of experimenting. It is important to use proprietary products at the correct dose and be under medical supervision, and especially when you get older.
There is Crinone progesterone gel used for fertility as well as Lutigest and Cyclogest but I haven't really come across anyone using it on here - there was someone a while back I think. It used to come in lower concentration but now only as 8% and looks like 90 mg per dose. There is some research into its efficacy for endometrial protection but I think this was using the 4 % gel - the BMS paper on progestogens refers to it. That might be a possibilty if you can persuade a doc to prescribe it?
I can't remember if you take utrogestan vaginally? Even though I have never taken it orally I still get the unpleasant side effects from vaginal intake, because of course there is systemic absorption.
The first progestogen I used was Cyclogest but it was quite messy. Also the efficacy in protecting the endometrium hasn't been properly studied I don't think? I was given a very high dose (400 mg for 11 days per cycle) by my GP, so lower quantities comparable with utrogestan, I think would be experimental?
Do let us know if you try something different and good luck with your choices!
I wonder if there is anyone of 80 still on HRT and having to bleed!!!!
Hurdity x
