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[Tulip123]

I've been taking HRT for over a year now. Prior to that, my periods were regular on the contraceptive pill. I'm still in perimenopause.

For the last 10 months or so, I've been using Evorel 50 patches and utrogestan (it was 200mg for 14 days, now 100mg for 25 days).

The bleeding and cramps have never settled and are now worse than ever. It definitely happens on the days I don't take utrogestan but also on other days too when I am taking it. I've kept a diary and I am bleeding around 20-22 days per month and have pain almost every single day ranging from mild to so severe when I can barely move. The bleeding is bad on the worse pain days and can sometimes leak through towels and underwear. The GP gave me mefanamic acid up to 6 tablets per day but it's not stopping the pain anymore.

I've already had an internal exam at the hospital where they didn't find anything. Next week, I'm booked in for a scan and a hysteroscopy with gas and air.

Does anyone know what this could be? I've read that my womb lining may be too thick. If that is the case, what is the usual treatment for that? I've also read that this can continue even after a hysterectomy if ovaries aren't removed and even if that's the only treatment, there will likely be a long waiting list and I'd need to find something to manage the symptoms on the worst days.

I'm desperate to get this fixed as it's impacting on my daily life so much.

I'm having to work from home when it's bad and luckily I have an understanding boss with a menopause work policy in place.
The HRT has solved all other symptoms I had so I don't want to come off it. It's just the period side of things that is still causing problems.

[sheila99]

I would wait and see what the scan shows, I think it's likely you could have fibroids or polyps that would explain it. Your lining can't be too thick after a hysterectomy because the womb has been removed. How old are you? What happened on the sequi regime? Could you still be peri? If the scan doesn't show anything you could double the dose of Utrogestan or you might consider a mirena which is usually the best option for problem bleeding. Let us know what the scan goes.

[CLKD]

Is this type of pain  'normal'?  Having suffered excruciatingly painful periods U have my sympthaty.   Which type of pain relief R U swallowing?   

[Nas]

Hi Tulip,
It’s likely, as Sheila mentioned, that you have either  a fibroid or cyst which is causing the bleeding. Or it may be that utrogestan simply isn’t working for you and you require a stronger progesterone.

A hysteroscopy will likely give you an insight into what’s going on inside the womb. Depending on what they find, it may be suggested that you have a mirena coil fitted. This can offer excellent womb lining protection.

Be careful you don’t end up anaemic. Norethistone can help stop bleeding fast, as can tranexamic acid tablets.

Were you period free for 12 months, prior to starting a continuous progesterone regime?

[Tulip123]

Thanks everyone.
I am 47 and still in perimenopause.

My periods have not stopped but I was on the contraceptive pill until about 18 months ago so I had light, regular periods for years.

Then I started on HRT just over a yr ago and I started having these problems within a few months of starting.

I was on 200mg of utrogestan for 14 days & that has been changed to 100mg over 25 days along with an Evorel 50 patch.

At my last hospital appointment they said they may try me on Utrogestan every day. At the moment I'm bleeding regardless of whether I take utrogestan that day or not.

For pain, the 6 x mefenamic acid tablets are no longer working. I've been stuck in bed for most of this weekend as the pain has been horrendous.

I'm looking forward to next week's appointment to get some answers.