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[Cookie50]

Hello, I wonder if anyone could offer a bit of advice  I have been on HRT fir 3 months taking oestrogel (2 pumps daily) and utrogestan 100 daily (but only days 1 to 25 leaving a break of 3 days before starting again.
This month at day 18 of taking utrogestan I started experiencing slight bleeding/spotting on and off for 2 days. I have been to the doctors today as was due 3 month review and they have told me to stop taking the HRT immediately and they are referring me for a scan. I am now worried about the scan but also stopping the HRT and symptoms returning 
The doctor did ask why I wasn't taking utrogestan daily without a break but this is what I was told to do initially (by a different doctor!)  I just feel so confused by it all
many thanks for any advice on whether the spotting could just be due to hormones settling or that I am not taking the utrogestan correctly by having a break 😊
Ps I was on HRT for 3 years from 2020 and had a 3 month break earlier this year but swiftly went back on it. So I have not had a period for probably 4 years, I am 50

[GraceM]

As you are post menopausal you should be taking the utrogestan every day without any break.  A break in utrogestan is probably causing the bleeds.  It is quite common to experience some bleeding in the first few months after starting HRT so personally I think your doctor is being overly cautious telling you to stop taking it.  There is no harm going to have a scan to ensure the womb lining is as it should be.  If you experience more bleeding or heavier bleeding you could try reducing the oestrogen to 1 pump daily, along with the 100mg utrogestan each night.

[Cookie50]

Many thanks for your reply and advice. It just seemed like a bit of a rush decision to just immediately stop taking it as I will most probably have all menopause symptoms quickly return!  I will go for the scan though as like you say best to get checked out.  Thankfully the spotting has stopped for now
It's all such a minefield isn't it! 

[Hurdity]

Hi Cookie

The licensed dosing of Utrogestan 100 mg is in fact for 25 days out of 28 day cycle even for post-menopausal women though in practice most doctors will suggest it is given continuously.

The 3 day break is to allow a bleed if the lining has built up, so yes you are taking it correctly. If the lining did not build up there would be no bleed. It's not a foregone conclusion from having a break fro the Utro.

As Grace says bleeding is expected during the first 3 months of taking  continuois combined hRT and though you are having a break, the bleed is consistent with what is expected. You should not need to stop HRT!

No problem with having a scan but it would not usually be indicated - though they are being cautious (in ordering a scan) probably because you only stopped HRT for 3 months, so possibly suggests some lining had built up? I presume you did not bleed when you stopped the previous HRT and what sort was it?

Hurdity x

[Cookie50]

Thanks for the info Hurdity 
The 1st month of taking oestrogel and utrogestan I had no spotting, the 2nd month a tiny bit and then 3rd month a bit more over a couple of days...
I was previously on elleste duet 1mg and I didn't bleed when I came off it back in April this year
X

[Cookie50]

Hi, I have been for a TVUS scan and as endometrial thickness was more than 4mm ( mine was 6mm) I also had a biopsy taken. Was just wondering if anyone else had this procedure due to abnormal bleeding on HRT and similar thickness.
As they recommended I stopped taking HRT for now I have been off it for nearly 2 weeks!  I haven't had any further bleeding since the initial one also 2 weeks ago but should I be bleeding if the lining is 6mm?
Plus I have to say that biopsy procedure is the worst pain ever! I actually screamed  ... 
Thanks for any responses 

[Dazedandconfused]

Hi Cookie50,

I was sent for a scan after a year on continuous HRT (1 .5 pumps of gel and 100mg Utrogestan) due to a sudden, quite dramatic bleed.  Having been through the menopause 7 years ago, apart from a bit of spotting on HRT I'd had nothing so it was quite a shock as you can imagine.  Lining was 5mm (it had been 2.75mm 6 months before) so they did a biopsy there and then which all came back clear a couple of weeks later.
 
In the meantime I decided to stop HRT.  I wasn't told to stop by anyone, just felt I needed to try take a break until I knew what was going on. 

By the time the biopsy results came back I'd been off HRT for about a month in total, the bleeding had stopped and my sore boobs were sore no more.  However, the night sweats and aching joints returned big time.
 
The gyneacologist who did the scan and biopsy suggested I might not be absorbing the Utrogestan well so suggested either upping my Utrogestan to 200mg a day or trying the Mirena.

I definitely wanted to continue HRT so upped my Utrogestan and after much discussion with the meno nurse and research, decided to try the Mirena.   I have recently had this fitted so will see how it goes.

Once I got back on HRT sweats and aching joints began easing off, I already feel better so am going to persevere and am hoping the Mirena will work for me as I know it isn't for everyone.

Hope you get sorted soon, I got in a right state about the biopsy and the waiting was awful but it was all OK and they do err on the side of caution when checking these things, which is a good thing. 

[Cookie50]

Hi dazedandcondfused

Thank you so much for sharing, the doctor did mention the mirena coil (dependant on results of biopsy )to me also but to be honest it was all a bit if a whirlwind and I feel like I have forgotten half of what she said!  Whilst it is fab to get a biopsy straight away after it I just sat in my car thinking what just happened! I don't think I expected to get that procedure that day so was a bit stunned 

It's just all such a worry isn't it.... but best to get checked and now the wait for results....

I hadn't really considered the coil before but if that is an option to be back on HRT  I would give it a go.  I hope it works out for you and you are able to stay on HRT and keep those pesky symptoms away