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[tootsieroll]

Hello I'm trying to understand how the uterus works along with hormones.  So is it the hormone estrogen which causes the lining to thicken and as it sloughs off, the progesterone is meant to rise?  So what happens when there is continuous heavy bleeding that doesn't stop?  Is it that estrogen remains high and the progesterone never rises to thin uterine lining?  Am I understanding this correctly? What if estrogen/estradiol was lowered, will it help stop the bleeding because progesterone can now thrive? Is it possible too much progesterone causes bleeding, or is that nearly impossible since that's not the purpose of progesterone?  Where does prolactin fit in this?  thank you!

Also what does this ratio indicate?  Is Estradiol still too high for the ratio:

The ratio of estradiol to progesterone is:
227 pmol/L estradiol to <0.5 nmol/L progesterone

[Hurdity]

Hi tootsieroll

 

I'm not sure whether you are referring to what's happening in your body naturally or as a result of HRT? I am assuming the former.

A really good article is here which tells you what happens to the body during peri-menopause https://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php. This will tell you about the role of oestrogen and progesterone better than I can as well as some of the bleeding problems and how to treat them.

There is also some information about heavy bleeding here: https://www.menopausematters.co.uk/heavyperiods.php

In terms of the ratio - I don't know if there is a ratio of oestrogen to progesterone that is necessary to ensure the lining is shed fully but the main point is that once the ovaries start to pack up and you don't ovulate some months but oestrogen is produced, which thickens the lining, then heavy bleeding is bound to result eventually. The ratio is not important in terms of a numerical value - just as a broad principle.

There is no need to reduce oestrogen - but increased progestogen can help with the bleeding eg through a Mirena coil, though the reason for the prolonged bleeding may need to be established through consultation with you GP?

Too much progesterone rarely causes bleeding but eg too much progestogen such as Mirena coil, in late perimenopause, in the absence of added oestrogen, can cause the endometrium to become too thin, called atrophic, and sometimes ulcerated which can lead to spotting/bleeding. Probably not heavy like bleeding from the thickened lining being shed.

If you are under 50 and want to regulate your cycle then one of the birth control pills designed for peri-menopause may help and they give replacement oestrogen in the form of as type of estradiol - the same as our bodies produce.

We can help you further if you need it!

Hope this helps

Hurdity x

[tootsieroll]

Hi tootsieroll

 

I'm not sure whether you are referring to what's happening in your body naturally or as a result of HRT? I am assuming the former.

A really good article is here which tells you what happens to the body during peri-menopause https://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php. This will tell you about the role of oestrogen and progesterone better than I can as well as some of the bleeding problems and how to treat them.

There is also some information about heavy bleeding here: https://www.menopausematters.co.uk/heavyperiods.php

In terms of the ratio - I don't know if there is a ratio of oestrogen to progesterone that is necessary to ensure the lining is shed fully but the main point is that once the ovaries start to pack up and you don't ovulate some months but oestrogen is produced, which thickens the lining, then heavy bleeding is bound to result eventually. The ratio is not important in terms of a numerical value - just as a broad principle.

There is no need to reduce oestrogen - but increased progestogen can help with the bleeding eg through a Mirena coil, though the reason for the prolonged bleeding may need to be established through consultation with you GP?

Too much progesterone rarely causes bleeding but eg too much progestogen such as Mirena coil, in late perimenopause, in the absence of added oestrogen, can cause the endometrium to become too thin, called atrophic, and sometimes ulcerated which can lead to spotting/bleeding. Probably not heavy like bleeding from the thickened lining being shed.

If you are under 50 and want to regulate your cycle then one of the birth control pills designed for peri-menopause may help and they give replacement oestrogen in the form of as type of estradiol - the same as our bodies produce.

We can help you further if you need it!

Hope this helps

Hurdity x

Thank you so much! Sorry for late reply but I didnt get a notification for this.  Curious if you know whether there are mental effects when discontinuing something like progesterone.  I heard it can affect the GABA receptors and i wouldnt want to go through some discontinuation syndrome if I decide to stop using.

[Battyboo]

I recently tried to stop utrogestan and oestrogel.
I can definitely advise that I felt awful.
Had a severe panic attack whilst driving, terrifying,  didn't want to go out , couldn't cope
I has to start taking it again.
Does anyone know of a regime to reduce hrt without severe withdrawal.?
I've re started it again and feel okay again, not 💯 but getting there.