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[Peach8]

Long story short, I'm progesterone intolerant and get horrific period pain (suspected but not investigated endometriosis). Just had mirena removed due to bleeding not settling after 6 months. About to try provera on days 15-27 in a hope that it suits me better than utrogestan. If that doesn't work, gp is suggesting trying continuous HRT. Are there any issues associated with continuous in peri menopause?  Would I likely still get a regular bleed?  Would my own cycle take over? Any suggestions welcomed. Thanks.

[Bandango42]

Hi Peach8

I've been on continuous hrt for the last 6 months and assuming I'm still peri. I've had nothing but erratic bleeding/spotting since. I persevered in the hope the bleeding would stop eventually but 2 days ago I started an horrific bleed (although this coincides with taking Gepretix instead of utrogestan, I have a feeling this is what's caused this awful bleed) so have stopped the progesterone now and I'm going back to sequi. I don't have a regular cycle anymore, there is no rhyme or reason to my bleeds so going to try and get back on track with sequi.

It's a shame though because I love utrogestan and conti made me feel brilliant despite the spotting. I'm really peed off my gp has switched me to Gepretix, I feel rubbish on it.

We're all different though and have heard of peri women trying conti and it working to stop bleeds.

Hope that helps x

[Peach8]

Thanks Bandango. The constant spotting/bleeding is my fear. Not sure I can even face trying after 6 months of it on mirena plus I had the same issue in my younger days on POP. If you don't mind me asking, did sequential hrt not work for you? I haven't heard of Gepretix, is there a problem getting hold of utrogestan? X

[Bandango42]

Hi Peach8

Sequential worked for just over a year but last summer I started getting, you guessed it, erratic bleeding 🤦‍♀️ my gp suggested trying conti in the hope it would stop the bleeding, but it didn't. I felt so much better mentally though, my body seems to love progesterone. I feel terrible now I've stopped it.

Gepretix is a cheaper brand of progesterone apparently and is replacing utrogestan, a few women have mentioned it on here with unwanted side effects. It's supposed to be the same as utro but I certainly don't feel the same. I've been taking it for about a month now and mood has gone downhill and now have this awful, heavy bleed with pain. I don't usually get heavy bleeds.

X

[Peach8]

Hi Bandango

I hope you get it sorted, if it's not one thing it's another! I don't know what to do for the best, feel like I'm going round in circles and I'm sick of experimenting with something for months only to find it doesn't work 🤷🏼‍♀️ x

[CarolineM]

Hi Peach8,

I'm 56 and been on Evorel 50mg patches and utrogestan 25/28 days for about 8 months now and have been tracking a week of significant bleeding twice every month for a while now! Looks like I'm still in peri and am getting a bleed from the utro as well as my normal cycle - even though the GP assumes at 55 everyone is postmeno.

Back to the GP discuss this in 2 weeks - following pretty continual bleeding on Evorel Conti I was investigated with biopsies 9 months ago and all was fine, so I can see I'll be lining up for another scan in a few weeks.

And yes, the continual bleeding is a damn nuisance, and so is the experimenting!

[Bungo]

I was late peri and went straight onto continuous hrt. My regular cycle still happened and also had spotting but it was light and never bothered me. Had hysteroscopy as even before starting hrt had had spotting and nothing sinister showed. Am still spotted 2 years later and will ask to do another ultrasound just to reassure myself. I've fibroids  and that's probably causing the spotting.I've switched from gel to patch a few months ago so in meantime may settle.

[RebJT]

Hi

If you are really progesterone sensitive I'd suggest seeing a specialist gynae and not leaving a GP to manage it.  There's other kinds of P to try, including cyclogest, including in lower doses, and also long cycle HRT where you have a bleed every three months but you'd need close monitoring and regular scans.  I'm very P sensitive and attempting conti made me very very very VERY unwell indeed.  Never ever again!  My gynae also uses lower dose coils which are not licensed for HRT but can be used, again with regular scans.

Progesterone tolerance can be built, but it takes real time and diligence and GPs tend to panic at wandering off the pathway, in your shoes I'd do your homework to find a clued up gynae.

x

[Peach8]

Hi Peach8,

I'm 56 and been on Evorel 50mg patches and utrogestan 25/28 days for about 8 months now and have been tracking a week of significant bleeding twice every month for a while now! Looks like I'm still in peri and am getting a bleed from the utro as well as my normal cycle - even though the GP assumes at 55 everyone is postmeno.

Back to the GP discuss this in 2 weeks - following pretty continual bleeding on Evorel Conti I was investigated with biopsies 9 months ago and all was fine, so I can see I'll be lining up for another scan in a few weeks.

And yes, the continual bleeding is a damn nuisance, and so is the experimenting!

Thanks Caroline. With my bleeding issues from POP and mirena, I sense I'd have the same problem on conti and I just can't face it.

[Peach8]

I was late peri and went straight onto continuous hrt. My regular cycle still happened and also had spotting but it was light and never bothered me. Had hysteroscopy as even before starting hrt had had spotting and nothing sinister showed. Am still spotted 2 years later and will ask to do another ultrasound just to reassure myself. I've fibroids  and that's probably causing the spotting.I've switched from gel to patch a few months ago so in meantime may settle.

Thanks Bungo. It's been a long 6 months of spotting with mirena, I can't face doing it again.

[Peach8]

Hi

If you are really progesterone sensitive I'd suggest seeing a specialist gynae and not leaving a GP to manage it.  There's other kinds of P to try, including cyclogest, including in lower doses, and also long cycle HRT where you have a bleed every three months but you'd need close monitoring and regular scans.  I'm very P sensitive and attempting conti made me very very very VERY unwell indeed.  Never ever again!  My gynae also uses lower dose coils which are not licensed for HRT but can be used, again with regular scans.

Progesterone tolerance can be built, but it takes real time and diligence and GPs tend to panic at wandering off the pathway, in your shoes I'd do your homework to find a clued up gynae.

x

Thanks RebJT
I am on the gynae waiting list so we'll see what happens when I finally get there. Kinda feel like every option so far comes with it's own issues rather than a full solution unfortunately. The latest suggestion has been induced menopause but I'm not loving that idea x

[RebJT]

Hiya

Yes that was suggested to me too and absolutely not, those drugs are brutal!  If you can go privately there are some good options (I'd suggest a proper consultant gynae not Newsom who are all GPs (charging consultant prices!!)).  I was in Nick Pannay's clinic on Harley St - Hormone Health - but now with the same gynae in a different clinic just for ease, but I'm sure if you ask on here you'll get some good suggestions.  Sometimes if you can afford to go private for one or two appts, they will write to the Gp and GP will then prescribe.  Most GPs just want the buck to stop somewhere else.  You can - or could - also ask to be referred where you want NHS.  I insisted on Chelwest for Polyp removal as I'd researched which doctor I wanted, saw him privately, he wrote to GP and asked him to refer me NHS.

And yes the best that modern medicine has to offer is 'trial and error' unfortunately ... and I've been through the wringer on that.  I started on utro at very low doses, eked out across second half of cycle, and I can now manage 14 doses of 100 vaginally but took a long time to get there.  I had several failed attempts with the pill and bottled out of the coil as I just hated the thought of having to get it removed if all the wheels fell off, and was worried about bleeding.  I was badgered and badgered and badgered to get a Mirena, but refused.

x

[Penguin]

Hiya

Yes that was suggested to me too and absolutely not, those drugs are brutal!  If you can go privately there are some good options (I'd suggest a proper consultant gynae not Newsom who are all GPs (charging consultant prices!!)).  I was in Nick Pannay's clinic on Harley St - Hormone Health - but now with the same gynae in a different clinic just for ease, but I'm sure if you ask on here you'll get some good suggestions.  Sometimes if you can afford to go private for one or two appts, they will write to the Gp and GP will then prescribe.  Most GPs just want the buck to stop somewhere else.  You can - or could - also ask to be referred where you want NHS.  I insisted on Chelwest for Polyp removal as I'd researched which doctor I wanted, saw him privately, he wrote to GP and asked him to refer me NHS.

And yes the best that modern medicine has to offer is 'trial and error' unfortunately ... and I've been through the wringer on that.  I started on utro at very low doses, eked out across second half of cycle, and I can now manage 14 doses of 100 vaginally but took a long time to get there.  I had several failed attempts with the pill and bottled out of the coil as I just hated the thought of having to get it removed if all the wheels fell off, and was worried about bleeding.  I was badgered and badgered and badgered to get a Mirena, but refused.

x

Hi RebJT
Does your gyne support you doing the 14 days x 100mg? If so, wondering if you'd mind pm'ing me their name please as I'd happily pay to be supervised on a regime like that. Does he do your scans too? Thanks
Penguin x

[Peach8]

Thank you. I'd be interested to know who your gynae is too, if you are happy to share?  I've had an appointment with Newson Clinic for testosterone which was okay. My NHS gynae consultant is not on the same page unfortunately and doesn't agree with me being on testosterone. I'm getting the one size fits all regime which isn't working for me. Last time we discussed issues with spotting I was told "I'm sure you can put up with that". Er, no thanks!
Mirena hasn't been the game changer I was hoping for, utrogestan vaginally gives me raging thrush and orally it gives me a whole load of physical and emotional issues.  Just started provera so we'll see how that goes over the next couple of weeks but now that I'm going back to bleeds , I'll have to deal with the monthly fainting and vomiting from the period pain. Dreading it.
It's such a magical time 🤣

[joziel]

I am on continuous and still peri - due to endometriosis. I stop for 3 days (sometimes 5 days) to allow a bleed. If I get to day 26 and I haven't bled yet, then I'll stop to 'cause' the bleed. If I bleed early (which has happened the last two cycles, maybe my cycles are getting shorter) then I stop the utrogestan for those 3-5 days when I bleed. (Ie - I let my body start the bleed and tell me.) If you don't stop at all and literally take it continuously, you might get random breakthrough bleeding which freaks doctors out and sends you off for scans to check lining etc. So it's best to schedule it if you can...

I am also on a high dose of continuous though - after those 3-5 days, I'm on 200mg utrogestan till day 16, then I increase to 300mg until day 26. I kinda made this up because it helps with sleep more to increase and I can basically tolerate endless utrogestan... I have a Newson appointment this Thursday and will see what the doctor says about all this    I'm also on 9 pumps of gel because I don't absorb it. It's giving me about 430pmol. Everyone is happier that I'm on high doses of utrogestan, seeing my estrogen dose is so high - even though I'm not really absorbing it well and probably don't need all that progesterone...