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[PinkCarnation]

Have been a lurker on here for some time and found a lot of useful posts. Hope someone can shed some light on current dilemma.

I was on Evorel Sequi 50 patches for well over a year (patches) and always had very regular bleeds.

I was still struggling so GP changes me to conti regime (as they class over 1 yr of HRT a being post meno). At first I was on 75 patches and have now reduced (at my request) down to 50 patches with Utrogestan 100's taken daily since the start of the conti regime.

They simply are not controlling the bleeds, which are coming pretty much regularly now every 14 days and last for approx 7 day. This is not just spotting (as GP mentioned I may get) but full on heavy periods. Has been 5 months now, so not even early days. 

At my last review he gave various options:
Switch back to a Sequi regime
Go on Mirena coil
Up Utrogstan tablets to 200mg a day
Try vaginal insertion

I think my next step is to try vaginal insertion, any advice ladies? I am a bit worried how the Utrogestan does not seem to be having any effect. I've had zero side affects either. And in fact actually feel much better on it that the non body identical Norethisterone.... just need to get rid of all this bleeding.

Anyone experienced the same or has any suggestions or advice? Thanks for reading  

[sheila99]

Another victim of the drive to get people on conti too soon (imo). Unless your own cycle stopped the day you started hrt you aren't meno a year after you start hrt so it's unsurprising you bleed. If you want to be bleed free your best option is a mirena. If it was me I'd go back to a sequi regime and wait until your body's ready for conti (200mg x 12 days utro, days 15-26). Or you can keep on increasing the utro dose and sooner or later you'll be close enough to meno the bleeding will stop  . I prefer vaginal anyway as it bypasses the liver. It may be a bit more effective this way but given the amount of bleeding it probably won't stop it. Not convinced that 200mg conti will either.

[CarolineM]

Hi PinkCarnation,

Sounds like you're having 2 periods a month, so you're still peri (1 natural period and 1 caused by the Utro). Same here, on Evorel patches + 100mg Utro (25 days out of 28) for 9 months now - 2 regular periods each month. I'm giving it another few months then upping my Utro as I don't want a Mirena either. They won't let me go back to sequi as I'm 56.

I agree with Sheila about you going back to sequi if you have the opton, hopefully your body can adjust back.

How ridiculous to class over 1 year of HRT as being post meno! What on earth is that based on?!

I do a mixture of oral and vaginal Utro, and certainly found my moods are a lot more stable that way.

Hope it all works out for you.

[bombsh3ll]

Micronised progesterone isn't strong enough to suppress any ovarian activity that you still have.

Going back to cyclical is usually what is recommended in your situation. The mirena IUS is also an option.

Another solution which may or may not be for you but is often overlooked is to take the combined oral contraceptive pill continuously to completely shut your own cycle down and add back a stable dose of estrogen.

I'm 44 and take Zoely continuously which keeps me bleed free and hormonally stable, it's great!

[PinkCarnation]

Thank you ladies for taking the time to reply. It was interesting to hear CarolineM, that you also bleed fortnightly on 100 Utrogestan. I am 50 yrs old, so I think I maybe need to switch back to the Sequi regime. And then maybe try again further on down the line.