Hi all,
I've been on Slynd 4mg as the progesterone element for HRT for 3 months, along with a 50mcg patch. All great, I'm so happy with this progesterone.
However, after my last consultation, my doctor increased my oestrogen to 50mcg and half of a 25mcg patch, with a view to getting me gradually to 75 mcg. I increased the patch for the first time 4 days ago and put a new lot on this morning. This evening I'm cramping and spotting. It's very slight, but unusual as I've not had any periods at all for over a year (I'm 46). Really I don't want to be taken off anything, the increased oestrogen is making me feel fantastic and this progesterone is a game changer for me.
I'm not sure if this is the increase in oestrogen, or a sign that my progesterone isn't enough. I've also switched from taking Slynd at night to in the morning.
Has anyone had similar experiences when increasing their HRT regime, especially on Slynd?
Slynd is listed on the British Menopause Society's list of suggested alternatives to licensed HRT products in cases of progesterone intolerance. It is given as suitable for opposing medium oestrogen doses but doesn't give any progestogen equivalents for higher oestrogen doses than 2 mg oral or 50 mcg patch.
Interestingly the amount in Slynd at 4 mg, as bombshell says, is higher than that given for angeliq at 2 mg (no longer available here). In other instances, the mini pill (POP) contains LESS progestogen than the HRT combined pill equivalent, hence the need to take two mini pills when used off-licence for HRT eg with Cerazette - desogestrel.
It could be the increase in oestrogen causing the bleeding or your own cycle breaking through. When you say you did not have periods for a year - wwere you taking any HRT before your current regime, or any contraceptive? Unless you have been without a NATURAL period for at least 12 months (and this is a conservative estimate) you cannot know when you reach menopause once you've started HRT.
Do you take the placebo pills or do you take it continuously?
It is very unlikely that increasing oestrogen by 12.5 mcg would result in cramping and bleeding 4 days later. If you changed the time you took Slynd to the morning at the same time ie a few days ago, then theoretically the slight drop in progesterone levels may trigger spotting, if the womb lining had thickened slightly - because there was a longer interval between doses.
However I do agree with bombshell that you don't need to be alarmed as yet, unless the bleeding becomes heavy or if you sense that something is wrong, and wait for 6 months, then ask to be referred. There are new detailed guidelines detailing how and when to be referred...
All the best and hope you continue to feel well.
Hurdity x
