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[Spangles]

Hello Ladies
My doctor has recently changed my HRT due to my periods stopping for four months again. I've been on various types for the last year and half.
When I first started using HRT I hadn't had a bleed for 4 months, when I started HRT it kick started my periods again, then they stopped and when I had had no bleed for 4 months again the doctor gave me a new regime.
Main reasons for the changes in HRT were intolerance to progesterones, nausea and diarrhoea.
My new regime is to use Evorel 50 patches for thirteen weeks and add Norethisterone 5mg for the last two weeks of this period. I am into the 8th week of Evorel now, I still haven't bled so its 6 months now.
I have noticed over the last week that my anxiety is up more than it has been and I am full of aches and pains in a morning, amongst all the other unwanted feelings trying to make a come back.
I suppose my question is; could this be due to a low level of progesterone? Or too much oestrogen? Really fed up with meno and wish it would do one!
I expected to feel a lot better for taking it and I suppose for a lot of the time I do but I still get lows and unwanted symptoms, is it normal to still be a little up and down even with HRT?
Thank you
Shellb
xXx

[honeybun]

Yes ups and downs are normal, horrible but normal.

This is a very long cycle. Was it a meno specialist that has got you on this regime. The progesterone that you will be using is not the friendliest one and as you said you were intolerant I wondered why this was the one chosen for you. Utrogestan is kinder if you have progesterone problems. Will you be having a scan to check your lining because this is a very long time to be on oestrogen alone.

Honeyb
x

[Spangles]

Hi Honeybun
Thanks for your reply, I don't have a scan booked but I will mention it. I agree about the progesterone which has been prescribed but I have to see the GP again during the first week of taking it so I am going to discuss the as she has asked me to keep a diary once I start it. It was a Gp that prescribed this for me. Do you know what level of dose 5mg of norethisterone is? Is it high or low?
Thanks for reading
Shellb
xXx

[Sarah2]

My previous regime was 12 weeks with 5mgs Norethisterone added for 10 days at the end. I was on this for 5 years under a specialist gynae. It's quite normal to have this long cycle HRT if you are not completely through meno- like you I'd had s 4 month gap with no periods when I started, but was advised to carry on with the long cycle until recently when the bleeding was becoming quite heavy.

You are on a medium dose of oestrogen- I think 50mgs equates to around 2mgs if in a daily tablet. You might want to try less- 37mgs patch?

It's easy to blame hormones and HRT especially for many of the symptoms of the menopause. You don't know if you would have aches pains and anxiety if you were not on HRT.  What is your lifestyle like generally- are you getting enough exercise for example because lots of us feel a bit stiff or achy or like an old crock as we get older unless we keep moving and keep the joints etc supple. The same for anxiety- were you anxious before peri meno, or is this something new?

Aches and pains ( in some of my friends) have been improved with oestrogen so it's not likely that is the cause of your problems, and if you haven't started the Noreth, yet then it won't be it or lack of it.

Sorry can't be of more help but all I'd say is don't assume it's the HRT that is causing the problems.

[Spangles]

Thanks for your reply Sarah
I am not blaming HRT for anything, I am just saying that since the regime change I have noticed some symptoms returning and was wondering if it could be due to a low level of progesterone or too much oestrogen? This is because I have been used to being on both but obviously with no prog for the last 8 weeks I feel this could be the problem.

Honeybun
My GP will be putting me onto a conti preparation if have no bleed during the regime mentioned
xXx

[Sarah2]

why did your doctor change the regime due to your periods stopping? It's only usual to change products if you are having side effects or you prefer a no-bleed prep if you are 54+ or not had a normal period for a year or more.

It sounds as if you have tried quite a few types if you have been on several within 18 months.

Combined HRT is recommended for women aged 54+ or women who have not had a period for 12 months. However there are no hard and fast rules on this. I am 58 and 4 years post meno and do not want a combined regime for various reasons to do with long-term safety.

It's almost always the progestogens that cause side effects so if you have not yet taken any in this 12 week cycle it is unlikely that the lack of them is giving you symptoms.

[Hurdity]

I agree that lack of progesterone will not be giving you aches and pains!

I also very much doubt whether you are getting too much oestrogen with a 50 mcg patch - this is the standard post-meno dose.

To me, apart from other reasons which Sarah2 suggested, you may actually benefit from more oestrogen.

You started HRT whren you were still peri so will still have some of your own. As you get further into menopause, and especially around 2 years post-meno - your oestrogen levels will be at their lowest and you may gradually notice a difference in how you are feeling.

I certainly noticed this - I too went onto HRT when I hadn't had a period for 5 months (although had been sporadic before this) and immediately felt a lot better and bouncing about like my usual self. This was the same dose that I am on now 7 years later - and I definitely don't feel like I used to (re energy levels). The only reason I do not increase my oestrogen is because I would need to take more progesterone and I don't like the side-effects of this even with a bio-identical one like Utrogestan.

On the other hand if your feelings/moods are going up and down then your own hormone levels may still be fluctuating.

You can be sure that norethisterone, as a powerful progestogen, will have a strong effect on shedding the lining built up from the oestrogen only weeks.

If you didn't bleed when coming off the conti HRT then your lining is likely to have been thinned sufficiently, so you will only have 10 weeks build up.

Neverthelss some women do bleed heavily on long cycle HRT so it will be a question of wait and see - and I expect your gynae may adjust the cycle length if so.

Hurdity x