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Author Topic: Does higher dose HRT mean heavier bleeds?  (Read 8228 times)

anna123

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Does higher dose HRT mean heavier bleeds?
« on: March 07, 2014, 02:23:11 PM »

I'm not sure how this works. I was on Evorel Sequi 50 and had very heavy,painful  bleeds  which was so annoying especially after being period free or light for some months. I was then on Femoston 1/10 for 2 months and had light,non painful bleeds. I've increased to 2/10 now and just wondered does the higher oestrogen mean periods will be heavier? Or because the progestogen dose in 1/10 and 2/10 is the same will this mean bleeds will continue to be light .I know the withdrawal of the progestogen causes the bleed,just unsure what determines the heaviness,length etc
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Dandelion

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #1 on: March 07, 2014, 02:43:21 PM »

Hi

I'm no expert but seven weeks ago, I switched from Femoston 1/10 to Femoston 2/10 and although my period was nine days long, it was much lighter than what I normally get.

I'm thinking of switching to another HRT like evorel etc as Femoston 2/10 does not seem to have sufficient oestrogen for me, please can you tell me how evorel sequi was for you and why you swapped to Femoston?

Thanks
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anna123

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #2 on: March 07, 2014, 03:09:05 PM »

Hi dandelion
Thanks for your response. I was put on  Evoreal Sequi by my GP and felt better straight away-slept better,anxiety reduced, flushes went,headaches stopped etc .The problem was in the progestogen phase I was very angry, irritable ,short tempered,crazy and having very heavy bleeding. I saw Dr  Currie who moved me onto Femoston as she said the progestogen is much easier to tolerate.  I felt much better during the progestogen phase of the Femoston,just needed a higher dose of oestgrogen and do feel much better since starting the 2/10.I'm just seeing how it goes. I would not want to feel as bad as I did on the Evorel in thesecond half of the month. 
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Sarah2

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #3 on: March 07, 2014, 04:09:55 PM »

I think it's so individual.

I use a low dose of Oestrogel- less than the 'dose' of 2 pumps a day which is less than a 37 patch ( which is classed as low dose.) BUT I still have very heavy periods. Yet I know of other women who are on 50mcg patches, take the same amount of progestogen and have barely any bleeding.

Go figure!
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Hurdity

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #4 on: March 07, 2014, 04:30:52 PM »

To amnswer your question anna, the amount of lining build up is dose dependent - which means the more oestrogen you take, the more lining will develop. In consequence there will be more to shed, so although it is individual ie how you react to the different types of HRT and the amount of bleeding you get, you should get a heavier bleed on 2/10 than on 1/10 as it is twice the dose.

Of course you may not actually get double the oestrogen into your system because of the digestive process - but it should be quite a bit more than 1/10!!

That is not to say your periods will be painful or heavy on 2/10 but there should be a greater amount of blood in total.

Hope this helps

Hurdity x
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Dandelion

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #5 on: March 07, 2014, 04:57:21 PM »

Hi dandelion
Thanks for your response. I was put on  Evoreal Sequi by my GP and felt better straight away-slept better,anxiety reduced, flushes went,headaches stopped etc .The problem was in the progestogen phase I was very angry, irritable ,short tempered,crazy and having very heavy bleeding. I saw Dr  Currie who moved me onto Femoston as she said the progestogen is much easier to tolerate.  I felt much better during the progestogen phase of the Femoston,just needed a higher dose of oestgrogen and do feel much better since starting the 2/10.I'm just seeing how it goes. I would not want to feel as bad as I did on the Evorel in thesecond half of the month.
Hi Anna

Thanks for getting back to me.
Did the evorel contain norethisterone for the second half of the month?

I may have to change HRT but I am afraid of trying norethisterone as I already have mental health problems and the many many reports of women experiencing mood issues on norethisterone has really frightened me off using it.
Unfortunately, at our surgery that is all there is on offer.
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anna123

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #6 on: March 07, 2014, 05:38:27 PM »

Hi Dandelion
Yes,Evorel contains Norethisterone whereas Femoston contains dydrogestorone. Can you ask your GP for another type? Surely they can't refuse you -or could you asked to be referred to a meno consultant/specialist.

I know I'm lucky as live in Dr Currie's catchment area but sure there must be many meno clinics everywhere.

Thanks Hurdity- that makes sense. It's the pain I find hardest to deal with which usually comes the heavier the bleed  :(
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oldsheep

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #7 on: March 07, 2014, 06:02:11 PM »

no idea if my experience is typical or just me, but when I was on 200mcg Utrogestan, I bled heavily and constantly during the time I took it. It seemed to cause shedding and I felt awful. When they finally lowered it to 100mcg (or is it mg?) I stopped bleeding and felt much better.
Have you had a scan at all to see how thick the lining of your womb is? Mine wasn't thick yet I was bleeding a lot. They don't like doing scans as they're expensive, but if you're bleeding, that quite often gets them to do one.
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Sarah2

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #8 on: March 07, 2014, 07:36:25 PM »

oldsheep- you mean you were taking 200mgs as continuous HRT- every single day? That's an incorrect dose- it's 100mgs daily/conti and some sequential regimes,  and 200mg if used for 10-12 days a cycle.
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Hurdity

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #9 on: March 08, 2014, 12:49:41 PM »

Too much progesterone can also cause bleeding through damage to the uterus lining - ie over thinning!

Hurdity x
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anna123

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #10 on: March 08, 2014, 01:06:05 PM »

Old sheep-I understand.The issue with Femoston is the progestogen stays the same on the 1mg 1/10 or 2mg 2/10 oestrogen type so I wondered if the oestrogen level changes
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Sarah2

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #11 on: March 08, 2014, 01:20:52 PM »

You are taking twice as much oestrogen with the 2/10- 2mgs instead of 1mg.
So it is possible that the bleed will be heavier but not certain because although the lining responds to higher levels of oestrogen it may not work like that in practice for you.
I have not found much change in my bleeds when I have changed my dose of gel up or down slightly, or when moving from a 12 week long cycle to an 8 week shorter cycle.  I think you'd have to give it a whirl for 3 cycles and see how it goes.
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Meeka

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Re: Does higher dose HRT mean heavier bleeds?
« Reply #12 on: March 08, 2014, 10:21:44 PM »

I use two pumps of oestrogel and have very light bleeds, tiny amount of blood for one day or two.  Only have light bleeds when I take 200mg of utrogestan vaginally for 12 days.  if I take less then I sometimes have no bleed at all.  If I take 200mg vaginally for 12 days I get some nasty headaches and don't feel good.

Before hrt my periods were quite heavy so I do wonder whats going on.  I think I will need a scan soon to put my mind at rest.
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