Hi abbyH
Glad to hear your GP is prescribing you bio-identcial HRT that many of us are using and many more of us would like to use!
Firstly regarding norethisterone - it is a much more powerful progestogen ( in keeping the womb lining thin) than progesterone itself, which is why it is used to control bleeding, and is used in many HRT types as the progestogenic opposition to the oestrogen in HRT.
Secondly the dose you have been taking ( 10 mg per day) is more than 10 times higher than used in HRT for the above purpose ( to keep the lining thin).
Therefore if whatever is causing your heavy bleeding is still there (albeit fibroids, or a lot of oestrogen), when you reduce the amount - I can understand why bleeding may continue. If your lining is still thicker than it should be then some still needs to be shed, and the effect of changing from the very hgih dose of norethisterone to the maintenance dose of Utrogestan, would be enough to trigger a bleed - because the falling progesterone has this effect.
It remains to be seen whether you will settle on 100 mg for 25 days out of 28 and just get a small bleed after the days off. However the near continuous progesterone and continuous added oestorgen in the form of gel should really help with sweats and flushes and should help to even out your mood swings.
I'm not sure what happenes to the progesterone used vaginally if bleeding is present as it isn't designed to be used vaginally with bleeding, and the flow may prevent the progesterone from reaching the uterus?
The way to not bleed at all (eventually) if you are peri-menopausal is to have a Mirena coil which is so powerful it stops bleeding for many women - or gives a small bleed only in women who normally have heavy bleeds.
http://www.menopausematters.co.uk/to_progestogens.php scroll down.
So difficult to predict if you are peri-menopausal and also with a fibroid. I have a very small one ( less than 1 cm in summer 2013) but I fear it might have grown since then as I am on cyclical HRT and oestrogen does promote fibroid growth. A Mirena is often recommended for those with fibroids because it can shrink them:
Fibroids
Fibroids are benign smooth muscle tumours of the uterine (womb) wall and are dependant on estrogen. They tend to shrink after the menopause but shrinkage may not occur, or they may even increase in size with HRT use. Increase is thought to occur in 25% of HRT users and mainly occurs in the first six months of therapy. There is some evidence that transdermal (patch or gel) but not tablet HRT nor tibolone may promote fibroid growth. [ref 24] Fibroid size can be monitored by regular examinations and sometimes by ultrasound scans. There is some evidence that the use of the progestogen releasing intra-uterine system, Mirena may cause fibroids to reduce in size. Mirena is often used in the perimenopause by women who have heavy periods and/or require contraception and can provide the progestogen part of their HRT. http://www.menopausematters.co.uk/atoz.php#GlossFTheoretically there is minimal systemic absorption of the progestogen with the Mirena although some women are sensitive to the little that gets through.
If the bleeding continues have a word with your doctor - but to me this would be expected from what you have said. Hopefully it will settle eventually!
Hope this helps.
Hurdity x
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Topic: New Member: Starting HRT with Oestrogel/Utrogestan but questions (Read 2660 times)