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[Chl123]

I am hoping that someone else might have experienced what I am finding now and be able to share their experiences To recap I am 68 and have been on elleste duet conti for about 11 years now. I had no problems for the first 6 or 7 years but am now getting unpredictable bleeds, occasionally heavy but I can't always predict them. I find myself dashing off to the loo to relieve pelvic pressure during these times and after a few hours, if I am lucky, it will go away and the bleeding will disappear until the next time. I can't predict when it will be back as quite light bleeds just appear and then disappear but are very inconvenient if I am out and about.  I have an appointment booked but couldn't get in any earlier than late August for a consultation at a good meno clinic. My question is, I have various things to attend in the next few weeks and want to know if any of you out there have any advice for me on how I could manage this situation for the time being.  I know from reading the great posts on this forum that progesterone could be the cause? Should I perhaps take one tablet every other day rather than every day or would this cause even more problems?
I would be really grateful for any help or advice.

[Pat2121]

Hi, I can identify with you on this. I am 66 and have been using Evorel Conti for years.. I now (due to a change in hrt dosage am having erratic bleeds .. It is a nuisance and I can spot/bleed for up to a couple of weeks. I can't give you any advice unfortunately but I can empathise! Hormones are indeed a tricky business.I would be interested to see what your meno clinic says. Please keep us posted.

[Chl123]

Thanks Pat for your reply. Of course I shall keep you posted about the meno appointment. Yes, it is a real nuisance isn't it? I notice you are on Evorel Conti while I am on Elleste Duet Conti - I suppose they must be similar?

[Pat2121]

yes as in they are both a continuous regime. I have been spotting/bleeding for about 18 months now to due increasing decreasing doses on the advice of my well meaning but not very knowledgeable GP .. it gets me down but I am hopeful now that I am slowly stabilising and this problem will sort itself out. I think that as we age our requirements changes and we either need more or less of the hormones which probably cause upset to our systems..ahh, the joys of menopause 

[Chl123]

I think you are right about it being all about hormones and our changing needs. I am considering changing to cyclical to get around this but have had so many easy years on  conti. This is one of the things I shall discuss with the meno specialist. Do you have any knowledge of progesterone as I am thinking that that may be the problem and that it might need adjustment. Of course it could suddenly not agree with me.

[Pat2121]

It's been suggested that perhaps I could have a problem with not absorbing the progesterone so, this could be a possibility. I know that the progesterone used in Evorel is quite strong.. I have been slowly cutting my patch down slither by slither the last cut I made has taken it down to half a patch now and that is why (I think) I am having all this spotting.. It can take up to 6 months and more to acclimatise so to speak.. I'm going to keep going till October and then see where I am.. fingers crossed things will have improved by then.. I do hope you get answers to your situation and that things improve for you. I didn't that at my age I would have to be wearing panty liners again! *sigh* 

[Dr. Heather Currie]

Sorry to intervene but while bleeding on continuous combined regimen, such as Evorel conti or Elleste Duet conti, is common in the first 6 months, if it persists beyond 6 months or occurs again at a later stage, it should be investigated--please contact your GP urgently.
The bleeding may be due to an imbalance of the hormones in the HRT but examination and full assessment is recommended.
I would not recommend taking tablets on alternate days, or cutting down the patch.
Elleste Duet conti is a high dose preparation and at age 68 it is very likely that a lower dose will still provide benefit and less problems such as bleeding. Taking a lower dose estrogen preparation with appropriate progestogen is better than alternating days.
Also, Evorel conti is medium dose and lower dose may be all that is needed. Similar to above, there are better ways of taking lower dose of estrogen patch, with separate progestogen.
These adjustments can be made once the bleeding has been investigated.
I hope that this is helpful
Best wishes
Heather

[dazned]

Thank you so much for taking the time to answer those questions,it also will be very helpful for anyone else who finds themselves in that situation.

 

[Pat2121]

In my case it was recommended by my GP that I wean off my patch slowly. I know others have had the same problems I have and it has been hormone imbalance. Of course a GP should be consulted if the bleeding just starts after years of no bleeds. I know every time I have changed the dose I get spotting.

[Chl123]

Thank you for all your really helpful comments.